It is no secret that the current Health Insurance system in America is not working. Whether you agree or disagree with the tenets of the Affordable Care Act that is now in front of the US Supreme Court, nobody can argue that the current health care system isn’t broke. It is.

Here is another example of why we need reform – a report from the News & Observer that non-profit hospitals which are supposed to be providing “charity care” to the poor, aren’t.

Charity care is health care that is provided to poor patients who lack health insurance. In return for their non-profit status, the hospitals are expected to write off the bills of patients who lack insurance and are financially needy. However, nearly 2 out of every 3 patients that would otherwise qualify for charity care are not even informed that is exists.

And when charity care is offered, it is often in the form of promissory notes with steep consequences if the patient fails to pay on time. In this report, the patient profiled was offered a promissory note in which 1/2 of her $5,000 debt would be forgiven if she made payments on time and paid off the other half of the balance. If she failed to pay, the entire balance would immediately become due, along with collection costs and legal fees. Where I’m from, those unconscionable contracts are illegal forms of “usury” agreements. The patient in the article refused to sign the agreement and is still being hounded by collections agencies.

It is my hope that articles like this will draw attention to these “non-profit” hospitals, such as Person Memorial Hospital in Roxboro, so that the state can take a closer look at their non-profit status.

Additionally, in my opinion, this is just another glaring example of why we need an individual mandate. If this patient had health insurance, all of a sudden she does not have a huge medical bill looming that she cannot afford to pay. Additionally, the hospitals will save money on collection efforts and unpaid medical bills, which are ultimately passed on to those of us that DO have health insurance.

Finally, the individual mandate would eliminate shady businesses such as AccessOne, a credit card company that offers interest free options to pay off medical bills. However, when payments are missed, rates will rise sharply. Interestingly, this company was started by a doctor who wanted to solve the problem of patients who can’t pay their medical bills.