What the future of health care holds for hospitals across the country, the Marion General Hospital president - like so many others - does not know.
However, figures showing approximately 50 million of the 350 million people living in the United States have no health insurance represents a force that John Sanders doesn't expect to diminish anytime soon.
"And we expect it to grow," Sanders said, elaborating that charity care is necessary care provided to patients who can't pay for the services, not patients who don't want to pay their bill.
The charity care the hospital has provided jumped from $796,000 in 2000 to $10,365,901 for the year ending June 30, 2009, according to hospital records.
"I think we do a very good job," he said. "... If you're sick, and you live in Marion, you're going to get taken care of."
Marion General Hospital, part of the OhioHealth system of not-for-profit health-care facilities, and OhioHealth "provide one of the most compassionate charity care policies to individuals and families who cannot pay for healthcare services they receive at our facilities," the MGH charity care policy states.
The policy includes guidelines that provide free care for individuals and families who earn less than 100 percent of the federal poverty level, sliding scale fees to provide discounted care for people who are between 100 and 400 percent of the federal poverty level and a hardship policy for patients who wouldn't otherwise qualify for charity care, "but have unique circumstances."
Marion General in many instances offers interest-free loans for up to six months to help patients. The hospital also has an uninsured discount policy for individuals who don't have insurance but who do not qualify for charity care.
The hospital's foundation, since 2003, has donated $150,000 per year to Center Street Community Clinic, which in 2007 provided health care for 1,411 patients, primarily uninsured or underinsured, on a sliding pay scale.
Sanders said the hospital has to be careful in providing charity care, maintaining sufficient margin of revenue over expenses for overall hospital operations.
"It's a matter of balancing," he said. "It's a matter of doing the right thing for people and our policy of doing things, so we have the money to care of people."
Referring to various versions of health care legislation, Sanders said, "There are so many parts and pieces to the health care legislation. Probably 80 percent of it everyone agrees on. It's the other 20 percent ... What's going to come out of it I don't know, but I think it's a great thing that we're addressing it, and let's see what comes."
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