OUR HEALTH-CARE system is undeniably broken. Insurance premiums are soaring, putting preventive health care out of reach for many. Employers and insurers are shifting costs to others by turning to plans with higher deductibles and co-payments. The result is a physically unhealthy society and a fiscally challenged health-care system overburdened byincreasing numbers of people facing health-care crises with no means to pay.

One of the major issues hospitals are facing is the increase in bad debt — patients who do not pay their bills. For patients who do not have the means to pay, we provide free care. To others, we provide a discount. Some, however, who have insurance and the ability to pay, choose not to pay, and that number is growing. Statewide in Rhode Island, the amount of bad debt from insurance enrollees reached $32,304,451 in 2006.

As the situation stands now, when a patient comes to the hospital on an emergency basis, we provide treatment, prior to seeking payment. If the patient has Medicare for his or her primary insurance and doesn’t pay his or her co-pay after reasonable collection efforts, Medicare will reimburse the hospital 70 percent of that amount so that we may recoup some of our costs. However, if a patient has private insurance, such as United Healthcare or Blue Cross, and he or she doesn’t respond to reasonable collection efforts for co-payments and/or deductibles, we have to write off 100 percent of that loss at the present time. The role of the hospital turns from caregiver to debt collector. This burden should not be placed on the shoulders of non-profit hospitals; debt collection should be the responsibility of the commercial insurance companies.

The legislature has passed House bill 7057/ Senate bill 2414, which would ensure that private insurance companies, such as United Healthcare and Blue Cross/Blue Shield, would bear the financial responsibility for hospitals treating their members. If this legislation is adopted as law, hospitals will be paid 70 percent of the uncollectible debt, a rate equal to that which Medicare pays us, thereby providing an incentive to the insurance companies to help us collect overdue payments for patients whom they insure.

What would be the impact? If the legislation were law in 2007, Westerly Hospital would have received an extra $300,000-$400,000 in income. Going forward, that would be expected to grow as an increasing number of employers are placing a greater co-payment and deductible responsibility on their employees.

Fixing the health-care system will take time. There is no single answer, rather a multiplicity of solutions that will take time to put in place. Between now and that time, however, more people will get sick and need hospitals because they didn’t get preventive care. Let’s take steps to ensure that hospitals are partially reimbursed for bad debt and can afford to continue to provide care. As a community, we need to rally to ensure that House bill 7057/ Senate bill 2414 becomes law. We are asking you to call Governor Carcieri at (401) 222-2080. Let him know you support the vital roles of hospitals in this community. Urge him to support legislation for equitable co-pay reimbursement and cite H7057/S2414 when you call.

Together, we can begin to mend the health-care system. We must begin today, one issue at a time. After all, our collective community health is relying upon it.

Charles Kinney is president and chief executive of Westerly Hospital, where Fred Allardyce is chairman of the board there.