Scalia's Vision for Health Care Takes Shape

You may remember my earlier mention of Accretive, a company with a bad name that lost an unencrypted laptop full of medical records belonging to its client hospitals.

Accretive is in the local news again, this time because state Attorney General Lori Swanson has found the company "used high-pressure tactics in emergency rooms, cancer units and delivery wards to try to collect money from patients before they were treated," according to the Star Tribune.

All this took place at hospitals in the nonprofit Fairview chain, which includes the University of Minnesota's facilities. Fairview immediately announced they have dropped this "service" from Accretive, although they continue to hire it as a consultant for "other services."

And get this:

Swanson's probe found that Accretive employed collection quotas, cash inducements and in-house competitions using National Football League team names to motivate staff members to squeeze upfront payments from patients. At patient registration desks, for example, employees were told to follow lengthy scripts, written by Accretive, to press patients for payments before they got treatment, according to the six-volume report.

In one case, a child who sought treatment at the University of Minnesota Amplatz Emergency Room reportedly was kept waiting while the parents, who were uninsured, met with an Accretive "financial counselor." The incident prompted the hospital's own employees to question whether Accretive was violating federal law, which requires emergency rooms to see patients without such delays.

Swanson started her investigation following the laptop incident, but that wasn't the only thing: "a group of Fairview ER workers went to Swanson with fears that they could be fired for failing to increase collections."

Accretive created "stop lists" of patients who were to be pressured for payments before the could receive treatment. The lists included breast cancer patients. Accretive also "used religion, gender and marital status to create credit scores on Fairview patients, a potential violation of state and federal law."

All of this is a foreshadowing of Supreme Court Justice Antonin Scalia's recommendations during the hearings on the Affordable Care Act. And imagine all of the nonproductive labor expended on tracking and pressuring patients... that's part of the 30 percent of health care costs that would immediately evaporate if we had a single-payer system.