Many studies conclude that cost-shifting is not a major factor in health care.  I will give you a concrete example of major cost-shifting.

In 2002, I had a left hip replacement at Rose Medical Center in Denver.  The hospital bill was $25,000.  I had a right hip replacement at Rose in 2009.  The bill was $50,000, and my insurance refused to pay the entire bill.  Rose demanded that I write a check for $10,000 to cover the unpaid balance.

I sent a letter of complaint to Rose with a cc to my orthopedic surgeon, who did 45-50 joint replacement surgeries per month.  It was exactly the same care for both surgeries – length of stay, physical therapy, occupational therapy, and other support. 

A week later, I received a call from the CFO.  The University of Colorado Medical School, which used to be two blocks from Rose, had relocated to the Anshutz campus seven miles east.  All of the poor and uninsured who used to use the UCMC emergency room started to go to the Rose E.R.

There is a federal law that ERs have to treat all patients, regardless of ability to pay.  Rose had to virtually double its payment rates for all procedures to compensate for E.R. losses.  Medicare and Medicaid do not pay in full for many if not most hospital bills, and hospitals need to shift costs to commercial insurance payers.  Medicare for All will destroy health care.

Photo credit: Pixabay.