Who’s Really Paying for Charity Healthcare? (It’s Not the Hospitals)

Doctors in an operating room giving anesthesia to a patient

One of the greatest travesties of our healthcare system in the United States is how difficult it is to access life-saving medical care if you do not have the financial means to pay for it. Charity, or pro-bono, care is an essential part of the healthcare landscape, allowing those with financial hardship to receive necessary care, but the current system doesn’t make it easy for doctors to provide.

Real-Life Charity Care

In 2021, I met Walter, who had migrated from Guatemala and had walked thousands of miles with a giant mass on his head before finally landing at a free clinic in South Carolina that referred him to me.

When I operated on Walter’s tumor, I knew I wouldn’t be paid. And, as an independent physician with my own private operating room, I didn’t need to cut through any hospital red tape to make this surgery a reality for Walter. The choice to operate was mine alone; I chose to do it—entirely at my own expense.

I’m not alone in wanting to provide charity care. I believe most doctors want to offer it, but the cost of providing such care is too great for many physicians to absorb.

The Cost of Charity Care

Unlike hospitals, which receive government grants and subsidies for the charity medical care they allow on-site, individual doctors do not receive any government funding or tax incentives for the charity care they provide.

Doctors who offer pro bono procedures aren’t just donating their time. Surgeries require additional staff, medical equipment, supplies, and medications. In addition, patients who undergo surgery need follow-up care.

Someone has to pay for that; if it’s not the patient and their insurance company, it’s the doctor.

Hospitals, on the other hand, don’t have this problem. When a hospital agrees to charity care, they have avenues for government-sponsored compensation and reimbursements (which they use to cover their own expenses but do not pass along to the doctors who actually conduct the procedure).

Doctors have no such incentive, and although many want to offer care to those who can’t afford it, fewer and fewer are able or willing to absorb the cost on their own.

We Need Tax Incentives for Doctors

We need to transform access to charity care by passing national and state-level legislation offering tax incentives to physicians who provide it.

I helped U.S. Senator Tim Scott write the not-yet-passed Charity Care Extension Act and continue working with South Carolina legislators to introduce a similar bill at the state level.

Offering tax incentives to physicians who provide charity care will greatly increase the number of physicians involved. This offers more options to patients, who will no longer be forced to cut through layers of hospital red tape just for the possibility of having their healthcare needs met.

Next Steps

For more information about Walter’s story, visit the Shifa Free Clinic website.

Many local government websites list active bills in progress; look for information about “charity care” or “physician tax credits for uncompensated care” in your area and support conversations with your local legislature to help make these programs a reality.

Original photo by Olga Guryanova on Unsplash.