Only 6 percent of the 100,000 people treated each year at Zuckerberg San Francisco General Hospital [SFGH] have private insurance. And the hospital has for years been slapping that minority of patients with exorbitant bills for costs not covered by that insurance, in a practice called "balance billing."
After some public outcry spurred in part by this January 7 piece on Vox, SFGH says it has put the practice on hold for 90 days while the hospital prepares a long-term plan. As Greg Wagner, chief financial officer for the city's Department of Public Health, said at a Board of Supervisors committee hearing Thursday, per SF Weekly, a revised balance billing policy will likely place a cap on what the hospital can charge that is based on a patient's income.
As the Examiner reports, the city and the hospital are also looking at overhauling the hospitals financial assistance policy. Under the current policy, patients are eligible for financial assistance if their income level is below about $60,000, or 500 percent of the federal poverty level. But even for a person making $100,000 in this city, a $20,000 hospital bill is still going to be a bankruptcy-inducing burden.
That's about how much 24-year-old bicyclist Nina Dang was charged after she broke her arm last year. Her insurance plan, from Premera Blue Cross, agreed to cover $3,830.79 of the $24,074.50 that SFGH charged her, and the hospital threatened to send the remainder to collections when it had gone unpaid for eight months, as Vox reported.
Following that January story, SFGH decided to forgive Dang's hospital bill, and the Board of Supervisors decided to hold hearings on SFGH's billing practices.
Vox proceeded to hear from other SFGH patients with similar tales of crushing debt after the story gained traction over the last month. 19-year-old Justin Sanders was struck in the face by a pole hanging off the back of a Muni bus in July 2016. As he tells Vox, the hospital held him liable for a $27,660 bill, and he began getting harassing calls from debt collectors when it went unpaid.
Setting aside the question of fairness when it comes to hospital charges that only get levied on the people who are playing by the rules and can afford private insurance — or have it through an employer — the Board of Supervisors now looks to be taking up the question of whether such exorbitant rates are even fair to start.
Reporting from the hearing, SF Weekly quotes Supervisor Rafael Mandelman who had some harsh words for the Department of Public Health, asking why it had taken so long for the billing practice to be questioned. "There have been people fighting these bills for years and somehow the pain and suffering that was happening out in the universe didn’t get a response from the Department of Public Health until it became a political problem,” Mandelman said. “We’re supposed to be providing oversight, we’re not supposed to be running this department."
The Examiner also notes comments from Supervisor Aaron Peskin who said that the reason Supervisors hadn't looked closely at the hospital's specific billing rates was that they "come to the board with a pile of other things," and just get summarily approved. "We need to contend with the question of whether our billing rates are higher than other similarly situated institutions for the same services," Peskin said.