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Rural MO Consumers, Hospital Fight To Stay Afloat

Like other hospitals around the country, Poplar Bluff Regional Medical Center in Missouri has been aggressively suing consumers over unpaid bills. This year alone, the medical center has filed more than 1,100 lawsuits in rural Missouri. Cases over unpaid bills have become so common that patients have started referring to the court appearances as “follow-up appointments,” according to The Washington Post.

Consumers, many of whom have insurance, come in to address bills of all sizes. One was sued for just $286, while another owed more than $12,000 after a heart attack. In the courtroom, the judge asks consumers to think of him as a referee, trying to find a fair deal for the consumers and the hospital system. The lawyer for the health system says it is simply trying to get what it is owed.

Behind him in the courtroom were some of Poplar Bluff Regional’s patients — a population that was on average sicker, older, poorer and underinsured compared with the rest of the United States. More than 35 percent of people in Butler County have unpaid medical debt on their credit report, about double the national rate. Most of the 19 people on the morning docket had been treated in the emergency room and then failed to pay their bill for more than 60 days before receiving a summons to court.

Consumers face having their wages garnished or liens placed on their homes, but most say that they cannot afford to pay the bills they have.

“How am I supposed to pay $4,000 to see a doctor if I’m barely making $2,000 a month?” asked another.

In recent years, the hospital’s cost of uncompensated care has increased from around $60 million to $84 million. Rural hospitals report that they have to pay higher salaries to attract qualified talent and have simultaneously lost funding from Medicare and Medicaid compared to urban hospitals.

The $173 million rural hospital in Poplar Bluff, which houses a cancer center, a cardiac center, dozens of specialists, and surgical suites, has survived while others haven’t. Ripley County Memorial hospital, roughly 30 miles away, shuttered six months prior. Patients are now directed to Poplar Bluff’s emergency room.

Many of those same consumers later find themselves coming in the courtroom. The suits are so systemic that even the Judge’s wife has been summoned before. On this day, like so many others, he has been working through a full docket of Poplar Bluff cases.

“How are we all doing today?” he asked, as he looked down at a docket with 14 more cases between a hospital ownership company that couldn’t afford to keep losing money and patients who couldn’t afford to pay. Both sides were drowning in debt, fighting to stay above water, and pulling each other back down.

“It’s another full docket,” the judge said. “We might as well get started.”


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