Patient health care advocates are worried that increases in health care costs at the county's public hospital could hurt the poorest residents, driving some to shun much-needed medical treatment.
Low-income patients skipping appointments for diabetes treatment and heart and kidney disease to save money is something all-too familiar to Melissa Rodgers, director of the Health Consumer Center, under the Legal Aid Society of San Mateo County.
Rodgers, a lawyer, advises low-income people who find themselves facing staggering medical expenses or who feel they've been billed incorrectly.
"I think it is really sad," she said, reacting to news that the county Board of Supervisors voted unanimously recently to approve increases for many common medical treatments at the San Mateo Medical Center. Rodgers is frequently put in the position of having to counsel people to tend to their medical care, even in the face of mounting bills, she said.
On average, emergency room service will increase 62 percent, lab and pharmaceutical work will rise 39 percent and clinical procedures will increase 21 percent beginning September 1, according to hospital officials.
"[The increase] was necessary because our prices need to be competitive with other hospitals," Board of Supervisors President Jerry Hill said. The increases will bring in an additional $200,000 annually for a total of about $91 million in net patient revenue, according to hospital officials.
Patients covered by the county's fee waiver program won't be affected, but patients on the WELL, discounted health care and self-pay programs will see higher bills.
Some of those expenses will be picked up by patients’ insurance, depending on their coverage, hospital spokesman Dave Hook said.
That may not help many of the county’s poorest and sickest. Low-income patients often avoid the hospital to keep from signing a lien or going into debt, even when faced with diseases that can be life-threatening, according to John Metz, chairman of San Francisco-based JustHealth, formerly the California Consumer Health Care Council.
Metz says the skyrocketing cost of health care, which he blamed largely on insurance companies, is driving many poor people to become "debt slaves" to both public and privates hospitals.
About 10,000 of the medical center’s lowest income patients, many of whom don't have private insurance, will be affected, officials said. By raising rates, which was done after surveying other area public hospitals, San Mateo Medical Center will increase its reimbursement rate from MediCal and Medicaid, officials said.
More revenue has been a focus of the hospital, which required a $65 million subsidy from the county this year alone.
"The other goal here is to cover our costs, because health care and labor are increasing each year," Hook said. Even with the increases, the medical center is a good deal compared to area private hospitals, Hook said.
The medical center last raised rates by 5 percent in an across-the-board increase in October 2005, officials said.