A local newspaper going after the local hospital for suing local residents over unpaid medical bills is very much en vogue right now, happening in Virginia, Oklahoma, New York, Tennessee, and other places across the country.
But full credit goes to the Washington Post for doing the best job at presenting both sides to this difficult debate.
The issues at stake are incredibly important for both sides. Individuals can be financially scarred for life if they are sued and a judgment is entered against them. But hospitals face the same financial peril as well, if they are not paid for the services they render.
To highlight this struggle, the Post goes to Poplar Bluff, Mo., where Poplar Bluff Regional Medical Center has filed more than 1,100 lawsuits for unpaid bills so far this year. A rural hospital, Poplar Bluff Regional is the only hospital left in a five-county radius and treats more than 50,000 patients every year. But the hospital’s uncompensated care burden has increased to $84 million from $60 million in the past few years. The money it recovers from its lawsuits are helping keep the hospital’s door open to people who need it.
The article looks at how difficult it can be for individuals to come up with the money to cover emergency treatments, even when they have insurance while also noting the strain it puts on attorneys representing the hospital who are only doing their job.
One by one the patients came up to plead their cases until the judge called Gail Dudley, 31, who was sitting with her mother in the third row. She had gone to the emergency room at Poplar Bluff Regional in 2017 after passing out because of complications from Type 1 diabetes. The hospital had given her medication to stabilize her blood sugar, kept her overnight for observation, and then sent her home with a bill for $8,342, of which she was still responsible for about $3,000 after insurance. She’d tried to appease the hospital’s billing department by sending in an occasional check for $50, but with accumulating interest and penalty fees, the balance on her account had remained essentially the same for two years.
“I’m grateful for what they did for me, and I know I owe it, but I don’t have that kind of money,” she said.
The judge gestured in the direction of the hospital’s attorney and then looked at Dudley. “Would you like a chance to talk to this gentleman for a moment and see if you two can work something out?”
“Okay,” she said. “We might as well try.”
Matthew McCormick, 27, led Dudley into the hallway to begin the same negotiation he’d been having with dozens of hospital patients each week. On Thursdays he was listed as a hospital attorney for the court docket in Doniphan, population 1,997. Mondays it was Kirksville, Tuesdays were Bloomfield, and Wednesdays often brought him here, to a 95-year-old courthouse in Butler County, where he’d represented Poplar Bluff Regional on more than 450 billing cases so far in 2019.
“We’d like to find a way to work with you on this,” he told Dudley as they sat down together in the courtroom lobby. He reached out to shake her hand. He smiled and offered his business card. For the past year, he’d been working on behalf of the hospital as the newest attorney for a law firm called Faber and Brand, which promised to “use the judicial system to recover money owed.” McCormick’s cases hardly ever went to trial. More than 90 percent of the people being sued weren’t represented by an attorney and at least half failed to show up in court, resulting in default judgments in the hospital’s favor. The rest of the patients McCormick met came into court with little to offer in their own defense except for apologies and stories of poverty, poor health, unemployment and bad luck.
“I’m real sorry about this,” Dudley said. “If I’d been thinking straight, I would never have let them take me to the emergency room. I know I can’t afford that. I wish I could pay you all of it right now.”
“Let’s make this as easy as we can,” he told her. “Is there something you can pay? A little each month?”
“I don’t have anything extra,” she said, thinking about the paycheck she earned for a full-time job as a clerk at Goodwill, which totaled $736 every two weeks. After paying for rent and utilities on a subsidized three-bedroom apartment, groceries, and child care for her 6-year-old son and 3-year-old daughter, she sometimes ran out of money by the end of the month.
“How about $15 out of every paycheck?” she offered, even though she doubted she could afford it. When McCormick didn’t immediately respond, she revised her offer. “Thirty? How’s that?”
“Let’s say thirty,” McCormick said.
He had more patients waiting to negotiate, so he thanked Dudley and led her back into the courtroom to sign her judgment. It said she had agreed to a total claim of $3,021, plus $115 in court costs and 9 percent annual interest. She would send the hospital $60 each month until the balance was paid in full, and if she failed to make a payment the hospital could pursue garnishment of her wages.
“I’m glad you worked something out,” the judge said as he signed off on the agreement.
The court clerk handed Dudley a copy of the judgment, and once she was back outside the courtroom she took out her phone to run the math. If everything went right, and she somehow managed to save and pay $60 each month, she’d be sending checks to Poplar Bluff Regional for the next 5½ years.