Quora Query: When a Hospital “Works Out a Payment Plan” for You to Pay Off a Large Bill Over Several Months, Does the Hospital Charge Interest?

[Originally answered 2012, slightly updated]

A very cool and complex query.

1. First of all, it depends upon the hospital. My suspicion is that most charge some interest.

2. If you are obliged to pay ANY amount, you can and should ask the following questions:

a. What is the amount I would pay if I had insurance? If I didn’t have insurance? Then demand that they charge you the lowest amount for the entire bill.

b. What is the COST of the procedures you have performed for / on me (not the CHARGE, the COST)?

c. What kind of payment plan will you  – the hospital – create for me so that I can pay you?

With these answers, you can decide what to do.

Most places – well ok, my experience is with the not-for-profits, I am unsure what would happen if you are going to a for profit hospital – will craft a plan that will not destroy you.

If they are going to charge interest, you can and should ask why? If they are going to charge you 7% interest, you should tell them that you are willing to pay 3%. In ANY hospital, a 3% return is considered pretty good. What is the worst that will happen? They will say “No”, you will ask to speak to a supervisor, and you will keep asking until you get to the Chief Financial Officer. At some point you will get a reasonable deal.

But this answer (and even the question) is really inadequate.

Your question should be (to my mind):

“Why is it, in a civilized country, that I run the risk of being financially destroyed if I get sick?”

And from that question flow answers that will make your head spin.

President Obama’s health (insurance) reform – the Affordable Care Act (ACA) was, and remains, inadequate, but it is a step in the right direction, even if only the first of a thousand steps.

Those who would roll it back / repeal it have nothing for you, my friend, nothing. Or should I say, they have more of the same.

One of the major causes of bankruptcy in our country – even today in 2020 – is health care bills. How is that remotely just?

We in the United States have the most expensive health system in the world, with some of the worst outcomes.

I submit we have given plenty of time for the (so-called) market to work its magic in health. We need a system of health reform that includes insurance reform, a single payor option, quality outcome metrics, malpractice reform, and the ability to have a discussion about end of life without wing-nuts screaming about death panels.

Until we do this – and President Obama has at least started us down this path – we are simply doomed. No money for health care, no money for education, plenty for a bloated military ( and I say this with all respect, I am a Marine father).

I hope this helps a bit. Let me know if I need to be more focused.

A very cool and complex query.

1. First of all, it depends upon the hospital. My suspicion is that most charge some interest.

2. If you are obliged to pay ANY amount, you can and should ask the following questions:

a. What is the amount I would pay if I had insurance ? If I didn’t have insurance ? Then demand that they charge you the lowest amount for the entire bill.

b. What is the COST of the procedures you have performed for / on me (not the CHARGE, the COST) ?

c. What kind of payment plan will you create for me so that I can pay you ?

With these answers, you can decide what to do.

Most places – well ok, the not-for-profits, forget about it if you are going to a for profit hospital – will craft a plan that will not destroy you.

If they are going to charge interest, you can and should ask why ? If they are going to charge you 7% interest, you should tell them that you are willing to pay 3%. In ANY hospital, a 3% return is considered pretty good. What is the worst that will happen ? They will say “No”, you will ask to speak to a supervisor, and you will keep asking until you get to the Chief Financial Officer. At some point you will get a reasonable deal.

But this answer (and even the question) is really inadequate.

Your question should be (to my mind):

“Why is it, in a civilized country, that I run the risk of being financially destroyed if I get sick ?”

And from that question, my dear Mr. Garcia, flow answers that will make your head spin.

President Obama’s health (insurance) reform is inadequate, but it is a step in the right direction, even if only the first of a thousand steps.

Those who would roll it back / repeal it have nothing for you, my friend, nothing. Or should I say, they have more of the same.

One of the major causes of bankruptcy in our country is health care bills. How is that remotely just ?

We in the United States have the most expensive health system in the world, with some of the worst outcomes.

I submit we have given plenty of time for the (so-called) market to work its magic in health. We need a system of health reform that includes insurance reform, a single payor option, quality outcome metrics, malpractice reform, and the ability to have a discussion about end of life without wing-nuts screaming about death panels.

Until we do this – and President Obama at least started us down this path – we are simply doomed. No money for health care, no money for education, plenty for a bloated military (I say this with all respect. I am a the father to a US Marine, and was in the process of being commissioned as USN Reserve Officer in the Medical Corps until Trump became President).

I hope this helps a bit. Let me know if I need to be more focused.

 

About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the approximately 10 years until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director and Co-Chairman of Critical Care Medicine in PA; this ended in 2017. He serves as a Physician in the Surgical Group with Médecins sans Frontières (MSF, Doctors without Borders). While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". Follow on Twitter @ajlayon
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