Across the country, a few hospitals have come up with a counterintuitive way to save themselves money: offer minor surgery for free.
To understand how that’s possible, consider the case of 32-year-old Lammon Green, a caretaker for the developmentally disabled in Macon, Georgia. He’s a really cheerful guy, but he’s been bothered for a long time by a cyst behind his ear.
“It’s been kind of giving me problems for the last few years,” he said. “It gets to about the size of a lemon when it gets infected.”
Most people would get something like that cut off pronto, but Green doesn’t have insurance.
“I actually am looking into the Obamacare now,” he said.
Because he lives in Georgia – where the governor has declined to expand Medicaid – there’s a good chance Green makes too much money to qualify for Medicaid, and not enough to get subsidized private insurance.
Nonetheless, Green recently found himself in an operating room, drifting off into a chemically induced sleep, while the doctors cut that cyst away with an electronic knife.
Green is one of the first people to come through Macon’s new volunteer surgery clinic. It’s called the SPIN program – Surgery for People In Need.
The doctors work on Sundays for free, while the facilities and diagnostics are donated by the Medical Center of Central Georgia.
“This is a way that we can support this program, with patients that we would likely see anyway, that would be in our system because they have a need that hasn’t been taken care of,” said Roz McMillan, one of the hospital’s vice presidents.
In other words, Lammon Green’s lemon-sized cyst was probably going to land him in the emergency room eventually, and since he’s uninsured, the hospital would’ve ended up eating much of the cost.
Cutting the thing off before it gets that bad is a much simpler procedure.
By donating their services instead, the hospital is saving themselves thousands of dollars in the long run, said Laura Ebert, who runs a program called “Surgery on Sunday” in Lexington, Kentucky that started in 2005.
This new free surgery program in Macon is a copy of Ebert’s – literally.
“We have something that, you know, we can provide on disk or zip drive that shows all the paperwork, how to apply for tax exempt status, how to apply for the federal malpractice program,” she said.
Using that template, free surgery clinics have also sprung up in Omaha and Dallas. Ebert predicts that list is going to grow as hospitals realize it’s in their economic interest to help out.
Low income people in many states are getting insurance through an expanded Medicaid, but their deductible for an elective surgery could be as high as $10,000.
“Hernias and gallbladders and things that we do on a regular basis are considered elective surgery, not life-threatening, so therefore they’ll have to pay their deductible,” Ebert said.
That means people are likely to put off their surgery. The problem gets worse, they end up in the E.R., and Medicaid reimbursements are low -- so again the hospital gets stuck eating some cost.
As long as a hospital has a doctor willing to donate her time, it might be cheaper to take out that gallbladder for free.