Fairly regularly there are stories in the media about uncompensated health care – that is, when people get health care services that aren’t paid for by them or anyone else. Hospitals and doctors have to write off these costs. Unfortunately, almost every one of these stories is superficial and inaccurate. The Baltimore Sun’s recent story “Maryland Hospitals Struggle with Uncompensated Care” was no different.

There is a lot of angst in stories about uncompensated care but not much in the way of facts. As the Sun article demonstrated, a few myths are usually brought up in every article:

Uncompensated care is a big problem. No, it’s not. As the Congressional Budget Office noted:

…uncompensated care is less significant than many people assume. According to one study, hospitals provided about $35 billion in uncompensated care nationwide in 2008—less than 2 percent of national health expenditures—and the estimates are much smaller for other providers. The extent to which such costs are shifted to other payers is also uncertain; well-structured studies have found modest effects.5 Further, some proposed expansions of insurance coverage would broaden eligibility for Medicaid, which might lead to additional cost shifting given Medicaid’s low payments to providers.

Medicaid expansion will reduce uncompensated care. No, it probably won’t. As CBO noted above, expanding Medicaid may actually increase cost-shifting, which is the reason people complain about uncompensated care.

There are also other problems with expanding At least, there’s research that indicates this won’t happen, as summarized in this Reuters report:

The government's Medicaid program for the poor may put more financial burden on overcrowded hospital emergency rooms than the nation's 47 million uninsured, according to a study published on Thursday.

Researchers at the University of California San Francisco and Stanford University found that the uninsured patients paid 35 percent of their overall emergency room bills in 2004, versus 33 percent for Medicaid.

In short, you can expand Medicaid but Medicaid patients (presumably, the formerly uninsured) will continue running up costs that aren’t compensated by Medicaid.

Preventive care will lead to lower health care costs. No, it probably won’t. As the New England Journal of Medicine noted:

Sweeping statements about the cost-saving potential of prevention . . . are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs . . .

Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical.

So let’s recap – uncompensated care doesn’t impose significant costs on our health care system, proposals to expand Medicaid will likely increase the amount of uncompensated care, and preventive medicine won’t save health care costs in the long-run. If the author of the Sun’s story would have bothered to research the basic facts about this issue, I doubt she could have written a story about it at all. We all would have been better off if one more inaccurate article about health care would have gone unwritten.