The Galveston County Daily News

Hospitals and clinics are required to post public notices informing people about their policies on charity care and financial discounts for care.

A study conducted in 2008 shows almost no one in Galveston County was complying with the law.

We are big fans of simple laws that require the disclosure of public information. Allowing ordinary people to become involved in processes that ultimately involve a lot of their money is a good thing.

If you’re wondering why this is so important, consider the report by the American Medical Association’s Council on Medical Service on “Appropriate Hospital Charges.” The council, chaired by Dr. David Barbe of Missouri, reported on how hospitals, to protect the bottom line, shift costs among privately insured, publicly insured and uninsured patients.

Let’s say a drug costs $10 a dose. Patients might be charged $30, $20 or $5, depending on their insurance, as the hospital passes on charges to make up for those who don’t pay or yields to powerful consumers — such as the federal government — that occasionally refuse to pay full cost.

The result, as the report says, can be “a lack of relationship between costs and charges.”

This Alice in Wonderland world of pricing has created worlds of mischief. One study cited in the council’s report showed that self-paying patients were charged $307 for every $100 in hospital charges that would allowed under Medicare.

In other words, if you’re a small-business owner, paying for care out of your pocket, you’re going to see higher rates than the people who have big insurance companies or the federal government negotiating on their behalf.

Such problems are notorious. States such as Maryland require that all payers — commercial, government and individuals — be charged the same rates.

In Texas, the requirements are less stringent. House Bill 1731, which went into effect in 2007, requires hospitals and physicians to develop and publish written policies on discounting charges. That includes having a policy on free care, or charity care.

The law says notices must be posted to make the public aware of those policies. The policies themselves must be available for public inspection.

Before Hurricane Ike, a subcommittee of the Cancer Coalition of Galveston County conducted a survey based on a model developed by the Free Care Monitoring Project. These surveys are in a standard form. People call and ask for information that the law requires and record whether the hospital or clinic is able to comply. Overwhelmingly, those in Galveston County were not.

The committee that collected the data was scheduled to meet on Sept. 13, 2008, the day Hurricane Ike struck Galveston.

The information is dated. Still, this is an important report.

It’s easy to comply with this law. The public notices are available on the Internet and could be downloaded and posted in hospital business offices and waiting rooms, as required by law, by a team of efficient elementary school students.

People who represent hospitals and clinics, rather than getting defensive, should direct the energy toward complying with the law.

The more information people have about how care is being delivered and priced, the more likely they’ll be able to make intelligent decisions about their own care — and about the proposals that surface daily in the national debate over health care.