Posted on 05/19/2005 7:14:23 AM PDT by Jim Noble
LACONIA — A Meredith woman in a battle with breast and brain cancer is now facing the costly reality of not having medical insurance.
A Superior Court judge has ordered her and her husband, sued by Lakes Region General Hospital for non-payment of medical bills, to make payment secured by an attachment on their home.
In March, the hospital filed suit against Paul Hough and his wife, Wanda, of 19 Water St., Meredith for $48,081.26 in medical bills, plus accruing interest and legal fees connected to the collection efforts.
Judge Larry Smukler granted the hospital's motion for summary judgment on the basis of statements and evidence presented for the record without a trial. Such action is used when there is no dispute to the facts of the case, and one party is entitled to judgment as a matter of law.
On Tuesday, the court also ordered the Houghs to pay $1,742 in attorney fees. Earlier this month, the court granted the hospital a $55,000 attachment against the Hough's modest Cape-style home in Meredith.
Mrs. Hough, 55, received treatment for breast cancer at the hospital between Aug. 2, 2004 and June 28, 2004 and underwent a single mastectomy. She has since been diagnosed with brain cancer.
She claims that just five days after having a brain tumor removed at Dartmouth-Hitchcock Medical Center she was getting phone calls from the hospital asking for money for her prior surgery.
"I'm sure there are a lot of other people in the community thinking 'this could be me,'" said Maureen Criasia, a friend of the Houghs who worked as a registered nurse for 30 years.
As health insurance costs continue to increase, Criasia predicts more people will be unable to afford health insurance and will be saddled with huge medical bills if they get sick.
"We owe the money and we know we owe the money," said Paul Hough, maintaining the collection tactics employed by the hospital have placed additional stress on his wife while she is battling a life-threatening illness.
The couple didn't have insurance when the diagnosis was made. They'd dropped their coverage and used the added cash to help bolster the operation of their antique and used furniture shop.
In its lawsuit, the hospital, through its attorney, Margaret Sullivan of Laconia, charges that the Houghs failed to pay the costs of the medical care even though Mrs. Hough had signed a standard agreement on admission authorizing the hospital to begin collection proceedings if the bills weren't paid.
The writ claims the Houghs were "unjustly enriched" by the services the hospital provided.
On March 1, 2005, Lisa Delaney a patient accounts supervisor at the hospital signed a petition to attach with notice asking the court to order a $60,000 attachment against the Houghs real estate.
The petition claimed that the hospital believed it would recover a judgment in the amount of $60,000 and that unless the attachment was allowed there was a reasonable likelihood that the defendant's assets would be insufficient to satisfy a judgment.
Smukler granted the attachment but limited it to $55,000 and also ordered it "subordinate to all existing liens and attachments."
In a handwritten motion objecting to the attachment request, Hough said that the couple were in the process of applying for Medicaid and were currently making monthly debtor payments as part of a Chapter 13 bankruptcy plan accepted by the U.S. Bankruptcy Court in Manchester.
Court records indicate the Houghs paid $450 on the original $48,081.67 total hospital bill. The hospital is charging 4 percent interest daily and is also asking to recoup $145 in filing fees paid to the court, $44 paid to the sheriff's department for serving the writ of summons, $1,742 in legal fees, $1.34 in postage and $20.75 in photo copying fees.
Paul Hough says he tried to make weekly payments to the hospital but was told the nearly $50,000 bill would need to be paid in its entirety. The hospital offered to have them take out a mortgage on their home, but Hough rejected it as he thought the payments were unaffordable.
According to court records, the Houghs filed for bankruptcy on March 16, 2004. The bankruptcy court approved a repayment plan in which the couple began making monthly payments of $180 for 50 months in June 2004. Outside the repayment plan the Houghs are also paying their monthly mortgage plus making payments on their 1999 Ford van.
In a motion filed with the court on April 29, Mr. Hough said the couple had retained the services of an attorney with New Hampshire Legal Assistance, who had taken their Medicaid case and is confident that he can get the denial reversed and the medical bills due the hospital paid retroactive to 90 days to last April's filing date.
The couple has signed an agreement with state that explains state law mandates reimbursement from "my or my spouse's estate," to the state and county as a condition of eligibility for Medicaid. Under the terms of such an agreement, Hough said he and his wife could maintain lifetime residency of the home. The debt would be repaid upon their deaths when the property was sold.
Meanwhile, Hough says both Concord Hospital and Dartmouth-Hitchcock Medical Center have both provided medical treatment to his wife and have agreed to cover her expenses until they find out during a June 8 appeals hearing whether she will receive Medicaid.
Hough maintains LRGH fast-tracked collection efforts to avoid having to accept a Medicaid settlement that would pay less.
On May 3, the hospital filed a motion seeking summary judgment of post-bankruptcy petition debt claiming that the Houghs failed to amend their bankruptcy filing to add the hospital as an unsecured general creditor.
The Houghs objected. "The objection is based on a bankruptcy filing which occurred before the billed services were rendered. It is not based on the merits of the claim. As the record indicates the (hospital) is entitled to judgment as a matter of law on the undisputed facts. The motion is granted," Smukler wrote in his order granting the summary judgment.
Christopher Boothby, director of development and community affairs for LRGHeathcare (which owns LRGH and Franklin Regional Hospital) has characterized such suits as infrequent.
But a review of records in Belknap County Superior Court shows the hospital filed 165 such suits last year and has two attorneys working to collect on unpaid medical bills.
This year, 28 such cases had return dates in May, 20 in April and four in March.
While Boothby said he could not comment specifically on the Hough case, he said, the number of lawsuit filed by the hospital considering the number of patients it serves remains small.
"I would re-enforce that it's a situation of last resort. No one, not the patient, not the hospital wants to have a matter go to court. We work very hard to provide options to people," he said.
Boothby cited the Patient Advantage program that he said has attracted interest from other hospitals nationwide.
Boothby explained that the program was the brainchild of CEO Tom Clairmont, and was sparked after the administrator watched the "average guy charged more than the big HMO and realized there had to be a way to level the playing field."
If patients pay their bills at or near the time of service they can receive up to a 20 percent discount. More importantly, Boothby said, each time a patient is discharged hospital staff has the chance to meet with them, learn about their needs and has the opportunity to offer counseling or refer them to HealthLink or other programs that can help meet their needs.
"This organization's commitment is secure and ongoing," he said.
But on the other side of the equation, Boothby maintains its unfair to individuals who meet their financial obligations to allow people who do have legitimate needs walk away without paying at least a portion of their bills.
"It's a delicate balance, one we've put a tremendous amount of time and energy into. To be fair to everyone in the community it sometimes become necessary to go to that last resort," Boothby concluded.
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The reason the hospitals are willing to pay this much to prevent CEOs from departing for greener pastures, is that there is a very limited pool of people with both the ability and willingness to serve in these positions -- and they all have lots of other options.
actuallym, as I'm sure you know, the "golden handcuffs" are used by all corporations to retain their top execs, because the corps have invested so much in the top execs. And quite frankly, it's hard to turn down the golden salary once an exec gets drawn into it and used to living it.
Looks like the bankruptcy allowed payments for the breast cancer operation, not the brain tumor operation that was performed after the bankruptcy. This would be a new debt, so they can go for a judgement.
It's getting to the point where it's just not worth it to own property. Just rent, and keep your cars in a relatives name.
Maybe you should go to medical school (4 years at about $30,000 a year tuition, plus living expenses), and then work 100 hours a week as a resident for 4 years, getting paid about what a McDonald's manager makes for a 40 hour week (while your $150,000+ in student loans are accruing interest), and then fork over $50-100,000 a year in malpractice insurance, and pay rent for your office space and salaries to your administrative and nursing staff, and spend lots of unpaid hours reading journals in your field to keep up with advances so you can give your patients the best treatment available, and so you don't get sued -- and then charge patients $20 a pop to tap into all the skills and knowledge you've acquired.
If doctors got paid what you seem to think "they are worth", nobody with a 3 digit IQ would become a doctor.
Corporations also regularly use bigger "golden handcuffs" to induce senior executives to c'mon over from a competing firm. It's the free market at work.
they would have been better off claiming they were illegals.....
we're in our fifties and I fear a lot of my age group will be the "have-nots" as far as medical insurance goes....too young for Medicare, and no retirement pension/health benefits.....
it'll cost someone, that's for sure....
that's already happening....
you don't think that the massive amount that most non-govt. employees pay isn't in reality an extra TAX on us for all those not paying for insurance or recieving free /reduced/ highly subsidized care?
in all reality....those of us who are taxed on income AND who pay additionaly for our health benefits are SUBSIDIZING ALL THE FREE CARE GIVEN OUT PLUS THE CHEAP RATES THAT GOVT EMPOLYEES RECEIVE.....
how else can govt employees get the benefits they recieve without huge govt subsidies, which average Joe the tax payer gets nailed for...
so while I personally pay over $600 /month for two people in my household, I also pay income and Ss and property taxes etc.....so I am getting hit from every direction for other people's health care....
I fear universal health care but for people like us, its making more and more sense to level the playing field......
Why is that unfair? I pay enormous premiums for medical insurance. Some years I never use ANY of the benefits. All my premiums pay for the services used by other people. The hospitals accept insurance coverage with the expectation of being paid for the actual cost of the service. Hospitals often inflate service and materials costs to cover all the people who won't pay their bills. If the hospitals pulled that BS on the insurance companies, they would be pulled as "in network" participants. That would trash the only certain source of repayment for services rendered.
I might add that for all the money I pay for medical insurance, the quality of care in Pocatello sucks. The service is poor and the hospitals and doctors often charge more than the insurance will pay. That means additional bills. My wife has insurance as well. Even with double coverage we still pay substantial additional bills.
I agree. I have been waiting for some Dr. to go into business where his business also is a small hospital with basic equipment such as the old type X-ray. He/she is also qualified surgeon. He limits his practice to a particular number of patients, requires them to sign waiver they will not sue and he offers his care to them. It should not take his patient's long to see if they like his style and if they believe he is the Dr. they want to keep. If you are insured you collect from your insurance company yourself. If a catastrophy takes place you have the choice of staying with what he can offer or you go someplace else. I think half the problem with health care is the affiliation with the hospital who had to go hi-tech, even if they were a small hospital.
I have car insurance, but I don't expect the insurance company to pay any part of an oil change or tire rotation. I have it for when some uninsured idiot plows into me or a tree crushes the roof.
We are required to carry insurance in our state or you pay a fee to an uninsured motorist's fund. It was suppose to be a great thing and so was no-fault insurance. Neither are worth the legislation. I have been in only one mishap which the person behind me had NO brakes and NO driver license. My insurance paid and I paid the deductible because I did not have something called collision. I soon got it. But I agree, no one expects anything from car insurance or house insurance for that matter, in fact the adjustors do everything they can to get out of it as cheaply as they can. Hmmmm, not that I put it that way, I guess that is what has happened to health care since insurance clerks determine the care an insured person receives. LOL
>>What say you? Hospitals are under increasing pressure from the Feds to aggressively collect these accounts. Medicare takes the view that, if you aren't aggressively collecting, any billing you do of the government (knowing you will be paid), is fraudulent.
However, these stories create enormous anger and resentment aginst hospitals among the public they serve.
What say you?<<
I'm 51 and went without health care insurance for over ten years. Saved a bundle. And if I got something really bad, I accepted that I would have died. The apostle Paul said "for us to die is gain."
A hospital bill is like a water bill or credit card bill. They perform a service and you agree to pay for the service. It is that simple. I have no sympathy whatsoever for this couple regarding the bill. I come down on the side of the Hospital in this particular case.
A real life lesson that federalized health insurance is only made to cover the elitists and those in government, they will never cover you when it is YOUR life that is on the line.
Damn, I thought this was about the UK.
Greedy baby-boomers wanting everything for free.
There are plenty of great Doctors. My Sunday School teacher was perhaps the best surgeon in our city and his income was small. He was also president of the local medical society. On the other hand I recall several Doctors who were making over a million a year.
They are preying on the public.
No parent is going to deny care to their child no matter what. That is the kind of thing Doctors prey on. Not just Doctors but the entire industry.
There was a time when doctors were poorly paid and literally made house calls.
Now most are in the business to get rich.
I don't know what the answer is. Maybe the market will take care of it eventually by increasing the number of doctors but some medical societies make a concerted effort to limit the number of Doctors.
I also agree that excessive mal-practice awards are part of the problem. They should be limited as to amount.
Are you in a position to bargain on a car payment, a water bill, a house payment? I agree about the child thing. But I made it clear in my post that I was talking about this particular case.
Gee, if they were illegals, this wouldn't happen to them...
"nobody with a 3 digit IQ would become a doctor."
So that's why all the low IQ doctors. (hehe, just kidding. too easy.)
The same thing has already happened in the engineering world. Same after hours study to be the best and loads of education and experience required. The problem is that a lousy engineer is all that 99.9999% of businesses know to expect, so they develop horribly engineered products. This goes for software, electronic, mechanical, chemical, etc. Engineering student entry into universities has dropped considerably over the past few years.
The answer to all the above except the water bill is "Yes".
Can you bargain on those any more than on a doctor bill?
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