CARING for people in need of medical attention during their most vulnerable moments is something hospitals across Virginia do each minute of every day.

That’s certainly the case at Mary Washington Healthcare (MWHC). In 2016, we had 26,657 inpatient admissions and a combined 119,682 days of care  were delivered to patients between Mary Washington Hospital and Stafford Hospital.

What isn’t commonly known is that many of the patients hospitals treat – about 63 percent of Virginia inpatient admissions, on average – are under-insured or uninsured. Hospitals often end up absorbing some, or all, of the cost of care for those patients.



That is true for MWHC and hospitals throughout Virginia. In 2016, Mary Washington Hospital provided nearly $44 million in uncompensated care, while Stafford Hospital provided more than $9.2 million. Statewide, hospitals in Virginia deliver more than $1 billion each year in uncompensated care, which is sometimes called indigent or charity care.

Caring for all patients, regardless of their ability to pay, is part of hospitals’ community and public service mission. It is also required by law, meaning hospitals have an unfunded care mandate from Washington that results in serious financial stress on providers.

Unfunded mandates and the pressure of uncompensated care are not just an issue for hospitals, however. They affect taxpayers, businesses and employers, workers, the government, and our economy.

One way we feel the effect is through insurance rates, which are prone to increases to make up for the uncompensated care that is built into our health care delivery system. When insurance rates rise, employers who provide health benefits to their workers feel the squeeze. So do employees who pay higher premiums and out-of-pocket insurance costs. That’s not good for the economy or for Virginia families.

A similar strain is felt by hospitals, which are some of the largest employers in local communities throughout the commonwealth. Over the long term, these challenges can force hospitals to make difficult decisions about staffing and even service offerings that can impact patient access to certain types of care when people need it. Those are outcomes we must work to avoid for the common good.

Right now, many people without health insurance delay seeking medical attention, even when they are sick or hurt, until their problem is so serious it can’t be avoided.

People in that situation often end up in the hospital emergency room in worse shape than if they had been able to see a family doctor at the first sign of trouble. By the time they come to the hospital, their treatment needs are greater, more serious, and more expensive than they initially were. This can mean missed time at work and missed pay for people who are already struggling to make ends meet.

Those circumstances are not the most effective way to deliver care, yet those of us who work in hospitals see them occur all too often.

In Virginia, we have an available option to improve health care efficiency and help as many as 300,000 hard-working, uninsured Virginians get the health care coverage they need. This can be accomplished in a way that not only helps people and makes them more self-sufficient, but also protects state finances and saves Virginia millions of dollars in the coming years.

By bringing our federal tax dollars back to Virginia, we can help thousands of our friends and neighbors, including approximately 7,300 in our local region of Fredericksburg, and the counties of Caroline, King George, Stafford, and Spotsylvania.

So far, 32 other states have pursued this option and the results have been positive. Uncompensated care has declined in those states. Access to care has improved as the number of people with health insurance has grown.

And the economic results have been favorable for those states. This is affirmed by numerous studies and analyses conducted by scholars at Georgetown University, Harvard University, the Kaiser Family Foundation, the Brookings Institute, and others, showing the benefits of coverage expansion.

By so many measures, helping more people get health care coverage just makes sense. Perhaps that’s why so many Virginians favor the idea when asked about it in poll after poll, with results showing as many as 83 percent of voters support enhanced coverage access.

Expanding access to health care makes sense for Virginia financially. It is broadly beneficial. And it is what Virginians want and need.

Mike McDermott, MD, MBA, is the President and Chief Executive Officer of Mary Washington Healthcare in Fredericksburg. He is also a member of the Board of Directors for the Virginia Hospital and Health Care Association (VHHA) and serves on the VHHA Executive Committee.

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