“They take a humanitarian approach to payment plans,” says state Rep. Steve Doyle, D-Onalaska, of Credit Bureau Data, Inc., the debt collection agency he represents as an attorney, often on behalf of Gundersen Health System.
Doyle has taken flak recently from a local conservative blog that highlighted his part in suing people in the La Crosse courts for Gundersen, a frequent client of Credit Bureau Data. But Doyle does not regret his role in collecting medical debt, which he said often results in a positive outcome for all parties.
“A lot of the time, people shake our hands and thank us for working out something they can live with, that’s the goal,” he said.
Gundersen, a billion-dollar nonprofit healthcare system, took at least 326 people to court in La Crosse County alone in 2018 to recoup $721,000 in medical debt, sometimes for amounts totaling less than $1,000, and occasionally from its own employees. The numbers come from public court records.
“Yes Gundersen is a large entity, but if a person doesn’t pay, somebody else is going to pay instead,” Doyle said. “It doesn’t help anybody if they’re spending money litigating these things, you know spending legal fees and everything else to take a matter to the court.”
In a 2016 report, Gundersen was named as the most profitable hospital in the nation, although it is technically a nonprofit. The study looked at net income from patient care service to measure profitability. By that measure, Gundersen “collected $302.5 million, or $4,241 per patient” to earn top spot in the study.
According to Doyle, most cases taken on by Credit Bureau Data are settled amicably, often before he gets involved. Gundersen first tries to work out a plan to recover the debt with their patient and “if that goes nowhere, that normally means the person is ignoring it,” he said. In that case, Gundersen sometimes hires Credit Bureau Data, which is Doyle’s client. He said the debt collectors will try and work out a payment plan, and if that fails he’ll send a demand letter, with the final option being a date in court.
Doyle said he does not make decisions on who Credit Bureau Data’s clients are, or who Gundersen decides to pursue for debt. Only a “tiny, tiny” percentage of cases result in a court hearing, he said, although that percentage still amounts to hundreds of people in La Crosse County being sued in a typical year for medical debt. In many instances, wages are garnished to collect that debt.
In 2018, the most recent year for which public records are available, Gundersen reported a surplus of over $117 million for its La Crosse hospital. That figure may be much lower for 2020, as covid led to elective procedures being canceled for part of the year, hitting hospital revenue.
“Gundersen has not taken any cases to court since April, with the pandemic they have completely backed off of suing people,” Doyle said. “I don’t know when or if that will change in the future.”
An unsustainable system
Although Doyle does not see his work suing people for medical debt as a mistake, he does think the fact there is so much medical debt is an issue, and he believes healthcare providers have the same view.
“I think even the medical providers would unanimously say it is not a good situation to have to pursue people for money,” said Doyle. “We should not be in a situation were poor people have a different level of health care than more well-to-do people, it’s not sustainable.”
La Crosse Mayor Tim Kabat in August called on Gundersen to stop sending medical debt to collections, noting it was a problem that affected “our most vulnerable low-income neighbors.” The mayor made his statement in response to a call from SEIU Healthcare Wisconsin for Gundersen to stop suing its own employees, some of whom are represented by the union.
Doyle has voted repeatedly for Wisconsin to accept increased Medicaid funding from the federal government as part of the Affordable Care Act, a move that has been blocked by Republicans, and would significantly expand healthcare coverage in the state. But, an expansion of Medicaid (known as BadgerCare in Wisconsin) would not address the underlying cost issues in the system that leave many unable to pay their medical bills.
In countries with single-payer or other forms of genuinely universal healthcare, the kind of medical debt issues Doyle sees in court are virtually unheard of. He said he could support a Medicare for All style system, but isn’t sure it would be the best option.
“I favor a plan that will get everyone covered, I just don’t know what that plan is, whether its Obamacare or Medicare for All I couldn’t tell you, but I support doing something rather than nothing,” he said.
Wisconsin Spotlight, a right-wing organization, and Coulee Conservatives, both recently published stories on Doyle’s work suing for medical debt. Both suggested that Doyle’s wife Gloria, who is a La Crosse County Circuit Judge, had presided over some of the Gundersen cases on which Doyle worked. That is incorrect.
“There’s a firm line, I can’t practice in front of her. She never has any of my cases,” Doyle said. “She has never, ever handled a single case of mine.”
By Eric Timmons. Email questions to firstname.lastname@example.org.
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