Cancer patient from Meredith ordered by judge to pay bill

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.

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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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.

One of my co-workers had the same problem. She and her husband declared bankruptcy. One of the things I think is unfair is that if you have insurance, the in-network provider is required to discount the cost of the services, sometimes by a great deal. But if you have no insurance, you pay the entire bill with no discount.

I'm beginning to think the best idea is to quit work, go on welfare and live under a bridge.

Carolyn

Couple cancels homeowners insurance in order to put more money into antique business. Children play with matches and burn down house. Builder comes and rebuilds house. Couple won't pay builder. Builder puts lien on house.

Any different?

They could start by getting the government out of the business of running the health care industry.

I agree. Based on informal discussions I have had with health care professionals, probably 25% of the cost is government mandated overhead and paperwork. They could also get the lawyers out the health care business (via tort reform). Probably another 25% of the high cost of health care is due to malpractice insurance, the necessity of keeping lawyers on retainer or staff, and the practice of defensive medicine.

...health care costs here are too high

Health care costs are too high because:
Doctors and hospitals must pay astronomical sums for malpractice insurance and for superfluous tests that drive up costs. Why? Because the attorneys in this country are out of control.
Solution: Tort reform. Unfortunately, it'll never happen. The dems will filibuster any attempt to bring our lawsuit-crazy system to heel.

Ronaldus Magnus Reagan wrote:

Couple cancels homeowners insurance in order to put more money into antique business. Children play with matches and burn down house. Builder comes and rebuilds house. Couple won't pay builder. Builder puts lien on house.

Any different?

--> Your Good! The only difference is that people are more attached because it's not a house. Big difference between someone's health and an object. But they did gamble and lost,, and now have the medical bills. At least they have a house to turn to for $$, and it's alot more than other "real ly poor" people have.

But they did gamble and lost,, and now have the medical bills. At least they have a house to turn to for $$, and it's alot more than other "real ly poor" people have

There's another difference in that there will probably be "follow up" bills. And now that they are "really poor" they will have better coverage.

You hit the point that sticks in my craw. Now, I'm blessed to have good health insurance thru my husband's employment and to be able to afford the premiums and copays. However, I have watched insurance change over the years, and watched costs go up to crazy amounts. Case in point. When my kids were little a visit to the pediatrician was 15$. Yes, that was the COST, not the copay, we didn't have those back then. Back then, you sent in your medical bills to the insurance company, and when you reached your deductible, they sent you a check for something like 80% of the cost.
Anyway, I had to see a doctor when we were between insurances (hubby had a new job--we really did have the new insurance but I didn't have the card yet, so was unsure what they would pay). The girl at the doctors office (this was a GP) said I could just pay and then my insurance would reimburse me. Guess how much that doctors visit was? 110$! Now, this was for a condition he had seen me for before, and was just to get a new perscription for a medication I had been on. 110$? I'm sorry, I have no problem with doctors making a good living, but what accounts for that sort of increase in costs?
And again, if I were an illegal alien I would just show up at the ER and get treated for nothing.
susie

I believe it's more like Medicaid=charity; Medicare=paid up insurance.

I know SS is something of a fraud, but it's something every taxpayer has paid into. It's not charity, and there should be no demand for reimbursement.

Welfare benefits require repayment from assets.

A little off-topic, but I visited Meredith during a recent visit to NH. I went out of my way to visit the town because I wanted to bring back some souvenir for my daughter, whose name is also Meredith. Couldn't find a single place in town that had a tee shirt, coffee mug, or so much as a pencil for sale with "Meredith" printed on it. Not even at the visitor's center!

rhombus wrote:

There's another difference in that there will probably be "follow up" bills. And now that they are "really poor" they will have better coverage.

True, I don't wish this position on anyone, it sounds really horrible to get a disease that you'll croak from if yuo can't afford the treatment.

Builder comes and rebuilds house. Couple won't pay builder. Builder puts lien on house.

Ha. No. Builder comes and gets 20% up front. Sets up schedule with dates when he’ll be expecting further payments. They miss scheduled payment. Builder stops answering their phone calls. That’s how that works.

I bet half the people on this thread have no clue as to what medical insurance for a 50 something husband and wife costs...

As the Blue Cross administrator for our companies group plan, I can tell you that my wife and I's coverage would be $1800 per month. Fortunately for us, I have retirement insurance from the company I worked for for 33 years... The same insurance only cost me $200 a month.

The problem is that people just see their contribution without realizing most is being paid (with their money) by the employer.

Unfortunately, hospitals are in the business of making money, not supplying us with medical services.

The object of health insurance is not to cover the common cold or hangnail, but to cover catastrophic health problems. Unfortunately, much of the general public doesn't think in this mindset.

Nonetheless, I find harrassing a sick person over copying charges and other lesser charges to be petty.

How much is the CEO if this hospital getting paid in executive compensation? A lot of money! I personally know of one CEO who requested that his compensation not be increased because it would push him into a bigger tax bracket. Rather, he settled for deferred compensation when he was retired (and in a lower tax bracket).

The hospital could take the paultry sums out of the CEO's pockets and quit harrassing the family which is already beat down.

I say people have to get used to the idea that they have to pay their own bills. This couple took a gamble that they wouldn't get sick, and would come out ahead if they stopped paying for medical insurance and put the money into their antiques business instead. Bad gamble, and they lost. The hospital should pay for their bad judgement WHY? And of course the only way the hospital can do this is to soak all its other patients and their insurers and/or the taxpayers.

People need to grasp the idea that just because something is "necessary", they shouldn't have to pay for it. Frankly, state of the art treatment for cancer isn't necessary. It isn't necessary to society for these people to live longer. They can die, just like all our ancestors died of these things before advanced treatments were even invented. Just because something good has been invented, doesn't mean that everyone who wants it is entitled to it. If people WANT to live longer than they'll be able to without expensive medical care, then they have to change their priorities and find a way to pay for it.

I feel sorry for the couple, but businesspeople should know better. At the very least, they should have paid enough for a catastrophic policy, to avoid bankruptcy in the event of a major illness or accident. How did they expect to pay?

I doubt these people are nominal supporters of socialized medicine, and yet they expect to contribute nothing beyond their taxes. Responsible couples in their fifties are paying a small fortune.

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