NY Times
By Laura Beil | Dec. 2, 2019

CARLSBAD, N.M. — The first time Carlsbad Medical Center sued Misti Price, she was newly divorced and working two jobs to support her three young children.

The hospital demanded payment in 2012 for what Ms. Price recalled as an emergency room visit for one of her children who has asthma. She could not afford a lawyer, and she did not have the money to pay the bill.

Ms. Price let the summons go unanswered, figuring she would settle the balance — with interest, about $3,600 — when she could. A few months later, she opened her paycheck and discovered the hospital had garnished her wages by $870 a month.

Her car was soon repossessed because she could no longer make the payments. She was on the verge of losing her house, too, when her mortgage company stepped in to help her save it.

“I was going to let it go,” Ms. Price said, tearing up recently in an interview at the Carlsbad Public Library. “It was tough.”

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And it was only the beginning. Ms. Price, 40, a nurse and local 4-H leader, has been sued five times by Carlsbad Medical Center, for bills totaling more than $17,000.

It’s not because she and her children are uninsured; according to the hospital, the charges are what she owed after her insurer had paid. But Ms. Price said she had never received an itemized bill outlining exactly what she owed money for. The collection agency wanted the balance in full, and she was not able to work out a payment plan until after she was sued.

In this town, she has a lot of company.

An examination of court records by The New York Times found almost 3,000 lawsuits filed by Carlsbad Medical Center against patients over medical debt since 2015, more than 500 of them through August of this year alone. Few hospitals sue so many patients so often.

Ms. Price’s sister, a police dispatcher, has been sued twice. Her husband has been sued. The county judge who hears many of these cases was once sued, too.

Carlsbad Medical Center is not the only hospital to have filed reams of lawsuits over unpaid bills. In Memphis, Methodist Le Bonheur Healthcare, a nonprofit hospital, filed 8,300 lawsuits from 2014 through 2018, including some against its own employees, according to an investigation by the journalism nonprofit groups ProPublica and MLK50.

In Virginia, hospitals filed more than 20,000 lawsuits over patient debt in 2017 alone, according to a study by researchers at Johns Hopkins University. Just five hospitals accounted for half of the resulting wage garnishments in the state.

People across the country are coping with soaring medical costs, opaque pricing and surprise bills, but these issues are felt acutely in one-hospital towns like Carlsbad, where residents have few options for care — and must pay whatever prices the hospital sets.

“Hospitals that have little competition can negotiate higher rates, because the insurer wants that hospital in their network,” said Sara Collins of the nonprofit Commonwealth Fund. Patient deductibles, which must be paid out of pocket, are rising for almost everyone, she added.

Nationally, more than one in four consumers in 2018 were reported to credit bureaus over unpaid debt, according to the Consumer Financial Protection Bureau. More than half of those reports involved medical bills. One survey of women with breast cancer found that a third of those with health insurance had been referred to bill collectors; among those without insurance, the number rose to 77 percent.

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