Sen. Grassley asking for details of hospital cost-cutting programs

Sen. Chuck Grassley (R-Iowa) has requested that two public hospitals submit information on programs and practices that he suggests could lead to unequal treatment of patients based on their ability to pay, the Wall Street Journal's "Health Blog" reports.

Grassley said the inquiries are part of his wider-ranging inquiry into whether not-for-profit organizations are "losing sight of the public service that comes with tax-exempt status" (Mundy, "Health Blog," Wall Street Journal, 9/5).

Grassley asked for documentation concerning a University of Chicago Medical Center strategy to direct low-income and uninsured patients with less serious injuries to other facilities, allowing the hospital to focus on more severe cases. The hospital recently began a program that helps educate uninsured consumers about how to get proper medical care without visiting emergency departments. Grassley criticized the hospital for "culling the least profitable patients from its emergency room" (Japsen, Chicago Tribune, 9/8). The hospital told the Washington Post, "An ER visit for something that's not an emergency costs the medical center $1,200. That's sucking up dollars in health care that we don't all have to just blow through carelessly" ("Health Blog," Wall Street Journal, 9/5). Sen. Richard Durbin (D-Ill.) said Grassley's investigation into the program "is troubling and shows that he simply doesn't understand the problems facing our hospitals today." Democratic presidential nominee Sen. Barack Obama's (Ill.) wife, Michelle, "played a central role in creating the health initiative before taking leave to join her husband's presidential campaign," according to the Chicago Tribune (Chicago Tribune, 9/8).

Grassley also sent a letter to M.D. Anderson Cancer Center in July after a Journal article profiled a woman who was told by the hospital that she would have to pay cash upfront before she could be treated. The hospital at the time said that only patients who meet income requirements are eligible for no-cost care. However, in a press release last week, Grassley said that the hospital "made it into the limelight for reportedly requiring a critically ill patient to come up with exorbitant amounts of cash upfront and badgering her for cash during medical treatment." The letter asked whether the case represents an exception to the rule for patients seeking care at the hospital and requests several financial details ("Health Blog," Wall Street Journal, 9/5).