Hogeland S
West J Med. 1988 Sep;149(3):359-61.
Practicing physician members of the San Francisco Medical Society were surveyed regarding reimbursement rates for medical care provided to underinsured and uninsured patients. Of 394 respondents, about $51,000 per physician practice was written off as uncompensated care or services not billed for in 1985. An average of 7% of each physician's patients was estimated to be "no-pay" or charity patients, accounting for $19,000 of this total. Almost $32,000 was reported as being uncompensated care, or that which is billed but not paid. In addition to these amounts, an average of $32,000 was reported as being discounted from the usual fee levels by government insurance programs. Extrapolating these results to the physician membership of the local medical society indicates that physicians in San Francisco may be providing as much as $81 million in uncompensated or charity care annually. These results emphasize that private practitioners are providing a significant amount of medical care at reduced or charity rates, an amount that can be expected to increase given present trends. Substantial changes are needed if the burden of providing medical care to poor and uninsured Americans is not to fall disproportionately on private providers.
旧金山医学协会的执业医师成员就为未充分保险和未参保患者提供医疗服务的报销率接受了调查。在394名受访者中,1985年每个医师诊所约有5.1万美元被核销为未补偿医疗或未计费服务。据估计,每位医师的患者平均有7%是“无付费”或慈善患者,这一总数中的1.9万美元由此产生。据报告,近3.2万美元为未补偿医疗,即已计费但未支付的医疗费用。除了这些金额外,据报告,政府保险计划平均还从通常的收费水平中扣除了3.2万美元。将这些结果推广到当地医学协会的医师成员身上表明,旧金山的医师每年可能提供高达8100万美元的未补偿或慈善医疗服务。这些结果强调,私人执业者正在以降低的费率或慈善费率提供大量医疗服务,鉴于目前的趋势,这一数额预计还会增加。如果为贫困和未参保的美国人提供医疗服务的负担不致过度落在私人提供者身上,就需要进行重大变革。