Wednesday, January 5, 2011


Several articles appeared last month in various Ohio publications blaming the economy which alas, forces The Cleveland Clinic to cut its costs.  In the guise of cost containment, Cleveland Clinic chose to axe the easiest and most vulnerable target: the uninsured patient population.   Goodbye to a geographically undesireable segment of Charity Care patients.   After all, who is going to complain?   Uninsured patients have no group representation and no Washington lobbyists.   Uninsured patients who live more than 150 miles from Cleveland more than likely will not band together to bring the country’s attention to this travesty.
Cleveland Clinic issues a cost report annually to the government and for the year 2009, reported a profit of $429 million.  This was not mentioned in the articles. 
Charity Care Charges…$120 million-----
Charity Care Costs…$34 million
What was mentioned: “Just last year, the health system spent roughly $120 million on free or discounted care.”  Dazzling, unless it is revealed that the $120 million appears to represent gross billed charges……which is baffling compared with a mark-up of at least 386% that Cleveland Clinic forces uninsured patients to pay.  In fact, Cleveland Clinic reported a very different number to the federal government; the total cost for uncompensated care (charity care, bad debt, etc.) was really 35 million for 2009.  Cost is a very different number than charges that are inflated beyond recognition.
35 million is 12% of 429 million dollars, the profit made by this not-for-profit hospital.  However, that 12% shrivels into oblivion when compared with the tax exemptions and benefits reaped by NFP status.
The Clinic can’t afford to ‘give away’ this much health care?   Not for profit clinics reap huge profits from tax exemptions and recently have come under fire from patient advocates and members of Congress and the Senate Finance Committee for stinting on charity care even as they amass large cash hoards, build new facilities and award humongous paychecks to executives.  Didn’t Cleveland Clinic recently expand to Florida?
What will be the total charge of a Cleveland Clinic hospital bill for $10K of cost? 
          Medicare/Medicaid will pay Cleveland Clinic:        About $11K.
          Big private insurers like the Blues:                            About $11K.
          Uninsured or HSA patients must pay:                        $38,600.
Is it any wonder that uninsured patients have a tough time paying their bills?   Doesn’t common sense mandate that people not be forced into bankruptcy because of the indefensible piggishness and profiteering not for profits?  In the land of Cleveland Clinic’s free flowing cappuccino, the State of Ohio should revisit its qualifications for awarding not-for-profit status to hospitals, especially this one.