Should medical debt be collected like all other debt?

Perspective: Sherry Jones

Posted 1/15/20

I could have died, they said later. Five years ago on New Year’s Eve I felt sick but was afraid to go to the ER because of the cost. Fortunately my daughter Jenny insisted, and for four days I …

This item is available in full to subscribers.

Please log in to continue

E-mail
Password
Log in

Should medical debt be collected like all other debt?

Perspective: Sherry Jones

Posted

I could have died, they said later. Five years ago on New Year’s Eve I felt sick but was afraid to go to the ER because of the cost. Fortunately my daughter Jenny insisted, and for four days I was in Jefferson Healthcare’s ICU where they gave me excellent care and I fully recovered.

But the cost was worse than I feared. I owed more than $10,000 on a $50,000 bill and was told I had to pay that in one year. After agreeing to pay $8,000 plus $200 per month, they threatened to send me to collection for a $500 doctor bill.

I was shocked. I wondered about patients unable to meet such demands. My research since then has revealed they have sent 9,000 families (mostly insured) to collection, sued dozens for deductibles every year, and garnished many families’ wages. Average income after garnishment? $2,000. One single mom making minimum wage was left with only $1,000 per month to live.

Even when wages aren’t garnished, patients with damaged credit records suffer diminished prospects. They’ve said it’s harder to get car loans needed for work, housing, even jobs. They suffer stress, and are more afraid to go to the doctor.

Jefferson Healthcare convened a task force in 2017, which increased outreach, and added aid to higher earners, but since then the number sent to collection and sued continued to rise.

It used to be unheard of to send patients to collection. But a new nationwide “collections culture” in medical billing treats it like ordinary consumer debt. They say it’s good business and necessary for financial health, even though it produces only a tiny fraction of overall revenue.

Many say the only remedy is single payer insurance, but I disagree. We could stop it right here at home if we wanted.

We could adhere to the 1989 financial aid (“charity care”) law requiring hospitals to give help to patients in need and to make “every reasonable effort” to determine need, including screening upon admission, as regulations require.

We could understand that medical debt is not like ordinary debt. When we are sick, scared, or injured we don’t shop around; we have no choice but to get help, no idea what the price will be (and price charged is many times cost), and no power to negotiate. Extreme inequality in power like this renders medical bills “unconscionable” and unenforceable, as at least one jury has held.

No insurance contract, no Medicare regulation, and no auditor requires sending patients to collection. In fact, the IRS calls such tactics “extraordinary.” The hospital must only make “reasonable” efforts to collect debt.

As an independent public hospital they could refrain from extraordinary debt collection. As one CEO recently said, “It would be bad press, and we don’t want to be the organization that does that to people.” New York Times 11/8/2019.

Giving aid is not “asking doctors and nurses to work for free”; it does not threaten the hospital with bankruptcy. After insurance pays (between 60 and 90 percent of charges, as the cases reveal) financial aid is refraining from collecting profit.

From my perspective the public should know more about our public hospital sending thousands of friends and neighbors to collection. What impact does it have on our health, resiliency, and ability to succeed? A community health survey just done by the city, Public Health, and Jefferson Healthcare did not ask any questions about collection, so the damage would have remained hidden.

I am contacting the Attorney General for help and hope you will join me in pressing for an end to punitive collection of patients’ bills.

For more information see: washingtonlawhelp.org/issues/health

(Sherry Jones is a graduate of UW and a licensed (inactive) attorney in Washington, Arizona, and New Mexico. After doing consumer law on the Navajo Reservation for five years, in 1994 she moved with husband Richard Davies to Port Townsend, where she was Executive Director of the first Port Townsend Film Festival, and a founder of KPTZ. )

Comments

No comments on this story | Please log in to comment by clicking here
Please log in or register to add your comment