I am a healthy individual and put off getting insurance because I paid cash for my doctor’s visits and really never needed anything major.  However, my doctor harped on me to get insurance because he had a heart attack and his bill was close to a million dollars.  Yes, I did not misspell the amount.  His out of pocket cost was minimal solely due to the fact that he had health insurance.  Of course I did not listen to him because he is just a doctor, what does he know.  I am sure my clients think the same thing when I give them advice.  Now lets return to my story.

On December 17, 2008 I was working in my office and stood up.  I walked around my desk and my foot caught on my computer tower on the floor.  It was enough to spin my body around and throw me off balance.  As I was falling to the ground I put my hand down to break my fall.  Hitting the floor I remembered to pop my wrist up or I knew it would shatter the wrist and I may never type again.  Keep in mind I have over twenty years medical experience as well as being trained as Risk Manager and an attorney.  I see and analyze risk almost every waking moment.

As a result of my quick analysis I saved my wrist and my forearm but  the entire force of the fall literally blew through my elbow.  The blow out shattered my elbow but luckily did not result in a compound fracture. The pain was excruciating and all I could think of was the lack of medical insurance.  My clients wanted to call 911, I told them no.  Why?  Because I wanted to minimize the debt due to the lack of insurance.  Just like my clients I compromised my own health due to impending debt.

I was coherent enough to remember my medical training and experience.  The pain was tremendous but I knew it was not life threatening. (This is stupid because a doctor or attorney who treats themselves has a fool for a patient/client) I had my office manager drive me to the state hospital because I knew that they could not refuse treatment and I would qualify for a discount.  That night in the emergency room was the beginning of a long as well as expensive rehabilitation of my elbow that continues today.

Since December 17, 2008 I have had five surgeries to replace and rehabilitate my elbow.  I thank God everyday that HE intervened and provided a surgeon of the highest caliber.  It just so happens that my surgeon is a Fellow in Elbows trained at the Mayo Clinic.  You see being an attorney only gets you so far in the hospital. Let me explain.

Hospitals will flag a file if you are a doctor, attorney, celebrity, politician or someone considered to be of importance.  Do not let anyone tell you any different.  These files are tracked and personnel are told to be on their best behavior.  It is just part of business.  But in my case my status as an attorney only took me so far. It allowed me to be seen quicker at the hospital but that is where advantage ended.   The fact that I did not have insurance overshadowed the decisions regarding the treatment.  Again any hospital personnel that tells “we treat all patients the same” is either naive or just plain lying.  It is a business bottom line and never forget this.  The only exceptions I have experienced a different way of thinking are hospitals such as Shriners, St. Jude, Cancer Centers of America and some Children’s Hospitals.  But these hospitals do a tremendous amount of fund raising in order to allow them to treat anyone who comes through their door.  The cold hard reality is that hospitals and doctors cannot treat patients unless they get paid from some source.  They too have bills that must be paid one way or another.  Unfortunately until our government changes the system the poor and uninsured will continue to suffer.  Currently we have a lose - lose health care system.

In my case one of the physicians on my surgeon’s team said “We should not replace her elbow because she has no insurance, just glue it back together.”  If the elbow had been glued back together I would not have the use of my arm that I have today.  In fact my surgeon said he refused to glue it back together because it would severely interfere with my quality of life.  So again I thank God every day that even though I did not have enough common sense to purchase insurance that HE provided a surgeon who put me first instead of the bottom line.

Also during the middle of this adventure the state hospital refused continuing treatment because I had not paid the bill in full.  This was before my last surgery and since I was out of any immediate danger they refused to continue treatment.  If it had not been for my background in hospital risk management, medical and legal training I would have never received that last surgery that allowed me to regain about 75% mobility in my left arm.

Today I am not allowed to have follow up for medical treatment because of the debt that I owe to my surgeon, hospital, anesthesia team, lab, x-ray and ER.  You see everything you do along the way for medical treatment is billed and usually each department has their own billing.  Think of it as getting in a taxi cab and the meter starts at the moment of the accident and does not stop accumulating a fee until the bill is paid in full.

My bill?  It is somewhere in the neighborhood of $35,000.00 or more.  I am reviewing and disputing some of the charges but my surgeon’s bill was over $6,000 alone.  I am not complaining in any way at all because this man saved my career and I will gladly pay.  Not to mention he was worth every penny.  It is very rare to find a talented surgeon who also has a tremendous bedside manner.    As such he is my priority in the repayment process.  But you see attorneys are no different than anyone else and hospitals are incredibly aggressive in their bill collecting process.  SO the bottom line is that if I do not work out a payment plan that is agreeable to the medical entities they will sue to collect their debt just like they would do to any of my clients.  Does the hospital care that you may need every penny to care for your family?  No.  They will sue you in a heartbeat.  Take judgment and begin garnishing your wages.  Why?  It is a business.

Hospitals and doctors are not the only ones.  Please do not think I am trying to throw the entire medical system under the proverbial bus.  All one needs to do is take a peek at the legal system.  Have you asked an attorney for free legal service lately?  I would love to file bankruptcy cases all day long for free.  Do I? No.  Why?  Because it is a business and I have employees to pay and they do not work for free.  I do quite a bit of work for free through Legal Aid but bottom line it is a business and I must charge a fee to keep my doors open.  Hence a hospital must charge and collect in order to keep the doors open. Truly it becomes a vicious cycle for any business owner.

So is medical insurance a luxury? NO! It is critical that you obtain and keep at least a minimum amount of health insurance so that that one split second in time becomes a small hurdle to overcome and not the moment that forces you into financial ruin.  It breaks my heart to see people choosing between paying for life saving medications or putting food on the table or maybe paying the electric/heating bill.    Sometimes if they had insurance in place to begin with they would not be facing those type of critical decisions.

Blue Cross/Blue Shield is a great place to start looking for health insurance or click here to see if you may be qualified for Medicaid insurance coverage.  Remember that knowledge is power and the more knowledge you the better prepared for medical emergencies you will be.

Written by Kansas City Bankruptcy Attorney, Rachel Lynn Foley.

It is unusual, according to the Brookings study, even in the depths of a recession, for wages to fall.  Usually, employers prefer to cut jobs than to cut salaries.  But in New York City, wages fell 1.5% in the first quarter of 2009.  Upstate New York suffered even larger declines in wages.  Rochester wages declined 2.3%, and in Syracuse wages went down 2.2%.

These decreases in wages, combined with large layoffs is having a devastating impact on New York’s tax revenues.  In May, personal income tax revenues were 44% lower than in 2008 according to State Comptroller Thomas P. DiNapoli’s office. 

The Fair Debt Collection Practices Act (”FDCPA”) sets restrictions on how creditors can attempt to collect debts.  The Federal Trade Commission enforces the FDCPA, and has stated that debt collectors cannot:      A full list of prohibited conduct and other useful information can be found on the Federal Trade Commission’s website at:

·         Call at inconvenient times, for example, prior to 8 a.m. or after 9 p.m.

·         Use threats of violence or harm

·         Publish a list of consumers who refuse to pay their debts

·         Use obscene or profane language, or repeatedly use the telephone to annoy

·         Use any false or misleading statements, such as imply that they are attorneys or government representatives; imply that you committed a crime; or say you will be arrested for non-payment of a debt

http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre18.shtm

You can sue offending creditors in State or Federal court and get statutory damages of $1000 plus any specific damages you incurred as a result of their inappropriate conduct.  Even if you don’t file a lawsuit, you can send the debt collector a letter stating that you are invoking the protection of the FDCPA and that you wish to be contacted by mail only.

The FDCPA is not necessarily the only law that protects the consumer from debt collector harassment.  Many states have their own version of the FDCPA.  Contact your local State Attorney General’s Office to find out if your State has its own version of the FDCPA.

1. Acknowledge that you are in debt and in over your head.
2. Forgive yourself and focus on repaying.
3. Understand how you got here so that you do not return in the future.
4. Make a plan to break the overspending habit.
5. Do not make the problem worse by waiting to take action because of procrastination or guilt.
6. Share your problem with your spouse or a close friend.
7. Get professional counseling, if needed.

This list provides a great starting point.  It can also be very helpful to discuss your situation with an experienced consumer attorney for two reasons.  First, many people find the process of discussing their situation with a consumer attorney often helps provide emotional relief.  Second, a consumer attorney is trained in issues relating to debt, credit, and finance and can often provide you with ideas and avenues you may not have considered on your own.

(Source of list:  eHow Personal Finance Editor)

SAFE HAVENS:  

1. Cut your budget
2. Use your emergency fund
3. Get a second job
4. Selling the car
5. Open a certificate of deposit
6. Stop contributing to education funds
7. Spend severance (or all) money wisely
8. Sell stuff

ENTER WITH CAUTION

1. Sell taxable investments
2. Ask family (friends) for gifts
3. Ask family (friends) for a loan
4. Cash in a savings bond
5. Consider peer-to-peer borrowing (www.prosper.com)
6. Take out a home equity loan
7. Take a 401(k) loan

KEEP WALKING

1. Taking cash from retirement  (not only do you pay penalties, you are robbing your future to pay the present)
2. Using credit card advances (usually a higher interest rate)
3. Borrowing against life insurance (if you die unexpectedly, the policy loses value)
4. Take a payday loan (huge interest rates)