Free care safety net patients are patients who are either not eligible or simply not covered by any sort of health care services. This is a rarity in the state of Massachusetts, considering the fairly new law that makes not having health insurance illegal. The question at hand here was whether the hospital was charging different fees for the same services to different people.

The Somerville Hospital is one of the many hospitals under the Cambridge Health Alliance.

According to Doug Bailey, the Chief Communications Officer of the Cambridge Health Alliance, charging patients at different rates according to their health insurance status is not just illegal, but impossible. He explained that some of the confusion might be from different co-payments, or even the differences in the cost of services. Each health care provider has different rates at which the patient will have to pay. Some would cover a large amount of the bill, whereas some would not.

Another source of confusion according to Mr. Bailey could have been a difference between the quote given by a doctor or the like to a patient going into an operation and what is actually charged. Each hospital has different methods of charging patients in accordance with their own estimates of a given procedure. To answer the question of is this how all hospitals work, it is apparently the case that they do all function this way with the billing process. As for the question of its legality, if a hospital were to be charging patients a different flat rate, (that is before the rate is divided between the portion covered by the health insurance and the co-pay), it would be very illegal.

Mr. Bailey made it very clear that no hospital charges different flat rates for people under different health insurance statuses.

This still falls somewhat short of an explanation to these specific questions. Although this argument very well might have risen out of pure confusion with the billing process of the hospital, it could also be a mistake on the part of the hospital in the way they either calculated or chose the price the patient would be charged. The cause of this could have also been a result of many other things, but there is no real and absolute answer to this dilemma.

I could not get in touch with the sender of the letter to the editor. The specifics of the their experience could prove to be helpful in pinpointing exactly where this either misunderstanding or wrongdoing started, and how to bring it to light.

As an aside, Mr. Bailey stated how certain health care providers like Medicare and Medicaid are not covering the cost that they insure they would. At the moment the Cambridge Health Alliance is on the path toward a $25 million deficit that could cause a lack of services for patients. Some of this, he believes, is a result of the lack of health care providers adjusting their payouts and rates with the growing expenses of the services provided by the hospital. He stated, "these need to be adjusted at a Federal level."