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I appreciate all of you advocating for healthcare reform. When we raise our voices we will be heard. Please send any topics on which you’d like more data either in the newsletter of privately. You can use the comment button at the bottom of the newsletter.
Medical Debt - Revisited
Last week we discussed medical debt and how some non profit hospitals make patients sign finance contracts before receiving medical care. There was a link to some of the contracts the University of North Carolina public hospital signed with these predatory lenders for your amusement.
Now a new story comes to light about non profit hospitals suing patients and placing liens on their homes. Here is a link to the NPR story.
The Duke University School of Law and the State Treasurer’s office have been investigating this behavior and found that North Carolina hospitals sued 7,517 patients and family members over medical debt between 2017 and 2022. Here is the final report.
In some cases, spouses were targeted after their partners died. In others, patients interviewed by researchers said they’d been surprised to learn about property liens only after they tried to sell their homes or after a parent who owned the home died. Sounds predatory to me. Here are a few examples from the report:
An 80-year-old couple did not know there was a judgment worth roughly $90,000 against them for medical bills that were over a decade old.
A cancer patient survived against incredible odds, but her illness cost her financial future. She can never afford to move because the hospital has a lien on her condo and she would lose her equity if she sold the property.
A 70-year-old woman knows she can never retire because the hospital has a $192,385 lien against her house after her husband’s heart attack. At the time, hospital representatives had assured the couple that they could receive financial help. They didn’t.
A family almost lost their house and their car after a broken leg interrupted the husband’s ability to work and the hospital sued them for thousands of dollars.
A widower lost his wife to cancer, and the hospital put a lien against his house after canceling their payment plans and financial assistance. They had health insurance, but the lien was worth $96,997.
There are a lot of problems with this system. The medical bills are opaque and difficult to understand and prices vary wildly across hospitals. A colonoscopy can be $600 in one hospital and more than $5000 in another. Interest continues to accrue when bills are not paid, and the judgement can be renewed for decades. Once you’re in this kind of debt you are also unlikely to seek medical treatment again.
I have a question: Hospitals are supposed to have a charitable fund to help patients pay their bills. Why weren’t these people offered help? The report details accounts of elderly people who chose to work rather than be on welfare, and the few thousand they earned for food was too much to qualify for charity. It is heartbreaking that the non profit companies running hospitals as profit making ventures ignore the public and the pain they are inflicting.
In North Carolina the Treasurer is pushing for a number legal initiatives to limit such predatory behavior. They would make hospital billing more transparent, remove usurious interest and predatory collection techniques. It passed the NC senate but is waiting in the NC house for representatives to take action. Sadly this behavior is everywhere, not just North Carolina.
This kind of disgusting behavior made its way into an article in the Journal of the American Medical Association. Some researchers decided to study such medical lawsuits in Virginia. Here is what they found and did.
“A total of 50 387 lawsuits, filed by 67 Virginia hospitals, were included in the study. 33 204 (65.9%) were warrant in debt lawsuits, and 17 183 (34.1%) were wage garnishment lawsuits. (Aside - a warrant in debt is an expdited motion in court for a judgement).
The researchers noted that suing patients who can’t pay is largely at odds with the hospitals stated mission of public service. The researchers crafted a plan to see if publicity about the hospital’s predatory behavior would have an effect. After they researched the debts and wrote about them in a JAMA article they requested that media outlets publish stories about the predatory hospital behavior in Virgina. They wanted to know if if public shaming made a difference. Amazingly it does because over the next year Virginia hospitals filed 59% fewer lawsuits and 11 hospitals banned the practice altogether. Note that there were still many lawsuits.
In my state of Washington, this kind of thing does not sit well with the attorney general, Bob Ferguson. He has sued some of the larger hospital networks for violating the Charity Care law. This is legislation he requested that makes financial help available to people whose income is up to 400% of the federal poverty level. The current suit is against Providence and Swedish and two of their debt collectors Harris & Harris and Optimum Outcomes for illegally failing to notify tens of thousands of patients of the availability of charity care. I like our attorney general. I don’t like the fact that you have to sue to get help.
Summary
Let’s review. Hospitals, whether for profit or non profit, are suing patients to get bills paid. They place liens on their wages and homes. Predatory interest can accrue over decades. People then choose to avoid healthcare.
We saw that public shaming of hospitals has some effect.
We saw that a sate can decide when charity care must be offered to patients instead of forcing them into collection.
NONE OF THIS HAPPENS WHEN UNIVERSAL HEALTHCARE IS IN PLACE.
EVERYONE IN, NO ONE OUT, CRADLE TO GRAVE, BETTER FOR BUSINESS, BETTER FOR PATIENTS, BETTER FOR DOCTORS AND NURSES. WE NEED THIS NOW.
ACTION
Let’s let our Congressperson and Senators know what we learned. Here is their contact info. Hospitals are practicing predatory debt collection against patients who cannot afford their bills. Shaming the hospitals publicly for not operating in the public interest does some good, mandating charity help does some good, Universal Healthcare solves the problem.
Use RESISTBOT by texting SIGN PHHYPI to 50409 on your cell phone to send this message.
“I am your constituent. I have just learned how hospitals, even non profit hospitals are suing patients who cannot pay. The are using predatory debt collection techniques, and taking people’s homes. All of this allowed by law. The AMA found that public shaming of the hospitals has some effect on reducing this bad behavior, but it is not a complete solution. Washington State has mandated a Charity Care Law to force hospitals to offer financial assistance if you are within 400% of the federal poverty limit, but hospitals have to be sued to comply. Once in debt people are shy about going to see a doctor and their health becomes worse. I know you don’t want this situation to continue.
I most strongly urge you to enact Single Payer Universal Healthcare (HR 3421 or S. 1655) now. It eliminates medical debt, covers everyone cradle to grave. It is good for hospitals, doctors, nurses, businesses, and patients. I am counting on you.”
Well Done - You’re making it another good day for healthcare reform!!
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Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Plan
Reproductive Health
NARAL - Pro Choice America
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Insurance Commissioner in your state- This website can get you their phone number.
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
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