First, Do No Harm. But If You DO Harm, Make Sure You Get Paid

We read an article a few days ago about psychiatric hospitals in New York suing indigent patients to recoup costs of treatment after those patients come into money.

In and of itself, we see no problem with this: We do not advocate withholding treatment from anyone because of an inability to pay; indeed, hospital budgets take into account a certain amount of charitable--i.e., unremunerated--services. At the same time, though, doctors and hospitals have a right to receive payment for services rendered. If people receive expensive medical services at no cost because they cannot pay, fine, but these same people have an ethical obligation to pay what they can and, if they receive some kind of financial windfall, they should repay the institution that served them in their time of need.

Here's the catch, though: The windfalls that the patients receive are often damages awards.

From lawsuits.

Against the psychiatric institutions themselves.

Thus, for example, a patient who successfully sued a hospital for negligent care that led to severe pain, suffering, and life-threatening infections, was subsequently sued by the hospital for $1.7 million dollars to reimburse for the costs of care.

We can't help but admire the sheer gall of these lawsuits, but we are troubled by the disturbing fact that judges tend to side with the healthcare providers. Think about the implication: If a hospital wants to recoup costs of indigent care, all it needs to do is to arrange an "accident." The bigger the damages award, the bigger the hospital's ultimate payday.