Pay your health bills or go to jail

There is a man well-known in footballing circles who still owes more than $12,000 for medical procedures related to his diabetes.  

There is a 42-year-old mother of five from Warwick who owes hundreds of thousands thanks to her brain tumor-related medical expenses. 

There is a 24-year-old mother who pays $100 a month because she gave birth to two children while uninsured.

The trio share a problem: They have all been to court over failure to pay medical bills. They have, in a sense, fallen through the cracks of the health care system. They were either uninsured or had ailments that the government-offered insurance plan — colloquially known as HIP — wouldn’t cover and now they are wrangling with debt they had not planned for.

The two mothers were even hauled off to jail; the former footballer was not — he credits his standing in the community with keeping him out of the clink.

Unemployment often plays a factor in these situations. Sometimes their medical problems makes it harder for them to be employed, which of course make it harder for them to get out from under their debt. A vicious cycle.

Sheelagh Cooper, the chairwoman of The Coalition for the Protection of Children, says her organization routinely encounters women who “are threatened with incarceration for debt incurred as a result of medical bills… These bills have been incurred either because the women are uninsured or have had to visit a doctor more than the four times in a year that HIP covers,” she said. 

Sometimes, said Ms. Cooper, the debts are incurred because of sick children who are referred to a specialist; the clinic and the hospital are free for the children but visits to specialists can entail out-of-pocket expenses.

“This situation is made worse by the number of newly-unemployed and thus uninsured individuals,” Ms. Cooper said.

Despite the coalition’s best efforts, there are scores of women whose situation is so dire they are incarcerated, Ms Cooper added.

“I will say that we have seen of late an increased awareness by the courts to take into account a woman’s genuine inability to pay but by the time the matter reaches court often the interest charged by the debt collectors has as much as doubled or tripled the original bill,” Ms Cooper said.

Ms Cooper recalls one woman who had been jailed for a medical bill that was less than $500. The father of the woman’s children owed her $70,000 in child support.

“Technically, the imprisonment is not for debt but for contempt of court, but that masks the reality and allows the practice to continue,” said Cooper.

One local attorney has said that the practice of incarcerating people in jail over medical bills may violate a UN charter that deals with global human rights. That same attorney, however, says he has spoken with corrections officers who say that incarceration can be effective; it sometimes “shocks” the individual into realizing they need to pay and their family usually comes forward with a sum that begins to alleviate the debt. 

Last week, Dr Christopher L. Johnson, a plastic and reconstructive surgeon, laid the blame for cash-strapped patients being dragged to court and in some instances jail squarely on the Bermuda Hospitals Board, something the board rejects, saying that patients are offered financial options and that no individual is denied medical care because of the inability to pay.

The debt for two child births for the 24-year-old woman topped $16,000.

She was uninsured at the time; she had been taken off her father’s insurance and was unemployed. In hindsight, she said she wishes she had procured insurance.

When the bills piled up and she couldn’t pay, she was taken to court, and ultimately to jail for less than a day; she estimates she was incarcerated between six and eight hours.

“It felt wrong, it really hurts, and at the end of the day, not everyone has insurance. I didn’t expect to get sent to the Co-Ed for this. There are no jobs out there for young mothers as it is,” she said.

The mother from Warwick with problems stemming from a brain tumor says she has been to court at least six times and been thrown in jail on numerous times for her medical debt.

“It’s always the same thing, I can’t pay anything,” she said through tears recently.

She says she needs more medical attention but wouldn’t be able to afford the bills. 

As it is right now, she worries about being evicted from her apartment.

The former footballer had two jobs in recent months, but was let go from both. In both instances, he was told it just wasn’t working out. His medical problem has employers thinking he is unemployable, he says.

“I’m equipped to do something, I just need a chance,” he said. “I’m not trying to owe people money. I’ve never had to go to court for not paying bills before.”

He added, “You’re coming home and you’re worried about: who is going to subpoena me today?” 

What do you think? Does the system work or is it too tough on people? Comment below or e-mail feedback to reporter Danny McDonald: 
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