Cost of care for state's uninsured hits $318 million in 2002

By Kyung M. Song
Seattle Times staff reporter

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Uninsured Washington residents received $318 million worth of uncompensated care in 2002, a tab subsidized by individuals, employers, doctors and hospitals in the form of lost income and higher taxes and prices for insurance and medical services.

That's the analysis released yesterday by the state Office of the Insurance Commissioner.

The findings, presented by Insurance Commissioner Mike Kreidler at Harborview Medical Center, include the most detailed breakdown yet of the burden that the uninsured population places on individual hospitals and counties throughout the state.

For instance, Harborview provided $25.2 million worth of charity care, 28 percent of all charity care provided by Washington hospitals in 2002, the most recent statistics available. Good Samaritan Hospital in Puyallup was a distant second, with $5.2 million worth of charity care, followed by Seattle's Swedish Medical Center's First Hill campus.

In all, Washington hospitals provided almost $90 million worth of charity care, which is defined as services rendered to patients who are unable to pay. An additional $228 million in uncompensated care was written off as bad debt from patients unwilling to pay or provided as charity care by doctors and other health-care providers.

In King County, uncompensated care totaled $87 million, more than 27 percent of the state's total. Statewide, an estimated 550,000 residents younger than 65 were uninsured in 2002. King County's uninsured numbered some 133,000.

Kreidler said people without coverage still use medical care, and that makes the uninsured everyone's problem.

"This is a problem that is only getting worse," Kreidler said. "I think everybody should have health insurance."

The percentage of state residents without insurance rose to 9.4 percent in 2002 from 8.6 percent in 2000. That decline was driven by a drop in employer-sponsored coverage and insurance purchased by individuals.

Much of the cost of treating the uninsured is borne by private health insurers, which may pay doctors and hospitals more to make up for the free care. Insurers then pass those costs on to customers via higher premiums.
 
In Washington, individual-health-plan premiums rose by an average of nearly 24 percent last year, and premiums for large groups increased by more than 19 percent, according to the Insurance Commissioner's Office.

Dr. Jeff Huebner, resident family physician at the University of Washington, said the uninsured can pay an even higher price — sometimes losing their lives.

Huebner recalled how lack of insurance affected three of his patients. One was a 40-year-old diabetic man with high blood pressure who stopped coming for treatments after losing his health coverage and whose disease Huebner suspects is "raging on inside his body."

The second was a severely arthritic man who couldn't afford hip-replacement surgery. The third was a woman who was brought to the emergency room with nausea and vomiting, and who died a few hours later from a rare, undiagnosed medical condition.

"She clearly should have come in earlier" to be treated, said Huebner, who gets angry at what he considers needless deaths. "The rest of the week, I couldn't sleep at night."

Kreidler said comprehensive reform is needed to reduce the ranks of the uninsured. His office supports several legislative proposals that tackle part of the problem.

They include a bill, backed by a coalition of labor and consumer groups and Democrats, that would use tax money to provide insurance for all children 18 and younger. An estimated 87,000 kids would be covered by the program.

Another bill would require all employers with 50 or more workers to provide health coverage for any employee who works at least 86 hours a month. That proposal died during the last legislative session.

Kyung Song: 206-464-2423 or ksong@seattletimes.com