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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We thought of that in the first (1975) malpractice crisis.
The lawyers made those waivers illegal back then.
It's still a good idea, but it's impossible that they will ever be allowed again.
It's not working...
Not that I don't believe you but how did the lawyers make the waivers illegal? What about a contract with my Dr. or can the contract also be made not legal?
Nope you are wrong. I know I deliver babies. Same payment (global fee) that covers the entire nine months of care plus 6 wk post -partum care. Doesn't matter if you come in and the baby if born in five minutes or if I'm up for 24 hours worring my head off and finally have to do a c-section. I get paid the same. The hopital however does get paid differently (except Medicaid really pays them very poorly which is one reason everyone else pays more).
The way they get you in court is to say you were injured by "negligence".
You have a civil right not to be injured by "negligence", and you can't waive your civil rights by contract.
Well, they're not going to get lower by saying it's OK for patients to not pay their bills.
Yes, you are right and the insurance has figured that factor into your payment. But how do you separate yourself from the hospital that you need to practice your medicine? How do you fill their beds or use their fancy equipment when they are in need of money? You are in a partnership and it is hard for me to believe that if you do not help support the hospital they will not be so helpful for you.
And I am not picking on Dr's. They can make as much as they want--they studied, spent many years doing it and spend many hours away from their family because of it. And people are glad you did. IT IS THE POLITICS THAT I DON'T LIKE!
Before Bush illegal alien problems were not even on the radar. He has w/o exception allowed the problem to increase and fester without restraint. We knew our enemy in Clinton - it was obvious he wanted illegals for the voting block - but to have Bush et.al. RINOs backstab the American public is disgusting and almost treasonous.
Actually there is another factor in this story. What about all the money that was collected for the workers (most likely insured) on 9/11 and what about all the money sent on the Tsumani and what about all of OUR money our government spends all over the world on humanity efforts? BECAUSE of this, it seems wrong that we cannot take care of our own.
I am in no partership with any hospital. I do not admit patients or perform procedues for the benefit of the hospital. If the hospital had all physicians like me(who make sure to admit only if necessary) they would probably go broke. Now, I MUST take unassigned call for said hospital without pay. I perform a FREE service for them. Now ,I realize there are many doctors who do have a very cozy relationship with hospitals espically in the cities and large for profit run entities. I however chose not to be part of that. I guess I am to stubborn and independent just the right type of personality to be a conservative with a libertarian bent.
Wasn't on the Radar? I agree he hasn't done enough, if anything about it,but to say he created this problem is...
sad to say the least.
He made me an offer $2500 better than any previous offer. I bought it.
Our family doctor is reasonable. I think office vistits are $40, but when my Father broke his hip a few months ago, we had the ambulance take him to the local hospital where the only specialist in the area operated on him. He did a fine job and his insurance along with Medicare paid it all. There was no bargaining tho.
See what I mean, the hospital expects something from the Dr's that practice in their facility.
If I understand your free service, do you believe the hospital should hire on-call Dr's? And why do you think this is a free service for the hospital rather than the community or the patient, who is certainly not getting the service free.
The problem is there are hundreds and hundreds of people not paying their bills.
The salary of the CEO working for free might pay for 3 of them. Then like many hospitals along the border, the hospital can no longer pay their bills, pay their employees and will go out of business.
Then nobody gets health care and nobody gets a pay check either.
It is working just fine for some. I had some dealings with a lady Doc whose hobby was collecting Rolls Royces. I think she had 18.
My only point to you is that every responsible person these days---individuals and small business owners alike---must grapple with the heavy burden of health care costs. My elderly neighbor spends more than half her limited income to pay for health insurance. I know two-income families with children who can barely afford the insurance premiums, but they pay them. They pay more because people like the Houghs (who are not destitute) remain willfully uninsured.
If you're arguing that we need to revamp the system as a whole, I am ready to listen---but solutions are hard to come by. Here's my take: given people's desire to lead a self-indulgent lifestyle AND avail themselves of the very best that medical technology and innovation has to offer, the future of the health care system looks grim. I think prevention is the best medicine we can offer at this point, but no one's interested.
Yes they REQUIRE us to do unassigned on call work in order to have the privilage of admitting our patients. As a matter of fact the only way I can do such work(and not get a headache) unpaid is by realizing(or is it rationalizing) I am doing it for the patients and the community. Have I ever been pressured by a hospital to admit patients
I say buy health insurance. It's a terrible burden until you get sick, then it's a blessing. One $5,000 bill for a few days in the hospital will teach you that.
Things have turned upside down. Today the insurance clerk dictates what they will pay, often prior to treatment, and the hospital's goal (based on what type of equipment they have on hand) certainly can't be one to lose any money. Getting many doctors (for more patients) so they can buy equipment seems to be their game.
I have sympathy for the doctor. He is constantly being scrutinized for his decisions and then sued if anything goes wrong. Don't get me wrong--some arrogant asses need to be sued if for nothing more than the reason they went into medicine to begin with. It is unfortunate that doctors cannot simply be people that are able to say well, maybe I should have done that but we agreed to do . . . But they don't dare or they would be in a courtroom most of the time with the patients that prey on them, and anyone else they can, for a free lunch.
My spin is that hospitals/communities falsely believe that if they do not have a cutting edge hospital that no one will want to live in the area and the hospital administration has nothing to brag about. I think they are wrong. Regional facilities are fine for the expensive complicated medical equipment needed for the extraordinary procedures. These extensive processes should be removed from the common/normal medical processes and be put into the extraordinary medical facility on a regional basis where these different so called highly specialized doctors still today make grand sums.
National health care is a given in my opinion and it will be disastous. I believe we will live to see it as it is not far down the road.
When this happens the litigation will diminish. There will be no malpractice as I expect doctors will be employed by the government and they are immune.
HIPPA made way for our medical records to be broadcast and for further scrutiny by the insurance companies of medical decisions and the doctors. I HATE HILLARY WHOM I HOLD MOST RESPONSIBLE FOR OPENING THE DOOR TO THE INSURANCE COMPANIES.
"Guess how much that doctors visit was? 110$!"
I went to my doctor here in Southern Oregon for one purpose...to have him rewrite my prescription for Diovan 160 to Diovan 320, with the aim of cutting the pill in two and saving myself $50 a month.
Well, he rewrote it, then I told him I had some excess ear wax. He verified that fact, then left, sent in his PA, and she spent five minutes cleaning the wax out.
I then went to pay the bill. I cannot get health insurance from any company because I have high blood pressure (which is controlled by the Diovan) so I have to pay all costs myself.
He charged me $110 for the 3-5 minutes it took to rewrite my prescription. He didn't examine me or listen to my heart, didn't do anything except look in my ears and say "Yup, you have excess ear wax" and send in his 19 year-old assistant to squirt warm water in my ears.
He then charged me $130 for that assistant to squirt water in my ears for a few minutes.
$240 dollars for TEN MINUTES WORK, five minutes of him looking in my ears and writing a few words on a new script, and five minutes of having his assistant squirt water in my ears.
I was shocked...I actually stopped cold at the desk, and asked how on Earth they could charge that much money for so little work. That works out to almost $1,500 an hour.
I can see spending that much on a surgeon, okay...but five minutes of writing a few words down, simply doubling the strength of my prescription, is worth that much money??
That's how much I make in two days work, after taxes. It boggles my mind that it goes for a few minutes of writing a doubled prescription and then having a girl squirt water in my ears.
Something is way wrong with our health care system.
Ed
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