Chen Wang, Deseret News
Editor's note: This is the fourth in a five-part series.
Two days after an auto-pedestrian accident, Sonja Jorgenson lay in a hospital bed worried sick about her husband, Jerry — still unconscious in intensive care — and wondering how on earth walking across the street had upended their lives.
Things were about to get worse. A visitor came into her room at the Intermountain Medical Center in Murray, not to take a reading on how her recovery was going but to ask how she was going to pay for it.
"I didn't think anything could make me feel worse, but it felt like adding insult to injury," she said.
The Draper couple's injuries were bad enough. Her husband spotted the pickup just before the accident, and pushed her out of the way — almost.
He was struck directly and dragged 125 feet, essentially being grated by the asphalt and twisted like a washrag underneath the vehicle.
Three months of intensive care, more intense physical therapy and a long road back later, he is blind in one eye, his right leg was amputated and he is just now able to walk a bit each day with a cane. He won't be able to work again.
Sonja Jorgenson had severe knee, foot and ligament injuries, "nothing compared to what happened to my husband."
The treatment, surgeries and around-the-clock attention was excellent, and the couple has nothing but gratitude for the care they received. It was American medicine at its best — high-tech, laser-sharp, white-coated, acute emergency intervention. And expensive.
The final tab: $3.2 million, including $1 million just for Jerry Jorgenson's hospital stay. It was a crippling amount the couple couldn't possibly afford. Neither had insurance. They couldn't afford the premium while she finished law school, and he is uninsurable due to a liver transplant in 1997.
Intermountain wrote off a big chunk of the debt and Medicaid stepped in to partially cover the rest through an acute care and disability plan. Intermountain donated $131 million in charity care that year and wrote off $177 million in bad debt. Bad debts are defined as uncollectable bills from patients who were able to pay or who have not provided the documentation to qualify for charity care.
If donations and sponsorships of community health care programs, support of medical research and donations of medical equipment and supplies are added in, Intermountain's charitable and community improvement efforts totaled $607 million that year.
In the Jorgensons' case, the charity care provided by Intermountain erased much of their debt, but they were still left with thousands of dollars in bills.
"We wanted to pay. We wanted to have insurance, but there was no way," Sonja Jorgenson said, noting that the accident "was just one of those things that happen that no one thinks is ever going to happen to them."
Money and how to keep it flowing in is the shadowy side of America's gleaming, towering medical industry. The network of Utah health care providers, singled out by national news media as a model system for the country, provides millions in charity care but also helps create untenable financial circumstances through their bill collecting efforts. Providers turn over collection duties to law firms that often ratchet up threats and pressures to pay. The system routinely picks on those who don't have insurance coverage, charging them top retail for procedures — more than they charge people with insurance — even though they have the least capacity to pay.
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