1. Introduction
With a substantial proportion of the population depending on charity care provided by Non-profit hospitals. Their upkeep is an important necessity. Their deterioration in the quality of services provided by Non-profit hospitals hits the uninsured people the most. (Moody’s Investors Service,2004 , p.3)
2. Types of problems
Non-profit hospitals face two major types of problems: (1) Financial problems arising from mismatch between revenue and expenditure (Fitch Ratings, 2004) and (2) Structural problems.
3. Financial problems
The financial problems arise because of the following reasons (1)Weak patient volume,(2)Declining governmental and non-governmental reimbursements,.(3)Mounting expenses especially labour,(4) Growing bad debt costs,(5)Increase in uninsured population,(6)Competition from physician owned diagnostic and treatment centres,.(7)Accumulated unfunded capital needs.The deteriorating financial health creates difficult access to credit markets . (Unland, James and Ponton, Kevin,2003, p.1) Many hospitals were forced either to close or to delay capital investments due to the above reasons. (“Crisis in Health Coverage: A Call to Leadership”, p.3)
4. Structural problems
1. Uncompensated care
During the years 2001 to 2009, the number of people without healthcare insurance increased due to rising
unemployment, reduced small business healthcare coverage and Medicaid eligibility cutbacks. The burden of caring for the growing uninsured population has fallen mainly on the hospitals through the Uncompensated Care Pool (“UCP”) created in 1985.The unsystematic and irregular functioning of UCP created disadvantages for many non-profit hospitals.
2. Over utilization of Teaching Hospitals
The preference of the patients of teaching hospitals to community hospitals is another problem for the non-profit hospitals. This led to downfall in patient inflow and falling revenues to the non-profit hospitals. (Mechanic, Robert E, 2003, p.132.) The reduced revenues affected their access to capital and federal research money. Their ability to compete in labour market suffer.
3. An increasingly unattractive place to practice Medicine
Because of the above problems, the physicians felt disinterested to work in these hospitals.(Holler Mark,2004). As a result, they are not coming forward to work in these hospitals creating a void as far as skilled medical personnel are concerned.(Kowalczyk, Liz,2004).
5. Recommendations for the needs of the uninsured
The following measures would help the uninsured.1. The federal government should implement the community benefit and charity care transparency requirements in the national health care law.2. The government should ensure that community benefits and charity care regulations are properly implemented.3. All states should enact laws for implementation of charity care policies and practices.4. Patients should be made aware of all avenues of the availability of financial assistance.5. The federal government and states conduct regular oversight to ensure that hospitals are complying with their legal requirements.
6. Conclusion
Many Americans are suffering under the weight of burdensome medical bills and lack of access to the much needed medical care. Many uninsured and underinsured people require assistance in paying these bills. Non-profit hospitals receive many benefits by way of tax exemptions. So they should bestow proper attention in providing medical care to the uninsured and underinsured.
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