Wester runs his own one-man welding business. His income is solidly middle class. And he has a health-insurance policy—albeit one with a $3,000 deductible—to cover himself, his wife Richelle and a teenage daughter. Wester thought the couple's newborn son Hunter would automatically be covered. He thought wrong. That was his first lottery loss.
When 9-month-old Hunter spent 18 days in Sunrise Hospital, where he was treated for a brain aneurysm, the Westers received a bill for $135,000. Bills from other doctors and health-care providers brought the total to $180,000. Wester says he began making payments on the hospital bill, but they weren't enough. Sunrise turned the bill over to a collection agency and then sued. A judge knocked the total bill down to $98,000, which included court costs and attorney fees. An attorney suggested bankruptcy, but then a friend of a friend who worked for a medical-billing company negotiated the collection agency down to a single payment of $40,000. The Westers took out a loan against their house to pay it off. They still owe a second collection agency more than $30,000 for other medical services. "I work my butt off practically every day," says Wester. "I don't buy things I can't afford, and I basically save every penny I have." He drives a truck that's worth less than $1,000, and his wife drives one that's 14 years old.
But wait—isn't it a pretty good deal to cut a hospital bill from $135,000 to $40,000? Maybe in any other field, but not in health care. What the Westers found out is that they had just lost the second lottery. Hospitals everywhere—public, nonprofit institutions as well as private, profit-making ones—routinely charge the uninsured, the people who have no clout, the most. How much more? On average, five times as much, according to K.B. Forbes, a patient-rights advocate who has spent the last three years analyzing and securing reductions in the hospital bills of uninsured working people from California to Florida. In the Westers' case, Forbes found, Medicare would have paid less than $10,000 for comparable services and private insurance carriers would have paid perhaps $18,000—instead of the $40,000 the couple agreed to pay and the $135,000 they were originally charged.
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