In an N&R op-ed, Dr. James Weissman places the Cone-BCBS sitation in the context of the bigger picture. Weissman acknowledges that Cone is getting squeezed:
An uninsured patient who is seen by hospital physicians, undergoes blood tests, X-rays, nursing care, physical therapy, rehabilitation, etc., is an expensive cost to the hospital system, which cannot be reimbursed directly. The hospitals must rely on other sources to make their payroll.
In the case of Moses Cone, this means higher charges for private insurance companies. That is basically its only source of additional revenue since it cannot negotiate with Medicare, receives little county tax money, and its endowment is restricted to capital improvements. In other words, the money that pays for the uninsured patient care must come from private health insurers — BCBS, UnitedHealthcare, Aetna, etc.
Weissman sees no end in sight to that scenario. The only thing left to do, he says, is to make healthcare a ‘public good’:
The U.S. health care financial situation is extremely complicated and will not be fixed by one or two changes. Indeed, the entire Western world is facing an increase in health care expense, regardless of what financial system is used. However, continuing to make health care a private good is blatantly unfair and violates what we as a country stand for. Imagine if we made the police a private good. Wealthy people would band together and be protected, leaving the remainder to disorder and anarchy. We can and should do better. During this upcoming election year, I suggest that you look carefully at the various proposals for changing health care finances.