Latinos Overcharged for
Health Care, Report Says
Latino patients, many of whom
lack health insurance, are often overcharged when they seek medical help
and harassed by debt collection agencies when they cannot pay, according
to a study released on June 9, 2001.
The report by the Consejo de Latinos Unidos, a group based in Los Angeles,
analyzed the medical bills of 123 Latinos in southern California who
received hospital emergency room treatment or were hospitalized in recent
years.
"Hospitals in southern California, both public and private, are billing
self-paying, uninsured Latinos almost five times the amount that hospitals
would receive and accept as payment in full from a health maintenance
organization," the report said.
"Hospitals, colluding with merciless billing departments and renegade
collection agencies, are charging outrageous fees ... while making a
profit on the most vulnerable," it said.
Over 44 million Americans lack health insurance, one quarter of them
Hispanic. In California, 40 percent of Latinos are uninsured. Previous
studies have found that uninsured patients are often charged higher fees
for medical services and drugs than those who have insurance and HMOs.
The report said debt collection agencies often played on the fears of
Latinos regarding their legal status in the country to squeeze money out
of them.
The report said Latinos who sought emergency help were often made to sign
statements in English, which they did not understand, committing
themselves to repay in full the costs of the services.
Josefina Basulto was charged over $13,000 for a caesarean delivery of her
son, which entailed a three-day hospital stay. The debt collection agency
eventually set up a payment plan that calls on her to pay off the debt in
268 payments of $40, which means she will still be paying for the birth of
her son when he turns 22.
Others described how collection agents forced them to place their bills on
credit cards, subject to interest rates of up to 30 percent a year.
In other cases, collection agents told patients they would destroy their
credit ratings, taking away their ability in the future to buy a car or a
home, unless they paid in full.
One Latino couple, Mario Sanchez and Norma Gonzalez, were involved in a
traffic accident and landed with a $14,000 bill that would have been only
around $1,200 for an HMO.
"I have never seen so much money as that in my life. They are taking away
our dream of buying something big like a home. What are we going to do?"
said Sanchez.
In some cases, Latinos were able to negotiate discounts with hospitals if
they complained. One man had his bill cut in half from $6,000 to $3,000.
But, the report said, an HMO would have been charged less than $1,000 for
the same services.
In other cases, hospitals were reluctant to offer detailed, itemized
statements of charges and refer the bill directly to collection agencies.
Source: Reuters
Hispanic Women Appear to be less likely to Seek Follow-Up Mammogram
This is the finding of a study that is
published in the May 1st issue of the journal Cancer.
Investigators looked at screening rates
among more than 21,000 New Mexico women in managed care plans. They found
that among women whose initial mammogram showed nothing suspicious,
Hispanic women had a longer lag time until their next screening test than
other women did. Previous research has suggested Hispanic women undergo
mammography less often than white and African-American women do.
But there was no such difference in return
rate among women who had suspicious tissue removed after their initial
mammograms. In fact, Hispanic women who had biopsy of suspicious breast
tissue were prone to return for follow-up mammogram sooner, compared with
other racial groups.
It is recommended that women have a
mammogram every one to two years starting at age 40. About 3% of these
mammograms will push surgeons to do biopsy of suspicious masses with less
than one fifth of which turn out to be cancer. The concern was that these
often-negative biopsy will needless scare women and deter them from
seeking further mammograms. This study showed no evidence of that.
It was among women who did not have a
biopsy that racial disparities were apparent, with Hispanic women being
late to return for subsequent mammograms. Cultural differences may
account for this disparity.
Source: Journal of Cancer
2001;91:1716-1723
