Kia Franklin

Civil Justice for Uninsured, Overcharged Patients

Cross-posted on OpenLeft.Com:

You know all those lawsuits that conservatives like McCain blame for the high cost of healthcare? You know, the ones that actually have nothing to do with the high cost of healthcare? Well, the fact is that at least one lawsuit has actually reduced health care costs for a group of patients. A recent class action settlement resulted in refunds for low- and middle-income uninsured people who were overcharged for the care they paid for out-of-pocket.

Tuesday’s settlement between patients and St-Louis health care provider BJC is a case-in-point for why our court system is an important and powerful tool that yields real results for real ordinary citizens facing real injustices. Uninsured patients allege that BJC hospitals overcharged them for all or some of their medical treatment, up to three times as much as their insured counterparts; denied uninsured patients access to the charity care that it was required to provide as part of its non-profit status; and used predatory collection practices when patients had trouble making payments.

According to this article:

BJC Healthcare, the area's largest health care system, will provide a 25 percent discount to all hospital patients without insurance under a class-action settlement agreement announced Tuesday. Some uninsured patients treated in the past also may be eligible for refunds or discounts.

Speaking to press, patients in the BJC class action expressed satisfaction:

"All in all, it's a fair agreement," said Dave Kuneman, one of the plaintiffs. "Agreements are never perfect for everyone. It's the best that Barnes and our class can do in the real world."

But this is not just a case in which the civil court system improved a difficult and unfair financial situation for individuals directly involved in the litigation. This case also had some positive reverberating effects on uninsured patients at neighboring health care providers. From the article:

Several area health care systems originally faced similar lawsuits or were threatened with them. Those hospital systems then began discounting prices to uninsured patients more aggressively...

Since then, hospitals across the country and the St. Louis area have made significant changes to their charity care policies…

Chip Robertson, an attorney representing the class, said Tuesday's settlement is a "serious attempt" by BJC to address the problem of the uninsured.

The civil courts are not just important for ensuring that individuals can find justice when they’ve been treated unfairly. Many lawsuits also have secondary effects that benefit whole communities, cities, and even the entire general public. In this way, the civil justice system—the system of public courts where plaintiffs bring these types of disputes—is an empowering tool for ordinary citizens.

Through the civil justice system, ordinary people have helped spark improvements in areas like product safety and medical treatment protocol. Their lawsuits have created incentives for corporations and other powerful entities to avoid litigation by improving the practices that would lead to litigation. In other words, lawsuits force powerful entities like corporations and even government agencies to consider the impact their actions will have on real human beings, and I’m not just talking about the individual human beings who stand to gain financially from the matter.

And why shouldn't lawsuits do this?

Most corporations are driven by the profit motive, not the moral motive. Obviously that doesn't mean corporations willfully go about seeking opportunities to harm people, but it can sometimes mean that human interests conflict with the bottom line. For instance, a corporate polluter may fight litigation because punitive damages would cut into the corporation's profits. It could—and probably would—do this even if the devastation it caused truly warranted a stiff penalty. As the BJC lawsuit demonstrates, sometimes even non-profits are susceptible to this troubling tension.

Through the civil justice system, people can fight for their interest in living free of the harms that are caused when corporations fail to implement human values as they execute predominantly profit-motivated business practices. This is why, especially in light of efforts to limit our access to the courts, it is important to continue the dialogue on how to strengthen the civil justice system.

We should not only point to cases like the BJC settlement as an example of the benefits of civil justice, but we should also ask ourselves how we can improve the civil justice system. How can it be more effective at empowering ordinary citizens who want to defend their basic rights and interests in court?

Kia Franklin: Author Bio | Other Posts
Posted at 12:54 PM, Mar 21, 2008 in Civil Justice | Health Care | Health Insurance
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Jason Grant Garza here ... please google my name and read an article that was written about at this site (TortDeform) and know that I have very personal knowledge about deceptive hospital practices and the illusion of compassion that they espouse. In 2001 I was denied emergency services, went to court and was denied due process ... still, I continued and now have a setlement agreement between the Office of Inspector General and the hospital admitting breaking the law. No one has (other than I) questioned the false representation in federal court. Anyway, after winning I thought I would be treated civilly ... after an admission of guilt (a signed confession ... settlement agreement) ask me if the hospital, Medicare, the federal court system or any other agency has called to make me "whole?" Rather I have been left to die ... if the law didn't have to be followed since they didn't pay for the damage and after a confession still no remedy, restitution, etc ... I have learned that I am dealing with individuals with black hearts instead of red faces ... I am still left to die ... luckily, I am the living dead ... no medical care for 7 years ... I dropped my Medicare for nonperformance and neglience and know that I am healther and better off rather than dealing with others who have no respect for my dignity nor place as a human. Yet they remain in their positions, continue to spout that they care and who knows what type of treatment others are receiving. Hospitals, corporations, cities have "risk management" departments but NEVER believe as the article states that these institutions are not "Bottom line" concerned; yet, as my case clearly and concisely exhibits ... the truth, honor and dignity do not apply. THIS IS WHAT IT IS LIKE TO BE DEAD RIGHT AGAINST THE GOVERNMENT and those allowed by then to be unaccountable, untouchable, and certainly EMPLOYED! I however struggle everyday ... dead right and alone after telling the truth, being denied, and now ... NOTHING!!!

Posted by: Jason Grant Garza | March 21, 2008 10:54 PM

I did google Jason Grant Garza. This guy's a nutjob if ever there was one. I think I'd give my Siamese cats more credibility

Posted by: Responsible for one's own actions | March 22, 2008 9:58 PM

Jason: Apply for free medication here:

It would be brought to you by pharmaceutical companies. They would do so "driven by the moral motive."

Posted by: Supremacy Claus | March 23, 2008 10:17 AM

I am afraid that this lawsuit only resulted in more money for the attorneys. Our hospital averages 11% on the AR of uninsured patients. 89% goes right out the door and is written off. What did this lawsuit do? It does nothing for the charges as the hospital will have to increase its charges in other areas to stay solvent. For what its worth, the best hospitals make a 4% margin when all is said and done.

Just what exactly do you think hospitals should be forced to do for free?

Posted by: throckmorton | March 23, 2008 10:49 AM

throckmorton: you say 89% of the charges are written off. OK. If they were written-off immediately then we wouldn't have a problem. The problem is hospitals bill these inflated charges to uninsured people AND attempt to collect on those "debts", squeezing as much money as they can out of patients, scaring them away from coming back, forcing them into bankruptcy, putting liens on houses, etc. The fact that you only recover 11% of your charges show that it is all a game in the first place. These lawsuits bring hospitals one step back to reality -- making them come closer to imposing reasonable charges in the first place.

Posted by: ctr | March 28, 2008 3:51 PM


I am on the 4th night of my week on call. So far I have seen 23 consults in the emergency room and taken 9 to the OR. 8 are self pay. 4 of these are illegeals.

Now as to how the hospital bills. By contract with Medicare, it can only charge a certain price for those patients covered by that plan. The same is true with all the other insurance contracts. Now how do you recover the cost from those without covereage? It costs the hospital the same amount to treat a pateint regardless of the insurance. Because so many do not pay for their care, that cost is passed on to those who do. As to the 11%, this is well below what is payed by Medicare and the other insurances. The only problem is that it does not cover the cost of the care.

Can you go to a car dealer and say, "I know that you sell a hundred cars to AVIS for this price, (they contract a low price because they buy in bulk), so I think you should sell one to me for 11% of that price? I don't think you will get a car.

What happens in the long run is that hospital tries to get compensated for the care that they give and people recieve. The hospital does write of 89%, the part you don't like is that it tries to collect is the 11%. Just remember, it is those with insurance that end up pating for all those without it.

Posted by: throckmorton | March 28, 2008 6:03 PM

Just finished the week on call. Here are the final totals, 51 consults, 27 uninsured. 22 patients went to the OR. Of the uninsured 9 were illegals or at least those who do not speak English and carry no ID and have no address. Of the 24 that had insurnace 17 were Medicaid or Medicare/Medicaid combinations.

Here is another little tidbit of information. For the hospitals that I cover to break even, they have to be about 93% filled.

Posted by: throckmorton | March 31, 2008 7:36 AM

What gets me is that I try to arrange an affordable payment for medical services I have received and then I am told that they won't take it becuse they want it payed off in 2 installements or some sort of unjustice like that. I think that we should be able to pay what we can afford and not be forced to pay in a certian number of installments. I am seriously thinking of bying some sort of recordering device so that I can prove that they are denying my payments.

I also believe that if potential patients are illegal they should be forced to give a certian amount up front, before they are treated, becuse those of us who have insurance are footing the bill for the illegals. Of course it would help if we ship them back home, close up those borders...

We need some sort of reform on the part of the hospitals and insurance companies...

Posted by: Rebecca | June 17, 2008 2:52 PM

Is $3,000,000.00 to plaintiffs counsel also considered civil justice?

That's what lawsuits are for. Don't pretend it is for anything else.

Posted by: Shirley | June 30, 2008 12:57 PM

I was homeless, between jobs and uninsured. I was sued by this same hospital and my bank account was frozen until I came up with the money for the hospital bill. I borrowed the money from my dying father to pay the bill so my account would be unfrozen. My child support payments, money I saved up to move and my first pay check all were in the bank but it was still not enough. I got 3 payday loans to repay my dad and to pay off the hospital. In the meantime the bank charged me over $500.00 in ISF fees during the freeze on my account. My credit is also jacked up so I can't get a loan to buy a home or put a downpayment on one. This is my first and only judgement against me in my 50 years. This was 3 years ago. I am still suffering the effects of this injustice.

Posted by: temporaryhomeless | September 8, 2008 9:15 AM