New Orleans There’s one thing that Paul Kiel, reporter for ProPublica.org, Steven Brill, author of the new book, America’s Bitter Pill: Money, Politics and Backroom Deals and the Fight to Fix Our Broken Healthcare System, Senator Charles Grassley, Republican from Iowa, and I can all agree on about healthcare, and that’s the simple fact that hospitals have gone wild, which was the subject of Wade’sWorld on KABF/88.3 FM recently.
Kiel has been all over the story of Heartland Hospital in St. Joseph, Missouri, famous as a staging area for exploration of the West during the Lewis-and-Clark Expedition, and not a lot since, and their practices of dunning patients and sending them over the financial cliff, despite their supposedly nonprofit and completely tax exempt status. Over the last few years they have put some 6000 of their patients in collection procedures that involved wage garnishment collecting about $3 million a year from the process. Heartland has a debt collector of course, but that’s a for-profit subsidiary owned by the nonprofit hospital, so not exactly arms’ length. Kiel noted that 100 of them were Walmart workers, which gives you a pretty good grasp of how little they make. The judges there charge 9% interest on the bills, so it’s almost a lifetime sentence. Kiel noted one case that we talked about where a fellow had to go into the emergency room at Heartland and ended up with a $15000 bill. He makes about $40,000 for a family of four and ended up with his wages garnished. Now several years later he’s paid $50,000 in lost wages for that $15,000 bill, and it’s not over yet. Today he still owes about $26000! And, he’s not alone. This story is common for them and common all over the country.
New rules may or may not stop this practice. Steven Brill, a veteran investigative reporter as well and now a bestselling author with America’s Bitter Pill, made the point firmly saying that the rules mandating that hospitals earn their tax exempt status by actually providing some charity care and forbearance was one of the few provisions in the Affordable Care Act that “actually reduced costs.” Brill was adamant as well that the Obama Administration had drug their feet on this regulation causing harm to tens of thousands who have been pushed and bullied unnecessarily on their bills or forced into bankruptcy because of the bureaucratic delays in writing the regulations. As Brill told Wade’s World, he could have written the regs himself in “two hours” in 2010 when the bill passed mandating them, rather than later as the rule goes into effect in 2016.
In talking to Kiel, he shared the fact that even with the 2016 dateline, hospitals better clean up their act. Senator Charles Grassley in reaction to his story sent a letter to Heartland asking them to account for themselves, which was sure to get a response, and did, as Heartland indicated it would immediately review its procedures. Grassley has been on the case tracking tax exempt abuse of hospitals and others for a decade and now with the Republicans in control of the Senate is going to have more weapons in his arsenal, so no matter how we might disagree with him on hundreds of other issues, he’s a champion on this score.
Both Kiel and Brill pointed out that hospitals have seen this rule coming with its attendant review of their tax exempt status for years now since Obamacare passed, so they don’t have any excuses for not having cleaned up their act. It could be that they, and their lobbyists, have been trying to get some last big paydays by squeezing the last pennies out of lower income families with their predatory billing and collection practices.
Hospitals gone wild may not be completely tamed, but they better sober up and get off the beach or they aren’t going to like the stories, videos, and actions forcing them to get right with their patients and communities or suffer the consequences.