Free Health Care Aid to the Poor: Illegal!
by Fred E. Foldvary, Senior Editor
Those favoring a gigantic government health care system claim the poor are not getting sufficient medicine, and even the middle class is underserved. But the US government, specifically the Health and Human Services Inspector General's office, has made it illegal for private organizations to provide free medical care. If private people can't offer free aid, then the real reason for nationalized medicine is not poverty, but statist power.
An article by Lucette Lagnado in the January 5, 2000 Wall Street Journal reports on the Deborah Heart and Lung Center in New Jersey, a hospital that has provided free health care to the poor and anyone else. This free service is really not new, but the restoration of the old tradition of charitable hospitals.
The Deborah hospital was founded 78 years ago as the Deborah Jewish Consumptive Relief Society by Dora Moness Shapiro, the wife of a garment maker, as a tuberculosis sanitarium for immigrants in Manhattan's Lower East Side. It has billed insurance companies, but never the patients. The free care is rooted in Jewish culture, which emphasizes charity to the poor. The Deborah philosophy is that medical care should be available to all regardless of wealth.
The U.S. Department of Health and Human Services has declared that the Deborah Heart and Lung Center free care is illegal and faces stiff fines because Deborah accepts Medicare without requiring patient co-payments. The hospital also may be accused of filing a false claim under the False Claims Act, because by not charging the patients, there is no loss to cover by Medicare insurance. Also, waiving co-payments while other hospitals charge them is unfair competition, according to the Inspector General's office.
US government officials say that the hospital should at least bill those patients who can afford to pay. But Deborah is intended as a free hospital. It has volunteers who get contributions for the free charitable hospital. Asking the patients to pay would ruin the whole philosophy of the Deborah hospital.
The chiefs of government in the US claim many Americans are getting inadequate health care. So they want to increase taxes in order to have more national medicine. But their insistence that private providers must charge for health care contradicts their cry about inadequate health care. Health care is inadequate because government makes it difficult for charities to provide it. In 1996, a federal statute made it explicit that free care is illegal. This law warned hospitals they could face large penalties if they routinely waive Medicare deductible and co-payment charges for outpatient care.
Free hospitals used to be common in Europe and the United States, until government forced them to shut down or switch to charging patients. The City of Hope Cancer Center in Los Angeles didn't even have a billing department until the 1970s. Only a few free hospitals are left, such St. Jude Children's Research Hospital in Memphis, Tennessee, founded by the actor Danny Thomas. At St. Jude, the head of the hospital's fund-raising expressed amazement in learning that they were violating the law by giving free care.
Fewer patients are now coming to Deborah. Given the threats by the federal government, the hospital personae are not widely advertising the free services. So many of its beds lie empty, while poor folk who need medicine go without it.
There are hospitals that provide low-cost rather than free health care to the poor, and so far, they have been able to operate legally. For example, an article in Investor's Business Daily (Jan. 10, 2000) describes the Church Health Center in Memphis, which serves patients using a sliding-fee. It offers a low-cost health plan for which the physicians donate their services. The center does not take government money.
So it is possible to provide some charity, but there is a clash between federal health care and private charitable care. The government competes with voluntary charity, and seeks to limit charity and not let it get too charitable. This exposes the hypocrisy of national health care. A government monopoly that has forced charities out will leave the poor at the mercy of heartless bureaucracies. Government can be a cruel master, and it is cruel to punish voluntary and benevolent acts of kindness to the poor.
-- Fred Foldvary
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Copyright 2000 by Fred E. Foldvary. All rights reserved. No part of this material may be reproduced or transmitted in any form or by any means, electronic or mechanical, which includes but is not limited to facsimile transmission, photocopying, recording, rekeying, or using any information storage or retrieval system, without giving full credit to Fred Foldvary and The Progress Report.