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Tri-County Project Care
State's insured bearing health insurance cost burden
Source: Charleston Regional Business Journal, May 17, 2004
Written by: Dennis Quick, Senior Staff Writer

Unless more residents have access to health care coverage, South Carolina’s health-insured employees will continue paying more for their health insurance and getting less.

That was a message made clear at the Business Journal’s 2004 Business Healthcare Summit recently.

Increased funding for public payer programs such as Medicaid and Tri-County Project Care would spread affordable health care to the uninsured and ease the financial burden of the insured, experts claim. Otherwise, the insured will continue picking up the health tab for the uninsured.

“Costs are getting shifted so that in the next five to seven years, the insured will pay premium increases of 10 percent or greater,” says Dr. Casey Fitts, medical director of Tri-County Project Care, a North Charleston-based nonprofit devoted to bringing health care to the Lowcountry’s uninsured.

The cost-shift to the insured stems largely from doctors and hospitals not getting reimbursed for services they provide to uninsured patients. Consequently, the insured are paying higher premiums to cover not only their own health care but those without health care coverage, explains Fitts, a speaker at the summit.

In 1999, Lowcountry hospitals provided about $60 million of un-reimbursed care, according to Fitts. That figure shot up to $125 million in 2003.

“Imagine doing business knowing that 20 to 25 percent of your receivables will not be paid. That’s what Charleston County hospitals face,” says Deb Campeau, director of business and government relations for Trident Health System, who was also a summit speaker.

The rise nationwide in hospital emergency room visits from uninsured patients with no other source of medical care is at the heart of the hospital reimbursement problem, experts say.

Also, financially squeezed state governments are trimming their budgets by cutting Medicaid reimbursements to physicians.

All of this is a snowballing problem speeding downhill toward the consumer. Hospitals and doctors shift the costs of uninsured patients to commercial insurance payers, who then pass the costs on to employers, who either pass the costs on to their employees or decide they can no longer afford to offer health insurance plans.

The result is more uninsured patients.

Rising malpractice premiums are also raising health care costs. The S.C. Medical Malpractice Joint Underwriting Association and the Patients Compensation Fund each will average an overall increase of 27.2% in medical liability premiums, the South Carolina Medical Association recently announced.

These increased malpractice premiums are forcing medical specialists to cut back on their services, thus further limiting patients’ access to medical care, claims the SCMA.

Campeau recommends that business owners urge their legislators to fund public health care programs. In addition, employers should ensure that employees who qualify for public-payer programs know about them.

About $230 million is needed to fund Medicaid, according to the S.C. Hospital Association. In the appropriations bill recently passed by the state House of Representatives, about $213 million is slated for Medicaid.

Founded two years ago, Tri-County Project Care received about $15 million in funds from the Medical Society of South Carolina, Charleston and Dorchester counties, area hospitals, Trident United Way and Duke University for its first three years. So far the organization has provided $7 million worth of health care services in the Lowcountry.