St. Louis churches buy up $12.9 million in medical debt, then give it away

[jayem]

This is cool. Local United Church of Christ congregations, in association with the Deaconess Foundation (a UCC medical charity) have bought $12.9 M of medical debt, which they are forgiving. It only cost them pennies on the dollar, but 11,000 poverty-level Missouri residents, owing medical expenses, will be relieved of their debt.

There is an agenda here aside from the philanthropy. The church wants to highlight that Missouri is one of the 14 states that still haven't expanded their Medicaid programs. And that 1000s of persons have been dropped from Missouri Medicaid rolls in the last 3 years. (Mostly children. The state says the parents didn't re-enroll on time. Or that job-related insurance became available. Hospitals and other reputable social service organizations deny this.)

The UCC has bought off medical debt in other cities. It's the kind of charitable good work that other churches should emulate. But even better would be a coherent, affordable, sensible, less fragmented health insurance system that obviates the need.

St. Louis churches buy up $12.9 million in medical debt, then give it away

 

[miamited]

Hi jayem,

While I certainly applaud this work and absolutely encourage it, I think we need to consider how this is happening.

The UCC, along with RIP Medical Debt, is buying medical debt that is about to be written off. They are buying the debt just as it is being given out to collection agencies to try and recover some pennies on the dollar of the real debt. So, we need to understand that this still isn't preventing people from being hounded or being themselves personally troubled by having a great debt that they cannot pay. Usually, a medical bill isn't charged off and handed over to a debt collection agency until 6 months to a year after the hospital's debt collection processes began to try and collect the initial debt.

The pennies on the dollar that they are paying for millions of dollars of medical debt, isn't helping the hospital or medical facility to continue its operations. All this really does, as I see, is just clear up someone's credit bureau report that a debt has been paid. It means that finally, after suffering through a year of listening to the hospital's billing office and receiving their statements each month showing the balance going from '30 days' to '180 day' overdue, that they won't have to worry about some debt collection company calling them now a year later.

It also doesn't really do anything to address the problem as to 'why' we continue this system that makes people feel bad about getting sick or being ill. People who are destitute and have no other option but to sit for hours in a hospital ER for treatment of a common cold because they have no medical insurance. People who could, if they had medical insurance, go to a local GP and find a remedy for their common cold for $150. but instead are forced to go to the ER where that same treatment costs $1,500.

God bless,
In Christ, ted

 

[com7fy8]

I think you have a point. If the medical people are not getting the money they need to operate, the obligation of the debt has not been met.

But I think it is reasonable that the low-income people should not be expected to pay what they do not have.

@miamited So, Ted > what do you think would be good so the low-income and financially isolated people plus the medical servers get taken care of?

 

[miamited]

I think you have a point. If the medical people are not getting the money they need to operate, the obligation of the debt has not been met.

But I think it is reasonable that the low-income people should not be expected to pay what they do not have.

@miamited So, Ted > what do you think would be good so the low-income and financially isolated people plus the medical servers get taken care of?

Hi comfy,

Well, the absolute best way to see that everyone gets paid in every situation is to adopt one of the medical single payer plans that are being discussed by some of the candidates in this election. In Great Britain and Germany and Canada and many, many other nations, they have adopted a form of medical care that through taxation, everyone is covered and everyone is paid. No patient ever receives any kind of bill for medical services, (except for possibly some elective procedures).

To date, the best way that the U.S. has found that most medical providers get paid is the ACA. A requirement that everyone, either singly or as a family, carry a private medical insurance policy. However, there are still, with these plans. co-pays and deductibles that can still leave people with some pretty hefty medical costs that they may not be able to comfortably afford.

I was watching a segment the other day with a man doing interviews on the street in Great Britain. Ordinary people passing by were asked what they thought certain medical procedures would cost in the U.S. It was really funny to see their expressions when they were told that an ambulance ride to the hospital could cost several thousand dollars and that a baby delivery would also cost the new family several thousand dollars out of their own pockets.

There are better ways to take care of medical expenses that isn't burdensome to the poor and destitute or even the family finances. We just have to be willing to let go of this idea that the American way is to pay for medical insurance out of our pockets with each of us purchasing some varying and different insurance company provided medical insurance, is really the better way. Even the gist of this effort that this thread is about says that their purpose is to bring to light the deplorable state of Missouri's healthcare and, in particular, poor families losing what government provided medical care they may have gotten in the past.

While this is certainly a good idea to make a family feel better after their father or mother has died of cancer and left bills that they can't possibly afford to pay, for which they have played phone tag for the last year to avoid the bill collections that arose from the cost of their loved ones final days, it doesn't alleviate the foundational problem.

According to the Commonwealth Fund, there are fewer people without insurance, by several million, than before the ACA. However, due to the increase in deductibles and co-pays with most medical insurance, we now have more people who are under-insured. We are also seeing that because of the repeal of the mandate of the ACA of a penalty for failing to carry medical insurance, more people are now dropping back into that 'uninsured' category. So, while the ACA certainly isn't perfect, and I'd be anxious to adopt a better plan, just striking it off the books is not that 'better' plan.

If we want to showcase American health insurance, then we need to come up with a way to improve the ACA or just go to the single payer system mentioned earlier.

That's my 2¢ worth.

God bless,
In Christ, ted

 

[dqhall]

This is cool. Local United Church of Christ congregations, in association with the Deaconess Foundation (a UCC medical charity) have bought $12.9 M of medical debt, which they are forgiving. It only cost them pennies on the dollar, but 11,000 poverty-level Missouri residents, owing medical expenses, will be relieved of their debt.

There is an agenda here aside from the philanthropy. The church wants to highlight that Missouri is one of the 14 states that still haven't expanded their Medicaid programs. And that 1000s of persons have been dropped from Missouri Medicaid rolls in the last 3 years. (Mostly children. The state says the parents didn't re-enroll on time. Or that job-related insurance became available. Hospitals and other reputable social service organizations deny this.)

The UCC has bought off medical debt in other cities. It's the kind of charitable good work that other churches should emulate. But even better would be a coherent, affordable, sensible, less fragmented health insurance system that obviates the need.

St. Louis churches buy up $12.9 million in medical debt, then give it away

The US spends more on healthcare than any other nation. The US ranks 26th of 35 developed nations in longevity.

Most other developed nations have universal healthcare. They only allow less expensive medical procedures.

 

[dqhall]

Hi jayem,

While I certainly applaud this work and absolutely encourage it, I think we need to consider how this is happening.

The UCC, along with RIP Medical Debt, is buying medical debt that is about to be written off. They are buying the debt just as it is being given out to collection agencies to try and recover some pennies on the dollar of the real debt. So, we need to understand that this still isn't preventing people from being hounded or being themselves personally troubled by having a great debt that they cannot pay. Usually, a medical bill isn't charged off and handed over to a debt collection agency until 6 months to a year after the hospital's debt collection processes began to try and collect the initial debt.

The pennies on the dollar that they are paying for millions of dollars of medical debt, isn't helping the hospital or medical facility to continue its operations. All this really does, as I see, is just clear up someone's credit bureau report that a debt has been paid. It means that finally, after suffering through a year of listening to the hospital's billing office and receiving their statements each month showing the balance going from '30 days' to '180 day' overdue, that they won't have to worry about some debt collection company calling them now a year later.

It also doesn't really do anything to address the problem as to 'why' we continue this system that makes people feel bad about getting sick or being ill. People who are destitute and have no other option but to sit for hours in a hospital ER for treatment of a common cold because they have no medical insurance. People who could, if they had medical insurance, go to a local GP and find a remedy for their common cold for $150. but instead are forced to go to the ER where that same treatment costs $1,500.

God bless,
In Christ, ted

In my area the ER is not required to give assistance except in life threatening situations. A cold or flu can be treated with over the counter medications. There are Urgent Care walk in clinics that are much cheaper than the ER where they can charge thousands of dollars an hour.

In the 1980’s I met a man who told me his ranch was seized to pay for open heart surgery. They may garnish wages too.

 

[jayem]

The pennies on the dollar that they are paying for millions of dollars of medical debt, isn't helping the hospital or medical facility to continue its operations.

I agree with everything you posted. I worked 40+ years in health care. I know how receivables that must be written off, or sold for a pittance can be a serious financial stress for providers. So what happens? At least part of those costs are shifted onto insured patients through higher fees. Which leads to higher health insurance premiums. Our failure to provide even a basic level of health insurance for everyone, means all of us who do have coverage pay more for it than we should. We all ultimately pay--through the back door--for those who can't pay. And I don't particularly like getting it through the back door.

 

[miamited]

In my area the ER is not required to give assistance except in life threatening situations. A cold or flu can be treated with over the counter medications. There are Urgent Care walk in clinics that are much cheaper than the ER where they can charge thousands of dollars an hour.

In the 1980’s I met a man who told me his ranch was seized to pay for open heart surgery. They may garnish wages too.

Hi DQ,

I don't think that you're quite up to date on your information. Urgent cares won't take you unless you have insurance or pay up front. The urgent care that I go to has a photo copied sheet of paper taped up right beside the check in counter that states that you must have insurance or pay up front for all medical care received. ER's have to see you. If you really want to know the truth of the matter:

The Emergency Medical Treatment and Active Labor Act, a federal law passed in 1986, requires anyone coming to the emergency room to be stabilized and treated, regardless of their insurance status or ability to pay.

Or here:

What happens if you go to the ER and don't have insurance?

In the second article, yes, you will be billed for the service, but if you won't or can't pay, they still see you. That's the issue. Under our system, if you feel that your cold or flu or whatever ailment you have is any emergency, then you can go to the ER. They are required to treat you, but you will be billed. With urgent cares, they can turn you away before they even know your name if you don't have the ability to cover the bill right then and there.

With the ER you just keep throwing the bills away as they pile up in your mailbox. This was the entire issue with why we needed an overhaul of our medical insurance 'plan' back in 2010 when the ACA bill was taken up for debate. Too many people were showing up at our local ER's without the ability to pay, but got seen and treated anyway and left the medical facility holding the bag for the bill.

If you want that confirmed, I imagine that jayim will be able to shed some light on the plight of the poor, or those who just choose not to carry health insurance, when sickness comes knocking at the door.

Now, let's imagine that you're right and ER's don't have to see you. So, the uninsured are what, just told to go off the property to die! You've just been run over by a hit and run driver. No auto insurance policy from the other driver to cover your medical expenses and no medical insurance of your own. Do the ER staff just wheel you back out to the parking lot and send you a bill for the gurney?

God bless,
In Christ, ted

 

[miamited]

Hi DQ,

You also responded:

In the 1980’s I met a man who told me his ranch was seized to pay for open heart surgery. They may garnish wages too.

Well, believe me or not, this issue of the uninsured not paying their medical debts is the number one entire reason that the ACA battle even happened. Personally, I can't imagine anyone thinking that it's a good thing that a man lost his home because he needed open heart surgery that he couldn't afford.

One of the blessings of a single payer tax funded system is that no one need ever face that choice. It doesn't have to be that anyone loses their home or their paycheck over medical costs. Some medical costs just can't be planned for such as your acquaintances open heart surgery.

No one in Great Britain ever worries about losing their family home when they come to those final expensive days of medical care and hospice. There are no court cases being held where a doctor or medical facility is suing someone for unpaid medical bills. It just doesn't happen there. It also doesn't happen in most of the civilized/industrialized nations.

According to Axene Health Partners:

• The United States is the only industrialized country in the world that does not have Universal Health Coverage for all citizens.
• While the Affordable Care Act (ACA) was a step in the direction of universal coverage, as of the end of 2016, 9% of all Americans (and 12.4% of US Adults aged 18 to 64) still did not have health insurance.
  
• Canada: The Canadian healthcare system is administered by the provinces with shared funding between the provincial and federal governments. It is a single payer system in that providers offering services covered by the government program generally are not permitted to receive any private payments for those services. Physician, diagnostic, and hospital care must be covered on a first-dollar basis and providers are not permitted to bill patients for amounts over the negotiated fee schedule. Additionally, specialists are not allowed to bill private patients for providing publicly insured services – all covered care must go through the public system.
  
• Taiwan: National Health Insurance (NHI) was introduced in Taiwan in 1994 and was modeled in part on US Medicare, though it covers all citizens and not just the aged and disabled. Coverage is compulsory for all citizens and foreign residents, with 99.9% of the population enrolled. Benefits are uniform and comprehensive, covering hospital care, physician care, prescriptions, and other services.
  
• Germany: Health Insurance was first introduced in 1883 and has evolved over time to a compulsory coverage system.7 The majority of Germans are required to purchase their insurance from 118 not-for-profit “Sickness Funds” regulated within the Statutory Health Insurance system (SHI). Self-employed and high income employees can choose to opt out of SHI and purchase Private Health Insurance (PHI) from a mix of 42 non-profit and for-profit insurers.
  
• Switzerland: Universal coverage was introduced in Switzerland through the Federal Health Insurance Law in 1996 with three goals: universal coverage with low-income subsidies, comprehensive and high quality coverage, and containment of growing health care costs. The program is administered by 26 individual cantons (similar to US states) with financing coming from general tax revenues, Mandatory Health Insurance (MHI) premiums, and contributions from social insurance related to accident, old-age, disability, and military insurance.

The list goes on and on. The citizens of these nations have peace of mind over any kind of medical issue that may come up. Yes, they pay for the care, but it's through taxes and often times cost regulations. But no one in any of these countries, or the other plethora of countries with similar systems has ever lost their home or been thrown into the poor house over medical costs.

According to studies done on some of the proposed plans going on today in our national election debate, they claim that a national single payer system would cost us $30B over the next ten years. Guess what? We already spend $4B/year for all medical costs. This $4B includes what we pay for co-pays, deductibles, insurance premiums, medicare and medicaid and prescription drugs. So, where is this, "Oh it's going to cost us too much money to have a single payer system. Over the next 10 years under the status quo, we'll spend about $40B. Go figure!

God bless,
In Christ, ted

 

[com7fy8]

through taxation, everyone is covered and everyone is paid

Thank you for taking the time to offer what you have

I suppose people could use the "this is socialism" argument. But they might want to have capitalism so the rich can get richer, and ones can invest and then spend their time spending their money, and who cares about anyone else?

I see that - - may be with a tax paid, everyone is equal system . . . this might save a lot of money on medical fraud, at least limiting the value of stealing someone else's identity in order to get care. And with our present system, it seems a doctor can slip me into accepting a service which I will have to pay for fully, without the person making it clear I will be charged; and, by the way, it seems Medicare has legal power to refuse to pay a full bill, while I do not! Even so, I understand medical service set-ups need money to operate, plus there is malpractice insurance and paying for medical school.

Plus, though . . . medical service places can have pretty well constructed and designed facilities . . . using enough space that no one hardly ever occupies, except to walk somewhere, and this could be space for some number of people needing a place to sleep Even with tax and insurance not paying full bills, these facilities seem to manage to have pretty large and nice space to operate in. But I think there are other places more space efficient, and also therefore fuel efficient.

Even so, I know one place that is raising its own funds to help pay off their million-or-so-dollars deficit for the year. And they have small quarters for work and residents, and seem to charge little . . . for nursing home care. This is another hard one > long-term care or rehab.

only allow less expensive medical procedures

Thank you, also . . .

Can this translate into saying a senior will not get treated for cancer? I have been told that older people won't be covered by Obamacare . . . for cancer. I know some bitter person might have made this up. But also I have been told that in Canada there are things which won't be treated; people are simply allowed to die, or something like this. So, I would ask does "only less expensive" mean a number of people are going to be culled from the population?? And is this what euthanasia would be meant to do > not really caring about the feelings of the patient, but really wanting to cull expensive patients from the population??

People have been cultured to fear old age and to feel ashamed of how they look in their old age. So, ones also might get cultured to feel they do not deserve to live if their continuation will be expensive. Which way is cultural conditioning of attitudes going to go, with whatever is used??

except in life threatening situations

But if someone starts to get a problem that is not treated, he or she can be showing up at E.R. when he or she is about to die of what the system did not want to pay to treat! Right?? So, they could be treated for a life-threatening thing . . . when it is about time to die, anyway.

So, I'd say there are different ins and outs of this.

But . . . trust the LORD

 

[dqhall]

Hi DQ,

I don't think that you're quite up to date on your information. Urgent cares won't take you unless you have insurance or pay up front. The urgent care that I go to has a photo copied sheet of paper taped up right beside the check in counter that states that you must have insurance or pay up front for all medical care received. ER's have to see you. If you really want to know the truth of the matter:

The Emergency Medical Treatment and Active Labor Act, a federal law passed in 1986, requires anyone coming to the emergency room to be stabilized and treated, regardless of their insurance status or ability to pay.

Or here:

What happens if you go to the ER and don't have insurance?

In the second article, yes, you will be billed for the service, but if you won't or can't pay, they still see you. That's the issue. Under our system, if you feel that your cold or flu or whatever ailment you have is any emergency, then you can go to the ER. They are required to treat you, but you will be billed. With urgent cares, they can turn you away before they even know your name if you don't have the ability to cover the bill right then and there.

With the ER you just keep throwing the bills away as they pile up in your mailbox. This was the entire issue with why we needed an overhaul of our medical insurance 'plan' back in 2010 when the ACA bill was taken up for debate. Too many people were showing up at our local ER's without the ability to pay, but got seen and treated anyway and left the medical facility holding the bag for the bill.

If you want that confirmed, I imagine that jayim will be able to shed some light on the plight of the poor, or those who just choose not to carry health insurance, when sickness comes knocking at the door.

Now, let's imagine that you're right and ER's don't have to see you. So, the uninsured are what, just told to go off the property to die! You've just been run over by a hit and run driver. No auto insurance policy from the other driver to cover your medical expenses and no medical insurance of your own. Do the ER staff just wheel you back out to the parking lot and send you a bill for the gurney?

God bless,
In Christ, ted

I paid cash when I went to Urgent Care due to an infection. More recently I got Obamacare, but it only pays part of the costs and some procedures are not covered by Florida Blue. Last year I payed all my insurance premiums as I had high enough income. Another year the government picked up the tab for the monthly premiums. I still had out of pocket expenses.

Michael Moore made a movie about universal healthcare in Cuba, but the Cubans could not afford the out of pocket expense for the subsidized medicine. I imagine some of these universal healthcare systems do not pay for advanced surgical procedures. One type of cataract surgery costs $5,000. in my area. Another type of cataract surgery uses multi-focal lens implants and costs $13,000. Obamacare does not cover the advanced implants.

How far a hospital will go to collect debts is unknown to me. Some people have debt upon debt with little extra savings. They owe on credit cards, student debt, subprime car loans and rented their homes.

 

[jayem]

I imagine some of these universal healthcare systems do not pay for advanced surgical procedures. One type of cataract surgery costs $5,000. in my area. Another type of cataract surgery uses multi-focal lens implants and costs $13,000. Obamacare does not cover the advanced implants.

Restrictions on treatments and procedures are imposed by all private insurance plans now—employer provided plans included. True story: When my niece was about 8, she was very short—below the 10th percentile in height for girls her age. She had all the testing done, and was diagnosed with growth hormone deficiency. Injectable HGH had just become available and was very expensive—like $5K a month, IIRC. And she would have needed regular injections for several years. Her health insurance, provided by my brother-in-law’s employer, wouldn’t cover it. The plan claimed it was still “experimental.” It took over a year, and the involvement of their Congressman, to get her HGH covered. My niece is in her 30s now. She’s about 5’2”. Still short, but she can drive a car. Which she may not have been able to do without the treatments.

A major advantage of single payer insurance is the buying power of a monopsony. When you’re the only customer in town, sellers will compete for your business. You can negotiate reasonable prices. That being said, a single payer health plan can’t go overboard. If it tries to stiff providers, it will lose them. Which is a problem in some states’ Medicaid programs. Their reimbursements are so low, few doctors will see Medicaid patients. But if fees are kept fair and reasonable, patients will get care, providers will be paid, and, there’s at least a possibility that medical costs can be controlled.

 

[trunks2k]

Restrictions on treatments and procedures are imposed by all private insurance plans now—employer provided plans included. <snip>

My wife is a PA and deals largely with a certain serious disease that, while it can be cured, the medicine to do so is craaaaaazy expensive. It among the most expensive courses of medicine there is. Trying to get insurance to approve a course of treatment is... difficult. At the hospital she used to work at, more than half her day was spent arguing with insurance companies, and there would be companies that made it next to impossible to get approvals with silly rules (i.e. she had to call between a small set of hours to talk to a specific person - she once spent 3 hours on hold). Now she works for a hospital that has a larger staff to do that all for her, but just think of the expense of dealing with that.

It's so expensive, such a pain to get insurance to approve, and so important to finish treatment on schedule once it starts that she has told patients who had accidentally thrown away their pills to dig them out of the garbage.

 

[Nithavela]

Drop in a bucket.

 

[miamited]

Hi dq,

Thanks for your response:

I paid cash when I went to Urgent Care due to an infection. More recently I got Obamacare, but it only pays part of the costs and some procedures are not covered by Florida Blue. Last year I payed all my insurance premiums as I had high enough income. Another year the government picked up the tab for the monthly premiums. I still had out of pocket expenses.

That's what I'm talking about in one not being fair in their assessment and blaming the wrong culprit. First, it is not 'obamacare', it is the ACA and it was voted in and cobbled together by Senators and Legislators. President Obama had nothing to do with it, other than to encourage that the legislature take up the fight and come up with a better plan than having 44 million men, women and children living without health insurance. What became the ACA is what they worked together to produce. Yes, the Republican party as a whole was dead set against it because they really don't care about people dying for no good reason. Just like now, it is basically the Republican party's agenda to repeal the ACA but it has actually become so popular that they can't do it. But they're sore about it and licking their wounds and still making feeble efforts now and then to fight it. I think it's sad.

If the Republican party really wants to do the right thing in this, then come up with a better plan and let's all vote on it and be done with it. However, just to repeal the ACA and go back to the way things were is not what the majority of the American people want. Certainly not the people who had previously been deemed uninsurable.

Your complaint about your insurance not paying all of the bill has nothing do do with the ACA either. All medical insurance plans have for decades contained co-pays and deductibles. The reason that they contain allowances for co-pays and deductibles has nothing to do with the ACA. The ACA has no provision in all of it's hundreds of pages that require that medical health insurance policies have co-pays and deductibles. That is the way health insurance companies write up their plans in order for 'us', their customers, to be able to afford them.

So, I have no problem with anyone not liking the current ACA legislation, but their dislike should be based on the reality of the situation and not some 'perceived' wrong that really isn't because of the ACA.

I imagine some of these universal healthcare systems do not pay for advanced surgical procedures. One type of cataract surgery costs $5,000. in my area. Another type of cataract surgery uses multi-focal lens implants and costs $13,000. Obamacare does not cover the advanced implants.

You should really do your research. As rated by healthcare professionals whose job it is to know, and not imagine, what things are like, there are many countries who are considered to have better healthcare than the U.S. and all of them are government tax paid systems. I'm sorry that your insurance plan doesn't cover what you want covered. That's not the ACA's fault. That's your insurance companies fault. You need to look for and buy the kind of health insurance that you need. Your health insurance policy only covers the less expensive lens surgery and that's your fault, if you need to have the multi-focal lens implant and you didn't buy a policy that covers it.

From eyeconsultants.net: Currently, multifocal lenses are not considered ‘medically necessary’, so many health insurance policies won’t cover the full cost of surgery.

Notice that the site doesn't put the blame on the ACA, but on the insurance companies themselves. Why don't insurance companies pay for them? Because the insurance industry deems the procedure not 'medically necessary'. Their position is that the standard monofocal procedure works and then you would wear glasses to correct varying distance sight issues. That isn't written anywhere in all of the hundreds of pages of the ACA. That's how the insurance industry as a whole feels about the issue. It is also a relatively new procedure and that also causes some insurance companies to consider whether the procedure is necessary or not or its value to the patient.

If you do your research, you'll find that most national insurance plans, speaking of the tax paid plans in other countries, don't cover the procedure either. The NHs (Great Britain) does not. Neither does the Canadian plan. I think that if you try to be more fair in your assessment of any health insurance plan, that yes, you'll find procedures that aren't covered, but it generally isn't because they're expensive so much as it's because they are yet unproven or considered not essential. Cosmetic procedures are also generally not covered unless medically necessary. Just because someone isn't happy with the way God made them is not a medically necessary procedure and apparently a procedure that works, but might leave you wearing glasses where you couldn't see at all before, is also not considered medically necessary. However, for whatever reason a procedure isn't covered by health insurance, it isn't the ACA's fault. That's the fault of our health insurance policies as written by the insurance companies that sell them to us.

Let's be fair and lay the blame for any problems with any health insurance issue at the feet of the entity that is responsible for said problem.

God bless,
In Christ, ted