Get Sick, Go To Jail
December 11, 2019 6:24 AM Subscribe
“ In jurisdictions with lax laws and willing judges, jail is the logical endpoint of a system that has automated the steps from high bills to debt to court, and that has given collectors power that is often unchecked. I spent several weeks this summer in Coffeyville, reviewing court files, talking to dozens of patients and interviewing those who had sued them. Though the district does not track how many of these cases end in arrest, I found more than 30 warrants issued against medical debt defendants. At least 11 people were jailed in the past year alone.” Welcome to Coffeyville, Kansas, where the judge has no law degree, debt collectors get a cut of the bail, and Americans are watching their lives — and liberty — disappear in the pursuit of medical debt collection. (ProPublica)
Can’t read it... it’s just too horrifying
posted by growabrain at 6:40 AM on December 11, 2019 [4 favorites]
posted by growabrain at 6:40 AM on December 11, 2019 [4 favorites]
Today Explained did a podcast on this with the author.
posted by googly at 6:56 AM on December 11, 2019 [1 favorite]
posted by googly at 6:56 AM on December 11, 2019 [1 favorite]
You may not like it, but this is what peak liberty looks like.
posted by acb at 6:57 AM on December 11, 2019 [28 favorites]
posted by acb at 6:57 AM on December 11, 2019 [28 favorites]
Flagged for Death of America.
(as I sit here, sipping a small bottle of my child's last azithromycin prescription; due to an infected badly hangnail and swollen puss filled pinkie; simply not wanting to mess with even going to a doctor; and not wanting to have to more or less spend more money on meds; and yeah. We're doomed.)
posted by buzzman at 6:59 AM on December 11, 2019 [2 favorites]
(as I sit here, sipping a small bottle of my child's last azithromycin prescription; due to an infected badly hangnail and swollen puss filled pinkie; simply not wanting to mess with even going to a doctor; and not wanting to have to more or less spend more money on meds; and yeah. We're doomed.)
posted by buzzman at 6:59 AM on December 11, 2019 [2 favorites]
Scenes From the Ragged Edge of American Health Care: At a Remote Area Medical clinic outside the nation's capital, doctors treat those who have fallen through the cracks in the system.
posted by The Whelk at 7:20 AM on December 11, 2019 [2 favorites]
posted by The Whelk at 7:20 AM on December 11, 2019 [2 favorites]
But, you know, healthcare reform is just a hobby horse for bougie white men and The Market can absolutely have a place in it.
posted by Reyturner at 7:22 AM on December 11, 2019 [6 favorites]
posted by Reyturner at 7:22 AM on December 11, 2019 [6 favorites]
What the fuck is wrong with Kansas? IIRC the long and short of the answer in the book of the same name was unfettered conservatism and republicans gone wild.
Hassenplug started collecting for doctors, dentists and veterinarians, but also banks and lumber yards and cities. He recognized that medical providers weren’t being compensated for their services, and he was maddened by a “welfare mentality,” as he called it, that allowed patients to dodge bills. “Their attitude a lot of times is, ‘I’m a single mom and … I’m disabled and,’ and the ‘and’ means ‘the rules don’t apply to me.’ I think the rules apply to everybody,” he told me.
This guy is somehow even worse than the asshole cattle rancher turned extremely shitty judge. This guy is literally going as far out of his way as he can just to attack poor people. Not even in the usual republican way where they pretend to be attacking some mysterious third thing that just so happens to consist of poor and minorities every time, he is explicit. He hates poor people and wants to see them suffer, it brings him pleasure to not mind his own fucking business and try to shakedown the poorest people in need of assistance.
I don't get evil minds like Hassenplug, and I would say I have an extremely classist and evil mind, the tyranny of wealth to me can only be solved with both figurative and literal guillotines. Still, I manage to not actively try and get rich people killed. Hassenplug is intentionally trying to get people killed. He isn't the sort of person I want in my country or planet.
posted by GoblinHoney at 7:23 AM on December 11, 2019 [35 favorites]
Hassenplug started collecting for doctors, dentists and veterinarians, but also banks and lumber yards and cities. He recognized that medical providers weren’t being compensated for their services, and he was maddened by a “welfare mentality,” as he called it, that allowed patients to dodge bills. “Their attitude a lot of times is, ‘I’m a single mom and … I’m disabled and,’ and the ‘and’ means ‘the rules don’t apply to me.’ I think the rules apply to everybody,” he told me.
This guy is somehow even worse than the asshole cattle rancher turned extremely shitty judge. This guy is literally going as far out of his way as he can just to attack poor people. Not even in the usual republican way where they pretend to be attacking some mysterious third thing that just so happens to consist of poor and minorities every time, he is explicit. He hates poor people and wants to see them suffer, it brings him pleasure to not mind his own fucking business and try to shakedown the poorest people in need of assistance.
I don't get evil minds like Hassenplug, and I would say I have an extremely classist and evil mind, the tyranny of wealth to me can only be solved with both figurative and literal guillotines. Still, I manage to not actively try and get rich people killed. Hassenplug is intentionally trying to get people killed. He isn't the sort of person I want in my country or planet.
posted by GoblinHoney at 7:23 AM on December 11, 2019 [35 favorites]
Salt Lake Tribune did a very very similar story the other day on payday loan companies and arresting people to collect debts. I can’t read this one because the last one made my blood boil so badly.
posted by azpenguin at 7:30 AM on December 11, 2019 [4 favorites]
posted by azpenguin at 7:30 AM on December 11, 2019 [4 favorites]
There is no law requiring that a court use civil contempt when an order isn’t followed, but judges in the U.S. can choose to, whether it’s to force a defendant to pay child support, for example, or show up at a hearing. A person jailed for defying a court order is generally released when they comply.OK, capitalism, you had a good run, but it's time to pack it up and head home. Guillotines will be dispensed on the way out; please form an orderly line to the right.
posted by Mayor West at 7:41 AM on December 11, 2019 [5 favorites]
He hates poor people and wants to see them suffer, it brings him pleasure to not mind his own fucking business and try to shakedown the poorest people in need of assistance.
This is the end point of the "zealotous representation" argument - he does this because he is "obligated" to by his "duty" to his clients.
At least, that's the lie he tells himself to sleep at night.
This is why the legal profession has a massive ethics void - it refuses to consider that there need to be ethical limits to what the profession does for their clients.
posted by NoxAeternum at 7:44 AM on December 11, 2019 [13 favorites]
This is the end point of the "zealotous representation" argument - he does this because he is "obligated" to by his "duty" to his clients.
At least, that's the lie he tells himself to sleep at night.
This is why the legal profession has a massive ethics void - it refuses to consider that there need to be ethical limits to what the profession does for their clients.
posted by NoxAeternum at 7:44 AM on December 11, 2019 [13 favorites]
At least Kansas isn't a state with Filial Responsibility laws on the books.
posted by Thorzdad at 7:53 AM on December 11, 2019 [3 favorites]
posted by Thorzdad at 7:53 AM on December 11, 2019 [3 favorites]
Yet.
posted by avalonian at 7:59 AM on December 11, 2019 [6 favorites]
posted by avalonian at 7:59 AM on December 11, 2019 [6 favorites]
Salt Lake Tribune did a very very similar story the other day on payday loan companies and arresting people to collect debts. I can’t read this one because the last one made my blood boil so badly.
Wow, even Florida, whose Legislature has an unbridled and very open hatred for the poor, explicitly wrote the payday lending laws to make it impossible to jail people for not paying. (At least within the law) Had they not, the hot check laws would apply and people would be even more fucked.
posted by wierdo at 8:47 AM on December 11, 2019 [5 favorites]
Wow, even Florida, whose Legislature has an unbridled and very open hatred for the poor, explicitly wrote the payday lending laws to make it impossible to jail people for not paying. (At least within the law) Had they not, the hot check laws would apply and people would be even more fucked.
posted by wierdo at 8:47 AM on December 11, 2019 [5 favorites]
At least Kansas isn't a state with Filial Responsibility laws on the books.
Oh apparently my state does. Great. Guess I'll be leaving.
posted by Young Kullervo at 9:44 AM on December 11, 2019
Oh apparently my state does. Great. Guess I'll be leaving.
posted by Young Kullervo at 9:44 AM on December 11, 2019
One thing you’ll read about in this article are huge ambulance bills. One way people are getting around this is to take a ride share to the emergency room. One study from 2017 found that when Uber entered a market ambulance usage dropped by 7%. This is fine.
posted by misterpatrick at 9:47 AM on December 11, 2019 [10 favorites]
posted by misterpatrick at 9:47 AM on December 11, 2019 [10 favorites]
One thing you’ll read about in this article are huge ambulance bills. One way people are getting around this is to take a ride share to the emergency room. One study from 2017 found that when Uber entered a market ambulance usage dropped by 7%. This is fine.
No, no, it's cool, this is all just the free market optimizing things for people. And I'm sure there are plenty of other ways to drive down the costs of health care. Maybe next we can start a crowd-sourced emergent-care service. If you've got a sewing kit, a pair of latex gloves, and once watched a few episodes of ER, our app will match you with a gravely wounded person near you!
posted by Mayor West at 10:00 AM on December 11, 2019 [8 favorites]
No, no, it's cool, this is all just the free market optimizing things for people. And I'm sure there are plenty of other ways to drive down the costs of health care. Maybe next we can start a crowd-sourced emergent-care service. If you've got a sewing kit, a pair of latex gloves, and once watched a few episodes of ER, our app will match you with a gravely wounded person near you!
posted by Mayor West at 10:00 AM on December 11, 2019 [8 favorites]
If you've got a sewing kit, a pair of latex gloves, and once watched a few episodes of ER, our app will match you with a gravely wounded person near you!
Psshhh I fixed my own A/C just fine. Just give me some wire and a YouTube tutorial and I'll do it.
posted by Young Kullervo at 10:12 AM on December 11, 2019 [2 favorites]
Psshhh I fixed my own A/C just fine. Just give me some wire and a YouTube tutorial and I'll do it.
posted by Young Kullervo at 10:12 AM on December 11, 2019 [2 favorites]
The world sure is looking Dickensian this holiday season.
posted by MrVisible at 10:20 AM on December 11, 2019 [8 favorites]
posted by MrVisible at 10:20 AM on December 11, 2019 [8 favorites]
I didn’t see the names of any of the physicians or other creditors behind these debts in the article; I know I would be appalled to see the families of my patients treated like this over unpaid bills.
posted by TedW at 10:33 AM on December 11, 2019 [7 favorites]
posted by TedW at 10:33 AM on December 11, 2019 [7 favorites]
Note that most of this medical debt wouldn't even exist if Kansas had simply accepted the free federal money to implement the Obamacare Medicaid expansion. All of these people's medical care would have been 100% covered by federal money. It wouldn't have cost Kansas a dime.
So why didn't Kansas and other Republican controlled states accept this free money? Just one reason. Pure unadulterated meanness and spite for poor people. It would have cost them nothing.
posted by JackFlash at 10:45 AM on December 11, 2019 [46 favorites]
So why didn't Kansas and other Republican controlled states accept this free money? Just one reason. Pure unadulterated meanness and spite for poor people. It would have cost them nothing.
posted by JackFlash at 10:45 AM on December 11, 2019 [46 favorites]
So, to protect the profits of insurance companies* and other parasites, we have reinstated debtor's prisons. This is not amusing in the least, let alone any shade of hilarious.
* By refusing to enact single payer health care.
posted by Kirth Gerson at 10:47 AM on December 11, 2019 [5 favorites]
* By refusing to enact single payer health care.
posted by Kirth Gerson at 10:47 AM on December 11, 2019 [5 favorites]
I have a sneaking suspicion that court rules are being ignored in these cases, which is very common when the debtor doesn't show up, especially in small courts that lack professional judges. All too often, service is faked and letters are intentionally misaddressed precisely so that it becomes impossible to contest without the means to pay an attorney in advance.
The debt collectors know that the file will receive no scrutiny, so they cheat, safe in the knowledge that the worst that will happen is that the tap will be shut off at some point in the future. Since there is no real penalty for abuse, it's pretty much standard practice at this point.
posted by wierdo at 11:06 AM on December 11, 2019 [9 favorites]
The debt collectors know that the file will receive no scrutiny, so they cheat, safe in the knowledge that the worst that will happen is that the tap will be shut off at some point in the future. Since there is no real penalty for abuse, it's pretty much standard practice at this point.
posted by wierdo at 11:06 AM on December 11, 2019 [9 favorites]
What do the insurance companies get out of sending people to jail?
posted by clawsoon at 1:02 PM on December 11, 2019
posted by clawsoon at 1:02 PM on December 11, 2019
Well, if the insurance company is an arm of UltraMegaCorp, one of whose other arms owns the prison...
posted by axiom at 1:31 PM on December 11, 2019 [2 favorites]
posted by axiom at 1:31 PM on December 11, 2019 [2 favorites]
The absence of single-payer allows the insurance companies to continue skimming billions of dollars off the healthcare industry. Sending people to jail for failing to put additional money into that industry keeps the actual health care providers from revolting against the industry racket, because they get paid more often.
posted by Kirth Gerson at 1:37 PM on December 11, 2019 [1 favorite]
posted by Kirth Gerson at 1:37 PM on December 11, 2019 [1 favorite]
What do the insurance companies get out of sending people to jail?
Off the top of my head:
a warning to anyone that doesn't have insurance
reinforces the belief that medical care costs the amount that's billed
a precedent for any money the insurance companies need to recoup from debtors
posted by avalonian at 1:42 PM on December 11, 2019 [5 favorites]
Off the top of my head:
a warning to anyone that doesn't have insurance
reinforces the belief that medical care costs the amount that's billed
a precedent for any money the insurance companies need to recoup from debtors
posted by avalonian at 1:42 PM on December 11, 2019 [5 favorites]
What the fuck is wrong with Kansas?
Simply put: the country isn't creating new ghost towns anymore. Any place that ever collected sales tax feels it has a right to exist for eternity, it would seem, even if they have to put the screws to their own residents.
posted by rhizome at 1:55 PM on December 11, 2019 [9 favorites]
Simply put: the country isn't creating new ghost towns anymore. Any place that ever collected sales tax feels it has a right to exist for eternity, it would seem, even if they have to put the screws to their own residents.
posted by rhizome at 1:55 PM on December 11, 2019 [9 favorites]
That’s a gross oversimplification. Coffeyville is, at 10k+ inhabitants, the largest town in the County. Don’t underestimate how much the state government has been willing to stomp on its own constituents’ faces in order to appease small government plutocracy. Saying these people are poorly off because everyone should have left a long time ago is inaccurate and unsympathetic.
posted by q*ben at 3:12 PM on December 11, 2019 [7 favorites]
posted by q*ben at 3:12 PM on December 11, 2019 [7 favorites]
"What do the insurance companies get out of sending people to jail?"
In the article it explains that when a person it bailed out of jail, the bail money is not returned to the patient/defendant. Instead the judge awards it to the creditor to pay down the debt. Basically, the court literally holds people hostage until a loved one pays off a chunk of their debt.
posted by Garm at 3:33 PM on December 11, 2019 [10 favorites]
In the article it explains that when a person it bailed out of jail, the bail money is not returned to the patient/defendant. Instead the judge awards it to the creditor to pay down the debt. Basically, the court literally holds people hostage until a loved one pays off a chunk of their debt.
posted by Garm at 3:33 PM on December 11, 2019 [10 favorites]
How can I keep my twirly mustache groomed professionally every week if I can’t use the prospect of losing health insurance to keep my employees overworked and underpaid? If I have to pay higher taxes and wages; I won’t be able to afford it. I’ll have to cut back somewhere. Will no one think of the mustache groomers!!!!
posted by interogative mood at 8:11 PM on December 11, 2019 [1 favorite]
posted by interogative mood at 8:11 PM on December 11, 2019 [1 favorite]
“I was a much more pro-debtor aligned judge, much more sympathetic, much less inclined to do anything that I thought would burden them,” he told me. “And over the years, I’ve gradually moved to the other side of the fulcrum. I still consider myself very much in the middle, and I don’t know if I am or not.”
If you send someone to jail over medical debt, you are very much not in the middle.
posted by xedrik at 6:47 AM on December 12, 2019 [7 favorites]
If you send someone to jail over medical debt, you are very much not in the middle.
posted by xedrik at 6:47 AM on December 12, 2019 [7 favorites]
That’s a gross oversimplification. Coffeyville is, at 10k+ inhabitants, the largest town in the County.
Yeah, I had looked that up. Thing is, the county has like 32K over 600 sq mi. There are a few cities of 2K, a bunch between 100-500, and still more in the double-digits. This is just clicking on the cities big enough to have their names on the Google map of the county! Not a legal document, but you get the idea. Lots of gas station towns along freeways with a smattering of preserved cabins and other frontier relics. More oversimplification, but I think there's something to my view.
Cars probably dictate a major portion of the survivability of these towns, there can't be 500 miles between stops like there used to be in the carriage days, and I don't know what to do about that. Unattended stations I suppose, but then we're in Amazon territory, which is a whole 'nother set of issues. And even so, in Montgomery County, which looks to be about 25mi x 25mi, one gas station could probably do.
posted by rhizome at 1:43 PM on December 12, 2019
Yeah, I had looked that up. Thing is, the county has like 32K over 600 sq mi. There are a few cities of 2K, a bunch between 100-500, and still more in the double-digits. This is just clicking on the cities big enough to have their names on the Google map of the county! Not a legal document, but you get the idea. Lots of gas station towns along freeways with a smattering of preserved cabins and other frontier relics. More oversimplification, but I think there's something to my view.
Cars probably dictate a major portion of the survivability of these towns, there can't be 500 miles between stops like there used to be in the carriage days, and I don't know what to do about that. Unattended stations I suppose, but then we're in Amazon territory, which is a whole 'nother set of issues. And even so, in Montgomery County, which looks to be about 25mi x 25mi, one gas station could probably do.
posted by rhizome at 1:43 PM on December 12, 2019
> JackFlash: So why didn't Kansas and other Republican controlled states accept this free money? Just one reason. Pure unadulterated meanness and spite for poor people. It would have cost them nothing.
Maine did the same thing with a mini-Trump governor. A large quantity of federal money was kept out of the state, money that would have been spent paying doctors, hospitals, pharmacies, that would have boosted bthe entire state economy. Some of those costs were incurred but not paid for by people who were broke. So it costs the state a fair amount in economic terms, just to fuck over poor and non-wealthy people. I'm pretty fucking tired of this nonsense.
posted by theora55 at 1:33 PM on December 16, 2019 [2 favorites]
Maine did the same thing with a mini-Trump governor. A large quantity of federal money was kept out of the state, money that would have been spent paying doctors, hospitals, pharmacies, that would have boosted bthe entire state economy. Some of those costs were incurred but not paid for by people who were broke. So it costs the state a fair amount in economic terms, just to fuck over poor and non-wealthy people. I'm pretty fucking tired of this nonsense.
posted by theora55 at 1:33 PM on December 16, 2019 [2 favorites]
theora55: So it costs the state a fair amount in economic terms, just to fuck over poor and non-wealthy people.
Wasn't there a book that came out a couple of years ago which argued that poor countries are poor because their rulers would rather be richer than everybody else than be rich along with everybody else, and that it's a very difficult trap to get out of once you've fallen into it?
posted by clawsoon at 3:51 PM on December 16, 2019 [1 favorite]
Wasn't there a book that came out a couple of years ago which argued that poor countries are poor because their rulers would rather be richer than everybody else than be rich along with everybody else, and that it's a very difficult trap to get out of once you've fallen into it?
posted by clawsoon at 3:51 PM on December 16, 2019 [1 favorite]
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posted by JohnFromGR at 6:38 AM on December 11, 2019 [8 favorites]