The R.I. Department of Health has proposed new regulations that would require not just hospitals and nursing homes, but a wide range of free-standing health care facilities, to provide free care to low-income, uninsured patients, and to provide at least 1 percent of their net patient revenue's worth of free care each year.
We don't expect this to go over very well. Charity care is an inherent part of Rhode Island hospitals' missions – they're all nonprofits created to serve their communities – and yet even they are expressing concern that a 1-percent minimum might be too onerous.
As for urgent-care and surgical centers and other facilities that would be covered, providing free and discounted care would, in most cases, be a radical new step. These are businesses that make their profits by offering convenient, lower-cost alternatives to hospitals, and they save money for the whole health care system in the process.
But they also create competition that is really straining hospitals, and there are many more people who could benefit from their services but are too poor – so they go to emergency rooms.
We're not sure what the answer is, though it's clear this wouldn't be an issue if we had universal health coverage. Until we do, maybe we should find ways to expand charity care. The proposed new rules offer a good way to start this discussion.