NC State Treasurer Held Hearing on Medical Debt De-Weaponization Act - TribPapers

NC State Treasurer Held Hearing on Medical Debt De-Weaponization Act

NC Treasurer Dale Folwell and Brevard Mayor Maureen Copelof listen as medical professionals and patients families tell their stories. Staff photo.

Asheville – It seems like you can’t turn anywhere lately without seeing a derogatory story about our local hospital system, lawsuits from City of Asheville, Buncombe County, and EMS, doctors leaving in droves, serious nursing shortages, lowered patient care standards, but now you can add to the mix a possibility of predatory pricing, Medicare fraud, and unethical collections practices. These allegations aren’t just local either, they are being looked into across the state of North Carolina.

NC State Treasurer Folwell Gets Involved

It’s become such a huge problem that NC State Treasurer, Dale Folwell, CPA, is leading the charge to combat these practices and help those harmed. As the NC Treasurer, it falls to Folwell to oversee the State Health Plan (SHP), which provides health care coverage to nearly 750,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees, and their dependents. It is the largest purchaser of health care and prescription drugs in North Carolina. Falwell stated, “One of my responsibilities as the keeper of the public purse is to provide healthcare and pharmaceutical benefits to those who teach, protect, and otherwise serve. The reason that’s important is that our state health plan has one of the largest unfunded healthcare liabilities in the United States. When I was sworn in, it was $32 billion. What does an unfunded liability have to do with medical debt de-weaponization? It all connects. Whether it’s the supply of healthcare, the quality of healthcare, access to healthcare, the price of healthcare, the secretiveness of healthcare, or the weaponization of a person’s credit score as it relates to healthcare, It all connects.”

Public Hearing on De-weaponizing Medical Debt

On Wednesday, Sept. 7, Treasurer Folwell held a public hearing at AB Tech, ironically at the Mission Health/A-B Tech Conference Center, on the Medical Debt De-Weaponization Act (House Bill 1039), introduced by Rep. Ed Goodwin (R-Chowan), Rep. Howard Hunter (D-Hertford), Rep. Bobby Hanig (R-Currituck), and Rep. Billy Richardson (D-Cumberland). The legislation would create a pro-family, anti-poverty, consumer protection law that sets parameters around the provision of charity care and limits the ability of large medical facilities to charge unreasonable interest rates and employ unfair tactics in debt collection. It would strengthen patients’ access to transparent prices and bring some accountability to medical billing.

Treasurer Folwell was joined at the hearing by Brevard Mayor Maureen Copelof and Dr. Mitchell Li of Take Medicine Back, as well as patients and community advocates. They listened to patients’ stories about medical billing, health professionals who have left Mission and are advocating for patients, family horror stories, and they discussed the need for accountability and patient protections.

NC Hospitals Made Massive Profits from COVID

We’ve heard a lot in the news about how hospitals were struggling during the pandemic, but according to a new peer-reviewed study by the State Health Plan, the largest hospitals in North Carolina reaped billions in profits during the pandemic while patients and rural hospitals suffered.

A press release from the Treasurer’s office stated, “North Carolina is one of the most unaffordable and monopolistic states in the nation for health care. Medical debt is crippling North Carolinians. One in five families is in medical debt collection. Workers lose 20% of their paycheck to health care costs on average. Nearly 40% of Americans reported cutting back on food, utilities, or gas to pay health care bills. Health care costs drove almost half of adults to report delaying or skipping necessary medical care.

“The stories we hear are heartbreaking,” Treasurer Folwell said, adding, “Everyone knows that something is wrong, especially in Western North Carolina.” According to Treasurer Folwell, “Many hospitals in North Carolina have failed to equal their tax exemption with charity care spending,” which helps the underinsured and uninsured. Instead, some hospitals billed $149 million to poor patients – or encouraged patients to open “medical credit cards” that can charge up to 18% interest on medical debt. Hospitals have even sued more than 1,000 patients for medical debt, including during the pandemic.”

Mayor Maureen Copelof of Brevard

Brevard Mayor Copelof, who has started a new lawsuit against HCA for the City of Brevard, spoke about hospitals asking people to pay their entire annual deductible up front before getting medical help, even though many people don’t ever reach their whole deductible; charges for services that were never done; and billing patients directly and threatening collections without submitting bills to insurance or Medicare/Medicaid.

At first, Copelof thought the stories people were telling her were just due to errors in billing, but when three people came to her in the same week with the same story, she realized it was a much larger issue. “Healthcare is one of the most critical things that every elected official needs to get involved with,” said Mayor Copelof. “Your stories are heartbreaking. I listen to them, and I say, “How in God’s name did we get to where we are right now?” It’s unbelievable.”

Errors and Uneven Pricing

On the North Carolina Retired Governmental Employees’ Association website it states that 80% of medical bills contain errors, that knee replacement costs can vary from less than $30,000 to more than $80,000, depending on where you go, but patients can’t find that information easily, “because most hospitals still haven’t fully complied with federal price transparency rules, hiding prices from patients…Worse, nothing protects family members from debt collectors. Both hospitals and nursing homes can pursue spouses and children for unpaid medical bills in North Carolina.” North Carolina currently ranks in the bottom half of states for consumer protections.

There are almost 50 bill sponsors from both parties supporting House Bill 1039. If lawmakers pass the Medical Debt De-Weaponization Act, North Carolina will jump to second place in the nation for protections against medical debt.

Dr. Mitchell Li

Dr. Mitchell Li is a North Carolina-based board-certified Emergency Medicine physician and founder of Thrive Direct Care subscription-based practice, which provides access to a primary care physician for an affordable monthly fee. Dr. Li is also the founder of TAKE MEDICINE BACK, an advocacy organization educating the American public regarding corporate takeover of U.S. medical profession and the resulting systemic financial exploitation of patients. “Our healthcare system is in crisis. Recently we’ve had covid as an excuse, used by opportunists to accelerate everything that was bad about the healthcare system, along with the addition of private equity firms, and extreme corporatization and monopolies. We don’t have locally accountable healthcare. The reason you don’t hear a lot of physicians speaking out is because their livelihoods are at risk. If you bring up an inconvenient truth, like patient safety is at risk, you will find yourself off the schedule because you are no longer a good fit for the culture of the organization. They have a silencing operation to silence physicians and healthcare workers.

Is there a solution? 

“How do we get around this? Dr Li and others have Direct Primary Care (DPC) practices, memberships. Li Explained, “What I have seen in my direct care practice is, we all think healthcare is extraordinarily expensive, it’s actually not. That’s part of the scam. Most healthcare is extraordinarily affordable. Asheville has a robust DPC community. We have transparent rates for patients and we get them the best prices, even without insurance. The labs and medication are cheaper paying cash than you are going to get with a co-pay with Blue Cross/Blue Shield.” Dr. Li then used the example of an MRI, “You think you’re lucky that you have insurance because that was a $10,000 MRI and now you’re only paying $1,000 because you had insurance. That’s all a joke, because I get the MRI for $300 bucks, with no insurance. It probably sounds unbelievable because they have peddled this lie for that long. We need to tell the real story.”