Zuckerberg San Francisco General Hospital is being criticized for leaving some patients with surprisingly big medical bills

• Zuckerberg San Francisco General Hospital is being criticized after a Vox article detailed how its insurance practices were leaving some patients with high emergency-room bills.
• The public hospital is considered "out of network" for all private insurance holders — meaning patients involved in traumatic events are often blindsided by its billing practices after being taken to the hospital via ambulance.
• In 2015, the hospital was renamed after Facebook CEO Mark Zuckerberg when he and his wife, Priscilla Chan, donated $75 million.
• Zuckerberg does not have an impact on day-to-day operations at the hospital, though his likeness is often closely associated with it, and the hospital now bears his name.

One woman who fainted while riding her bike was unable to answer basic questions when taken to the emergency room at Zuckerberg San Francisco General Hospital. Months later, she received a five-figure bill.

Another woman fell and broke an ankle while rock climbing. She has now hired an attorney and is fighting a $31,250 bill she received from that same hospital after a one-day stay.

These stories and others were detailed in a new Vox report about how Zuckerberg San Francisco General Hospital is being criticized for sometimes blindsiding patients with large emergency-room bills because of its insurance and billing policies.

The hospital was named after Facebook CEO Mark Zuckerberg when he and his wife, Priscilla Chan, made a $75 million donation in 2015. The money was used to build a trauma center, which opened in 2016. And though Zuckerberg does not have an impact on the day-to-day operations of the hospital, it is largely associated with his likeness because of its name.

The public hospital claims to serve one in five city residents, according to the Vox report, though it is considered "out of network" to everyone with private insurance. This means it doesn't accept the kind of health-insurance coverage that most people get through their jobs, which can leave people with large bills if they visit the hospital for care.

In the article, a spokesman said the situation was fairly common for public hospitals serving folks he said were generally underserved. But according to a 2017 study quoted in the Vox piece, this practice is highly unusual for a renowned trauma center. But it's not unheard of.

That is how Nina Dang, 24, a woman featured in the Vox piece, ended up with a five-figure bill after she fainted while riding her bike. Upon her arrival to the hospital, doctors performed an X-ray of Dang's arm and a CT scan of her brain and her spine. She was sent home with medication and was told to see an orthopedist. Months later, a $20,243.71 bill came in the mail, according to Vox.

A similar situation happened to Alexa Sulvetta when she broke an ankle after falling from a rock-climbing wall. The hospital was not in her network, and after a one-day stay she was billed $31,250.

Reaction to the Vox piece has been mixed. Some on social media are criticizing the hospital's billing practices and its namesake, others online are attempting to highlight that Zuckerberg is distanced from the day-to-day policies of the hospital and simply donated a large sum years ago.

It is more common for doctors to be out of network, not entire emergency rooms — especially not one boasting that it is the "busiest" in the city, the piece concludes. The hospital also holds the title for the longest average emergency-room wait time of all San Francisco hospitals — at 54 minutes, according to ER Wait Watcher, a tool developed by ProPublica.

Zuckerberg San Francisco General Hospital released the following statement:

"Zuckerberg San Francisco General Hospital and Trauma Center, owned and operated by the San Francisco Department of Public Health, provides world-class care for all the people of San Francisco, regardless of ability to pay or immigration status. We take this mission seriously and are absolutely committed to its execution.

As a Level 1 trauma center, we must meet certain requirements, 24/7/365, as delineated in the California Code of Regulations (CCR) and by state and national credentialing agencies. The requirements are substantial and, because they require such commitment of resources, costly. Our city needs the services of a Level 1 trauma center to respond to thousands of incidents annually, and our fees help meet that need.

The issue of our affiliation with private insurers is complex, and involves the preferences, incentives and cost structures of all parties involved, not merely those of our hospital.

We realize there are challenges, difficulties and inefficiencies in our national system of healthcare insurance. We realize burdens are often placed on individuals who are least able to afford them. And we are not in the position of defending the inequities of this system, only working within our prevailing system to the best of our abilities."

The feature on the hospital is worth a read — head on over to Vox for the deep dive.

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