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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However, these stories create enormous anger and resentment aginst hospitals among the public they serve.
What say you?
Solution: Become a Mexican Citizen and come here illegally, you are covered. (scarcasm)
"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."
I've had people tell me that, "Doctors make lots of money and I don't need to pay the bill."
They hospital provided a fee for services, as agreed to in their contract with the patient. The patient owes the fee. They chose to drop thier insurance.
I don't really know what to say. It's truely a conundrum. Expenses for medical care have skyrocketed out of sight and out of the reach of the average person if they don't have insurance (or are an illegal alien). Then again, 30 years ago they were not able to treat and cure many of the diseases they routinely cure today.
I do know that 28 years ago, when my first child was born I got the hospital bill (don't remember how much it was, but to us at the time it was an unmanagible sum of money--and like alot of stupid young people we had no health insurance). I panicked, and called them. A nice lady said, "Honey, don't worry, pay something every month until it's paid off. As long as you send us something, even $10.00, you're ok." It took awhile to pay it off, but we paid every penny. Today, I guess I would have to take out a second mortgage.
As I said, it's a conundrum.
susie
Which is it? Medicare or Medicaid?
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.
You make your decision and then live with it. It is called risk management. Personally, I opt for a high deductible insurance and use an msa.
Hey - it is the sad , sad truth . Welcome to Mexamerica . Unreal ...unbelievable ...Don't forget - Jorge loves ya !
This can't be correct. Can it?
What's this story's point?
That doctors should treat people
for free? Or we all
should chip in to pay
the doctors who treat poor folk?
Where's the thread going?
I'd say this is a big problem. I suppose there might be options like "I can't pay for this so I'll just live (or die) with a tumor" or they could have sold their house in advance and moved toward medicaid more rapidly which is what will happen to them anyway.
while it is easy to feel sorry for a person that has cancer and needs help, notice that the couple decided to DROP their insurance coverage in order to put their money into an Antique Business. There is much more to this story than is covered in the article. As in many news stories, it is what not reported that may tell the REAL tale.
Maybe they simply couldn't afford to keep it. I know Universal Health Care is not the answer (I lived in too many countries where that was offered -- to disastrous consequences.) But health care costs here are too high.
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.
Do you feel so sorry for them now?
This happens all the time, and has been happening all the time for years. A very large percentage of bankruptcies are caused by high medical bills that the debtor can't pay, and it's been that way for decades.
I'm surprised that it made the local newspaper, but I guess it's a small town.
The real problem is the high cost of health care, not so much the collection practices. And there are a lot of reasons for that. Our politicians (Dem or GOP) simply don't know how to deal with it.
They could start by getting the government out of the business of running the health care industry. It's the most regulated industry in the country.
If she was an illegal alien then her bills would be paid for by you and me. This is the travesty that Bush et.al. have created for us - Time to get serious and stop giving to those who have given nothing to the system - its past time that we start taking care of Americans first.
Yup they gambled and lost. So the hell with boneheads? Well sorry, either way the Gov't's gonna bail these people out. They can force the sale of the house and then these folks will be destitute and will qualify for subsidized housing and subsidized health care. Where's the victory there and for whom?
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