A hospital sued thousands of patients. Then a reporter called them out

Dan: Hey there— you may have noticed: There have been a BUNCH of stories in the last year about hospitals suing their own patients over past-due bills. Or maybe it’s just me noticing— that is the kind of thing I notice these days.

But there is one story I knew I wanted to spotlight on this show, because in this story, the good guys win a major victory.

Last summer, independent journalist Wendi Thomas published a bunch of stories about how the biggest hospital in her city— Methodist University Hospital in Memphis, Tennessee— was suing thousands of patients. Including a lot of its own badly-paid employees.

It was devastating. The hospital runs its own collections agency. And although it’s technically a non-profit, it banked millions in… well, profits, the year before.

And then, a couple months later, BOOM: Methodist Hospital dropped thousands of lawsuits. And said it wouldn’t file any more.

I mean, wow, when a reporter does a story about one person getting stuck with an outrageous bill— and the medical provider says, “Hey, we’re gonna reconsider this bill” — that is one thing.

And it’s great, but I can tell you based on my own personal inbox, there are a LOT more of these outrageous bills than all the reporters in the world could write about.

So seeing a reporter go to SCALE? And WIN? Yeah, that gives me some hope. Let’s go there.

This is An Arm and a Leg, a show about the cost of health care. I’m Dan Weissmann.

A dozen years ago, Carrie Barrett had surgery at Methodist hospital in Memphis. Her share of the bill was about twelve thousand dollars. She says she doesn’t remember getting a bill.

But after a few years, Methodist sued her for that balance, plus attorney fees and interest that eventually brought the tab to more than thirty-three grand.

A couple years ago, she entered into a payment plan — 40 dollars a month — but then she fell behind.

BARRETT: It’s because I had missed some times of paying them because I really just didn’t have it. I really just didn’t have it.

So Methodist had the court garnish her wages. And she works part-time at a supermarket, earning nine dollars and five cents an hour.

In January, Barrett asked the court to stop the garnishment and bring back the $40 a month payment plan. That meant paying a $27 fee to file a motion, and showing up in front of an impatient judge.

BARRETT: And she said you’ve been here four times now because you hadn’t been able to pay your bill on time. She said you will be made [to] pay this bill.

And Carrie Barrett could not quite get the words out to plead her case. She just started coughing uncontrollably.

BARRETT: And I didn’t have no cold, I wasn’t feeling bad or anything that day, but that cough just came up on me

The judge did not want to wait for that to pass. Carrie Barrett’s case was the first on a long dockett— ALL of them lawsuits by Methodist against its patients.

BARRETT: So she said you’re going to have to get out and we’ll call you back when we finish in here.

So Carrie Barrett stepped out into the hallway. She’s religious, and she has come to see the cough itself as providential.

BARRETT: It wasn’t nothing but God that did that because it was due to that cough I had. And by me going out in that hallway to wait, I had asked God to send me somebody to help me. And after I came out the courtroom, Wendi was there

WENDI: Yeah, I had been observing court for weeks at that point.

This is Wendi Thomas, the reporter who eventually did all those stories about Methodist Hospital.

WENDI: listening to cases, and you know, looking for people to interview, you know, I don’t want to quite call it stalking, but…

WENDI: I just followed Miss Carrie into the hallway, introduced myself, and she was, um, kind enough to trust me with her story. And I appreciate that.

That meeting led to the hospital’s lawsuit against Carrie Barrett getting dropped.

BARRETT: So she was the angel God had sent to me.

Wendi Thomas: Reporter, angel.

By the time Wendi Thomas met Miss Carrie, she had been observing court for MORE than a few weeks. She had been on the case for months. And meeting Miss Carrie turned out to be a big deal.

MUSIC

Wendi Thomas grew up around Memphis. She worked as a columnist and an editor at the Commercial Appeal, the big daily paper in Memphis, for years. She left the paper a few years ago and spent a year on fellowship at Harvard.

And she likes to quote a question one of her professors posed:

Wendi: What if poverty isn’t an accident, but it’s a robbery?

That resonated for her.

Wendi:I believe poverty is a robbery. And if it’s a robbery, then there are thieves and the thieves names can be known.

Publicizing those names sounded like her kind of gig.

She returned to Memphis and started a non-profit journalism project she calls MLK 50.

Here’s the story behind that name: When she started the project: the city of Memphis was getting ready to commemorate the 50th anniversary of Martin Luther King’s assassination there in 1968.

Wendi: The civic remembrances or events being planned for this were really celebratory and they focused on some of the pablum King quotes. And I felt like it was, um, it was dishonest. We were being dishonest about why King came to Memphis. He came to support underpaid, mistreated black public employees. That was why he was here.

So, she was all about going up against the status quo. And it was a SUPER-bootstrapped project. She lived off credit cards for a while. She got a little money from national funders and made it work.

Wendi: And I really didn’t give mysef a plan B. So plan A had to work, it had to work. I didn’t have any choice.

She got interested in medical bankruptcy. She visited the courthouse, and the story was right there, hiding in plain sight. Methodist hospital was suing a TON of people.

Wendi: Methodist would have so many cases on the docket that one courtroom was reserved for them in the mornings on Wednesdays.

Wendi: So if you didn’t spend time at a general session, civil court, you would just have no reason to know this is going on

Some contours of the story leapt right out. Visible just by looking

Wendi: The racial makeup of the defendants was very telling. Black people were super overrepresented and some of the defendants I talked to would say, you know, it’s nothing but us down there

And another dramatic angle was obvious right away too: The hospital was suing its own employees.

Wendi: Oh you saw them there, in their scrubs. You know, I could see their Methodist, badge clipped to the front of their uniforms.

And the courtroom drama wasn’t exactly a fair fight.

Wendi: The defendants are just outmatched, you know, they don’t have the resources of a, a billion dollar hospital with its own collection agency and attorneys.

Defendants generally didn’t have attorneys at all, and didn’t exactly know their way around the court. On the other hand, the hospital’s attorneys were at THIS court all the time, in front of the same judges, every week. For years. They had an easy rapport.

Wendi: i mean and that’s kind of rapport you would kind of expect to have with somebody you see all the time. But where does that leave the defendants? You know? Um, they’re not going to be up there joking about the colleges they went to or who won a football game that weekend. You know they just, they don’t have that.

And guess who was supposed to pay the attorneys fees? The people being sued. That’s how the system works. The fees just get tacked on to the debt.

Wendi: So they’ll have in there that the hospital bill is $10,000. And so since they charge either 30 or 33%, that bill automatically goes to $13,000.

The starkness of this injustice spoke directly to Wendi Thomas.

Wendi: For the however-long I was living off credit cards, if I would wake up at night and remember it in that just brief moment, I couldn’t go back to sleep. It was stressful. It was stressful as hell. And I can’t imagine what it would be like to do that with children, in a low wage job that there’s just not going to be, there’s just like really no way out.

Wendi: And any kind of minor emergency is just going to throw things into complete chaos. You know, a flat tire, your refrigerator goes out. I mean, a sick child, you know, that you’re having to take to the hospital, a child with special needs that you’re having to miss. I mean, it’s just a lot of people’s lives can be so precarious anyway. And then to have a hospital do this to them? It’s not fair. And I think people get that, that it’s not fair

And this wasn’t just any big institution. It’s a religious institution— and it’s an institution that doesn’t pay any taxes because of its non-profit status.

Wendi: You know, the taxes, they’re not paying to some degree for roads and city infrastructure. The rest of us are paying for that. As tax payers, we’re all subsidizing that. And yeah, that’s pretty noxious as well.

And this was a bigger story than she could do justice to while also bootstrapping MLK 50.

And then, ProPublica— a national non-profit newsroom that specializes in big investigative projects — said it was taking pitches for year-long projects from local reporters. Wendi Thomas pitched them hard.

And that was in fall 2018. ProPublica said yes. It was ON.

Now Wendi Thomas needed something else: She needed defendants to go on the record.

She needed at least one person to be the face of this whole, huge thing.

And finding that someone was super, super hard.

Wendi: So that was probably the most exhausting process.

We’ll hear just how hard it was — and WHY— right after this.

[MIDROLL BREAK]

OK. Wendi Thomas’s search for SOMEBODY to open up and tell their story. Begins with a simple truth.

Wendi: There’s a lot of shame around debt we’ve found. And so people don’t necessarily want to talk about it. Understandably

Week after week, Wendi Thomas went to court, followed people into the hallway, and asked them if they would talk with her.

Lots of people just said no. Others gave her their phone number but never picked up when she called, never answered her texts. Wendi Thomas did NOT give up.

Wendi: I spent several Saturdays where there were people maybe that I’ve met in court who then wouldn’t talk to me and I’d go knock on their door, um, using the last address available in court records. And I would say things like, Oh, you know, I wasn’t sure if your phone got cut off or not, you know, or maybe I had the wrong number. I had the, I had the right number.

Wendi: I’ve left all kinds of handwritten notes in doors, in the hands of relatives who I knew weren’t gonna relay the message, under windshield wipers.

By the time she met Carrie Barrett, in January, Wendi Thomas was getting a little discouraged.

Wendi: After trying to reach out to, I don’t know, 50, 60 people and having so many of them, you know, flame out i mean you just can’t keep getting your hopes up.

DAN: And so Ms Carrie thought you were at an answer to her prayers, and she was kind of answering to yours.

WENDI: Well, I’m not religious so I …

Dan: [laughter]

Wendi: … I’m not, I wasn’t praying, but yeah I was looking for somebody who would cooperate and she made things a lot easier.

Especially because: What Wendi needed was a lot more than for Miss Carrie to just return a phone call.

Wendi: She had to give me a whole lot of information so that I could verify what she was saying was true. So she gave me like, I don’t know, 10 years of tax returns and you know, permission for the hospital to give me a copy of her medical records and her billing statements. You know, I saw her, uh, checking account statements, her car insurance bills, you know, um you want the story to be airtight and your evidence to be unimpeachable

That also meant airtight data about the big picture. And that was no small task.

It meant pulling years’ worth of data on every case in Shelby County, to make sure to find every case involving Methodist. And you can’t get it all in one go— just getting the data from the County was a big job. And then that data’s gotta be CRUNCHED.

Wendi: You have to join those files and then you have to dedupe those files. Um, you have to join plaintiff names. That’s for one year and one year and one file type.

ProPublica helped, and still it took months.

Wendi: I’ve never had children, but it was like what I might imagine, um, birthing a child would be like, cause toward the end, you were just ready to get it out. You know, I was a columnist for 11 years and most of that time I was writing three columns a week. So spending six months on a story? Jeez, Louise!

Finally, in late June. The story came out And it was airtight and it was a blockbuster. The headline said a lot:

The Nonprofit Hospital That Makes Millions, Owns a Collection Agency — I mentioned that part right? They own a collection agency? And Relentlessly Sues the Poor

That story documented 8,300 lawsuits in just five years. Carrie Barrett’s story tied the whole thing together.

And there were follow-ups ready to go. Like the very next day:

Low-Wage Workers: Sued for Unpaid Medical Bills by the Christian Hospital That Employs Them

… which documented 160 cases where Methodist had tried to garnish the wages of its own employees. And the hospital paid some workers as little as 10 dollars and eight cents an hour.

Another story: Methodist Flouts IRS Rules by Not Publicly Posting Financial Assistance Policies

Wendi: The law says you have to have these posted conspicuously.

So she had gone to the emergency rooms for all of Methodist’s locations, walked around and LOOKED. Nothing.

Oh, also: Meet the board of directors. Names, photos, where they worked.

Wendi: You know, getting back to that, the idea that poverty isn’t an accident, it’s a robbery and there are thieves and the thieves names can be known? And so the board members have the authority or had the authority to say: “We’re not — we don’t want these practices to exist. Change them. You know I tried to reach as many of them as I could find phone numbers for before the story published. Nobody would agree to talk. Um, so we found their photos online. I thought that was important. You know, often the people who are struggling to make ends meet, we see their faces, right? We see their black and brown faces, but the faces of the majority white male board, those people are kind of anonymous and I didn’t think they should be anonymous.

That was a good one. And it all got noticed.

Wendi: People were outraged. I think a lot of people in the Methodist church were very disappointed in what the church was doing. I heard from doctors at Methodist who said they had no idea this was happening and they were outraged and took their complaints to the board. You know, the story also got a lot of national attention.

Actually, international attention too.

Wendi Thomas’s first story came out on a Thursday. Over the weekend, the hospital CEO announced that the institution would be reviewing its policies and procedures over the next 30 days.

At the end of that 30 days, the hospital announced a bunch of changes:

It was adopting a more-generous financial aid policy, and it would not sue anybody below a certain income threshold.

It would raise its minimum wage from ten o eight an hour to 13.50 starting in September— and then bump it to 15 dollars an hour by 2021.

And it would no longer take interest or attorneys fees — the kind of charges that had blown Carrie Barrett’s bill up to more than 33 thousand dollars.

Pretty soon, Miss Carrie got a call from the hospital. They were reducing her balance to ten thousand.

And a few weeks later, she says she got another call from a hospital official.

CARRIE BARRETT: And he told me that my balance will be zero balance and he was sorry for what I went through with that. And, um, and I asked him, repeat the, could you repeat that again? And he said, your balance is zero. And sorry for what had happened.

DAN: Wow.

CARRIE BARRETT: And I said, this sounds good to my ears.

CARRIE BARRETT: And so he said I would be getting it in the mail, and I did.

Wendi Thomas heard from another defendant that their case had been dropped too. So she went to the courthouse, to look at the files, see if there were more.

Wendi: And I could see that they were filing, Methodist was filing hundreds of case satisfied notices.

“Case satisfied” — as in, we are dropping this case.

WENDI: So many were coming in that the court couldn’t even process them fast enough. And so, um, a court administrator estimated that there were 2000 notices sitting on a desk and he measured those by, stacking up reams of printer paper to measure the height of these stacks that they had so.

Soon, those stacks got tall enough to bump that estimate to 4500. And you can see a picture of them in the story that MLK 50 published.

Wendi: I mean shame is a powerful motivator. It just is. And, the hospital didn’t look good, so they had to address it

When I met Wendi Thomas about a month after Methodist dropped all those cases she was still processing it.

Wendi: So, yeah, it felt— felt good. It was kind of surreal. You know, it all happens so fast and you’re writing stories and taking calls and still doing reporting on for your next stories. And so I still don’t know if I’ve had a, like a chance just to say like, wow, you know, me and my team, we did that, but it feels good.

WENDI THOMAS: But it had, you know, really, you know, good impact and not just for the people who had their bills, forgiven or reduced now. But for the thousands of people who won’t be sued,

Wendi: Yeah but of course we’re still following up. Right. And so I have a reminder in my phone every two weeks to check court records to make sure they’re not, they haven’t started to sue people again.

Still on the case.

AND: Around Thanksgiving, Wendi Thomas and MLK 50 scored another big victory. She had noticed, by paying attention to court records: The company that employs the ER docs at another big local hospital— Baptist Memorial — had filed thousands of lawsuits against patients, just this year.

She called that company up. And — before Wendi even published a story — they promised to drop those lawsuits. And stop suing patients. And create a new, more-generous discount policy for uninsured patients.

I mean: WOW. WOW. I wrote Wendi Thomas a note, I asked her did she had time to say a few words? Nope, she’s on deadline, had calls to make.

I’m like YEAH. Make those calls.

We will have links to Wendi Thomas’s amazing work at arm-and-a-leg-show, dot com— and in our newsletter!

Which — I’m gonna tell you, given this show’s topic, is AMAZINGLY CHEERFUL. Not even kidding. Also informative and useful.

You can sign up at arm-and-a-leg-show dot com slash newsletter.

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Speaking of holiday season: Next time on An Arm and a Leg, it is Christmas in July. Or maybe it’s July at Christmastime.

Ed Buehler is 40 years old. Every year — every July — since he was born, his family and friends have organized a softball tournament to raise money for a family with big medical expenses.

This year, the tournament raised ten thousand dollars.

ED: I don’t want to say $10,000 is not a lot of money, but when, you know, life is hard and when something’s gotten in your way, $10,000 doesn’t go really, really far.

Especially when the something in your way is a big medical bill. So this year, they decided to do something a lot bigger. You’re going to want to hear all about this.

That’s next time, on An Arm and a Leg.

Till then, take care of yourself.

This episode was produced by me, Dan Weissmann. Our editor is Ann Heppermann, our consulting managing producer is Daisy Rosario. Our music is by Dave Winer and Blue Dot Sessions. Adam Raymonda is our audio wizard.

Special thanks this week to Jay Hancock of Kaiser Health News, Sarah Kliff of the New York Times, and Dr. Marty Makary of Johns Hopkins University. They have ALL done kick-ass reporting this year on hospitals that sue patients. They all took time to talk about that work with me.

This season of An Arm and a Leg is a co-production with Kaiser Health News— a non-profit news service about health care in America that is an editorially-independent program of the Kaiser Family Foundation.

Kaiser Health News is NOT affiliated with Kaiser Permanente, the big health care provider— they share an ancestor, that’s it. This guy Henry J. Kaiser— he had his hands in LOT of different stuff. It’s a fun story— you can check it out at arm and a leg show dot com, slash Kaiser

Diane Webber is National Editor for Broadcast and Taunya English is Senior Editor for Broadcast Innovation at Kaiser Health News— they are editorial liaisons to this show. They are very kind and very smart.

Finally, thank you to some of our new backers on Patreon— You guys are so coming through and I couldn’t make this show without you. If you pledge two bucks a month or more, you get a shout-out right here. Thanks this week to:

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