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2004-01-07

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Hospitals hound uninsured patients for bill payments and now rank among America’s most aggressive debt-collectors using one of the harshest and least-known collections tactics of all: seeking the arrest of no-show debtors. We speak with Jim Bean who was jailed in Illinois in part because he failed to pay a hospital bill and we hear from the CFO of the hospital that sought his arrest as well as a member of a grass roots citizen action organization in Illinois. [includes transcript]

Hospitals hound uninsured patients for medical bill payment using collection agencies and lawyers who use such methods as filing lawsuits, slapping liens on homes, seizing bank accounts, and garnishing wages to extract payment.

Some hospitals now rank among America’s most aggressive debt-collectors. Some also use one of the harshest and least-known collections tactics of all: seeking the arrest of no-show debtors.

Hospitals in several states have secured the arrest and even jailing of patients who miss court hearings on their debts. This legal tactic is chillingly known in some areas as "Body Attachment."

  • Jim Bean, Urbana, Illinois based musician who was jailed for several hours in November 2001 in part because he failed to pay a hospital bill.
  • Claudia Lennhoff, executive director of Champaign County Health Care in Illinois Consumers
  • Robert Tonkinson, chief financial officer for Carle Foundation Hospital, the primary teaching hospital of the University of Illinois

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: I want to read the first paragraph of a report in the "Wall Street Journal" by Lucette Linado. She has done a crusading series of people on health care and the insured and uninsured in this country. This comes from October 30. It’s dateline, Champaign-Urbana, Illinois. It says "Late one night in 2000, a police cruiser pulls up inside of a house on Mr. Bushman’s house. A officer handcuffed the burly truck driver and took him away to jail. The charge, missing a court hearing about a $579 hospital bill. The hospital that pursued Mr. Bushman, a 295-bed, not-for-profit facility called Carle Foundation Hospital is one of several that has at times applied debt collection tactics that are shunned by many other creditors. It has filed hundreds of lawsuits, garnisheed patients’ wages and seized tax refunds. Since 1995, Carle, the primary teaching hospital of the University of Illinois confirms that it has sought $164 arrest warrants for debtors who missed court hearings. In one case, Carle went after an uninsured part-time musician whom it treated for a gunshot wound in the suicide attempt. When the man, James Bean, missed a hearing on his $7,718 hospital bill, Carle asked the court for an arrest warrant and in November of 2001. Mr. Bean landed in jail. He was in jail several hours." Jim Bean joins us now on the telephone from Champaign-Urbana, and maybe you can tell us your full story.

JIM BEAN: : Good morning. I’m certain we don’t have time for me to tell you my full story but when you are interested in is the time that I spent in jail I suppose. Yes?

AMY GOODMAN: Yes.

JIM BEAN: : What happened with me, I’ll try to give you a short version of this. I have a 12-year-old bill at Carle hospital. As you stated, I was there because of an attempted suicide that failed. I was in Carle for about eight days in the intensive care unit. Never at any time while I was in the hospital was I made aware of anything called charity care. I never heard about charity care until I spoke with Lucette from the "wall street journal," which was this past summer. That’s the first time have I ever been aware of charity care. At any rate, I was the lead singer in a working band at the time. I had sporadic pay and no health insurance. I moved to Chicago after I got out of the hospital, and when I came back in 1995, and in between those times, I had not really received any bills. I’m not holding Carle accountable for that. That’s probably also because I moved around a lot. I would also like to state that the care that I received at the hospital was impeccable. I have no problem with that. What I do have a problem is their collection practices.

So, when I came back, I started making some payments. I had several court dates where they took me in and their attorney was asking for more money than I could afford to pay. I tried to explain this to their attorney and to the judge on several occasions. It basically fell on deaf ears. I was trying to tell them, look, I cannot afford to pay my rent and eat and pay child support payments and make this — you know, make this huge payment to you each month. I was paying what I could pay. I missed a court date that I had no idea about. And this is one of the big problems that I have with what they state about me being a deadbeat or they use these body attachments for people who don’t communicate or don’t show up to court. I was in court 13 times with these people. I always showed up for he my court dates. On one occasion when I did not know about the date, they put out this body attachment that I found out about the next day. I went and turned myself in. Well, I went to find out what was going on, and they told me to go across the street to the county sheriff’s office where I turned myself in. I was jailed, and I was put into general population at the satellite facility here until my brother could come up with 10% of $3,500 to bail me out of jail. The next time I went to court, their attorney asked for that bail money to then be — for me to put that towards the bill. And of course, that’s what happened. So, basically it was just a really quick way for them to collect $350. I had no say in that.

AMY GOODMAN: Well, let me ask Robert Tonkinson about this, the chief financial officer for Carle Foundation Hospital, which is the primary teaching hospital for the University of Illinois. Can you talk about your practice of body attachment, of arresting people who cannot pay.

ROBERT TONKINSON: Yes, I can. I think one of the things that we discovered through this process is that we, prior to being contacted for the story, weren’t any more familiar with body attachment than I think most of the nation has been with that term. It’s a practice that is allowed under law here in the state of Illinois. It’s used very commonly in the state by a variety of people who provide credit. In collecting their bills. Was it a practice that was being pursued very aggressively by one of — one of our collection agencies, and a collection agency in fact that we stopped using about. Four years ago. And so, Mr. Bean’s case is certainly a very old one. As he mentioned, it’s almost 13 years old at this point, and was related to that. Since we have been educated about this, and I’m not excusing ourselves. I mean, the collection agency was acting as our agent in these things, and we probably should have been more familiar with what was going on, but as we became more familiar, you know, we truly regret situations where people — patients are not able to pay their bills for factors that are unknown to us. There are lots of situations that — where the information we know would seem to indicate that they could pay their bills, but there are factors unknown to us, and one of the things that we have done since becoming aware of this is we have created a three-person committee that includes two internal people and a community member to sit down and evaluate every case before — before we seek some — before we approve our collection agency pursuing of the debt in a way similar to this.

AMY GOODMAN: Are you saying that you are going to stop the practice, you will not have people arrested?

ROBERT TONKINSON: Well, I think what I’m saying is that we are exercising more review, and more care and more direction over that practice. We still believe that there are times when — when there are people who have gone through our internal collection process, and not been in contact with us who are contacted by the collect agency and provide no information, and who will — we seek court action, at least to be able to — we have a responsibility to find out if these people have resources, and that can pay their bill, and sometimes we get the situations where we have gone through all of that, and they won’t have appeared at the court date, and the only option left in order to get the information we need to see if these people qualify for our charity programs or in assistance in other ways is to — is to pursue that process. But I’d say that it’s — we use it much more rarely than we did 13 years ago, and it’s a process that we’re going to exercise even further control over in the future, because

AMY GOODMAN: So, but — so, the teaching hospital of the University of Illinois, your hospital foundation will continue to have people arrested?

ROBERT TONKINSON: I want to clarify that we’re the teaching hospital for the Champaign campus of the University of Illinois, and that the University of Illinois Medical School in Chicago has a much larger teaching facility, but —

AMY GOODMAN: Let me ask something — you made a point, you said, that this is a very old case, something like 12 or 13 years old. Jim Bean, this started 12 or 13 years ago, you were arrested two years ago, is that right?

JIM BEAN: : 2001.

AMY GOODMAN: mm-hmm.

JIM BEAN: : mm-hmm.

AMY GOODMAN: It’s an old case that you were arrested for. Now, have you paid your bill?

JIM BEAN: : Honestly, I have made payments totaling $1,340. Now, when I started making those payments, my bill was $7,718.23. My bill today is $10,620.46, none of the money that I have paid has been applied to the debt whatsoever, and it states here, all in interest charges. Now, Carle hospital told Lucette that they do not charge interest. I’m holding this document in my hand with their name as the plaintiff in court, and their attorney’s name at the bottom of this. I showed this to Lucette. That being the "Wall Street Journal" reporter.

AMY GOODMAN: Let’s ask the chief financial officer of the hospital, Carle Foundation Hospital—

JIM BEAN: : As a matter of fact. I’d like to say this also. This is the first time that I have heard from anybody from Carle hospital as they have told Lucette and other people they were willing to work with me or talk to me, no one has contacted me whatsoever. This is the first time that I have heard from anyone from Carle hospital. I’d like to hear what he has to say.

AMY GOODMAN: Robert Tonkinson, does the hospital charge interest so that he knows owes 300 more than he did when he first attempted suicide.

ROBERT TONKINSON: We do not charge any charge on the cans that we have. We have arrangements with our collection agencies. When agencies. When they take a case to court, they can ask the judge to grant them the right to charge to apply interest to that account. In this case, that’s what this particular collection agency has done. We don’t receive any part of that interest. That is —

AMY GOODMAN: Well, let me —

ROBERT TONKINSON: That is there interest. But the attorney for — for that collection agency has written a letter, and sent a letter to Lucette as well, that —- that he is not going to collect that interest from Mr. Bean. And so -—

AMY GOODMAN: So, the bill he has is wrong, will it be corrected?

ROBERT TONKINSON: I don’t know how they will handle it, internally from their systems, but I know that that — that interest that the attorney has said will not be Mr. Bean’s responsibility. And as to his comment about contacting him at this point, based on our arrangements with the collection agency, that account is theirs to collect, and no longer our, and so his contacts need to be with the attorney at that agency.

AMY GOODMAN: Well, Claudia Lennhoff, Executive Director of Champagne County Health Care consumers in Illinois, can you talk about this practice? Now, there is another hospital in town, Provina Covenant Medical Center in Urbana, which has stopped the practice of body attachment after the "Wall Street Journal" report. Can you comment on that, the significance of the media coverage and the two different practices, the teaching hospital of the University of Illinois continuing to arrest people who cannot pay?

CLAUDIA LENNHOFF: Yes. I mean, we are really appreciative and we applaud Provina covenant’s decision to say that there is no place for the use of body attachments in hospital debt collections for their cases. That is something that they are communicating to all of the collection agencies that they contract with. They are saying in our cases, do not resort ever to using this tactic. And we applaud that. That’s appropriate for just any health care provider, but especially a non-profit, charitable, tax exempt hospital where our community members pay the — you know, shoulder the property tax burden for this hospital. We expect nothing less of Carle hospital, and I would really hope to hear that Carle would take the same position as Provina and basically say, you know, there’s no place for this practice in hospital debt collection. To say that people won’t communicate and therefore we have to use body attachments to bring them to court is misleading, because the body attachments are not solely for the purpose of bringing somebody in who has been, you know — you know, who has not showed up or to whom they are not spoken. The purpose of body attachments as is illustrated by Mr. Bean’s case, he went and turned himself in to court. There was an opportunity to communicate with them then. Instead, what happened was the warrant for arrest was executed, and he was incarcerated, and I would maintain that he was incarcerated for the purpose not of assessing his financial status and whether he would call phi for charity care or whether he could pay, but he was arrested for the purpose of being able to apply bond and then extract payment, you know, through that method, and I think it’s completely unacceptable, and, you know it, just — and it creates a bad dynamic in our community where people become very afraid of getting health care because they are afraid that they will be jailed if they cannot pay the bill, and with regard to Carle hospital, they do need to be concerned about that, and there are many things that can happen that are no fault of the individual like they might not get the summons to appear in court. But then they are treated as a criminal. And that’s outrageous.

ROBERT TONKINSON: well, one thing I’d like to say about that —

AMY GOODMAN: Robert Tonkinson, Chief Financial Officer for the Carle Foundation.

ROBERT TONKINSON: A body attachment cannot be granted by the judge unless there’s proof that the person was served with a notice for court, but that aside, I think that the things that Claudia has talked about there are really things related to the practice as they were, and not the practice as we see using it going forward. The reason we’re not willing to say that we’ll never — never use that practice again is because we do feel very strong obligation to be a good steward of the resources we have, because not-for-profit hospitals have no investors, no shareholders, every dollar we take in is either used to provide care and support the provision of care, to build facilities or to acquire equipment, or to hold in reserve to use for that purpose at a later date.

CLAUDIA LENNHOFF: Look, overwhelmingly, people who end up in court —

ROBERT TONKINSON: So that any —

CLAUDIA LENNHOFF: Under body attachments are issued are low income people. That’s overwhelmingly the case. These are low income people. Jim Bean went to court 13 times and tried to assert his financial status. He sold his guitar so that he could make payments. That’s the tool of his trade. That’s like a plumber selling his tools. He made all kinds of extraordinary efforts, given his circumstances to try to make payments. The court process is not a place where somebody’s capacity to pay will be fairly assessed, and then, you know, and then carried out appropriately. And I think that, you know, to rely on body attachments and to say that we need to do this as a matter of fiscal responsibility is ridiculous because first of all —

AMY GOODMAN: We’re going to have to leave it there, Claudia. We have come to the end of the program. Claude Lennhoff, Executive Director of the Illinois Health Care Consumers. Robert Tonkinson, the Executive Director of the primary teaching hospital of the University of Illinois. That does it for the show.

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