Ran (liberal use of the term) around Burke Lake today. It was nice out if ridiculously windy.
Things I managed to forget: my inhaler, a water bottle.
I thought several times about mugging another runner for their water, except it would have involved outrunning them.
New boy ran with me partially due to a really crappy couple of days for us. I feel like crying should burn a lot of calories, it's so physically exhausting. Anyways, I'm glad I didn't run with the group this weekend, there's no way I could have done the slated seven miles.
Tuesday, January 1, 2008
Sunday, December 30, 2007
The Name Game
Yesterday, I got off my lazy ass and went to Rob's 3 hour spin class. This was my first time back at spinning, always smart to jump in to an endurance class after a long absence. The music always has a theme. This time it was Names- so Bad, Bad, Leroy Brown, In the Name of Love, Mambo Number 5, etc.
I also learned how to play "Screw Your Buddy" which kept me entertained while I bruised my booty beyond repair.
Screw Your Buddy:
The first person chooses a torture the class will endure for a set time period, like a minute.
The person next to them has to work harder than the rest of class, and gets to pick two other people to share in the misery.
Next round person two picks the torture and their two buddies to share the pain.
And so on and so forth.
If you chose someone to feel the burn, chances are you'll be their buddy next time.
If you chose a torture the class especially hates, you'll be everyone's buddy.
Torture options:
Seated climb
Standing climb
Freezes: low resistance while standing where you try to maintain a perfect circle
Sprints
Jumps: Stand up, sit down, stand up, sit down, sort of like mass on wheels.
I got home, took a shower, and ate an entire calzone.
I also learned how to play "Screw Your Buddy" which kept me entertained while I bruised my booty beyond repair.
Screw Your Buddy:
The first person chooses a torture the class will endure for a set time period, like a minute.
The person next to them has to work harder than the rest of class, and gets to pick two other people to share in the misery.
Next round person two picks the torture and their two buddies to share the pain.
And so on and so forth.
If you chose someone to feel the burn, chances are you'll be their buddy next time.
If you chose a torture the class especially hates, you'll be everyone's buddy.
Torture options:
Seated climb
Standing climb
Freezes: low resistance while standing where you try to maintain a perfect circle
Sprints
Jumps: Stand up, sit down, stand up, sit down, sort of like mass on wheels.
I got home, took a shower, and ate an entire calzone.
Thursday, December 20, 2007
Cancer quicker to claim the uninsured
Election year coming up. And a picture of who suffers when health care legislation is neglected:
Patients with no insurance twice as likely to die within 5 years
The Associated Press
ATLANTA - Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.
People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.
The research by scientists with the American Cancer Society offers important context for the national discussion about health care reform, experts say — even though the uninsured are believed to account for just a fraction of U.S. cancer deaths. An Associated Press analysis suggests it is around 4 percent.
Those dealing with cancer and inadequate insurance weren’t surprised by the findings.
“I would just like for something to be done to help someone else, so they don’t have to go through what we went through,” said Peggy Hicks, a Florida woman whose husband died in August from colon cancer.
Edward Hicks was uninsured, and a patchwork health care system delayed him from getting chemotherapy that some argue might have extended his life.
“He was so ill. And you’re trying to get him help and you can’t, you can’t,” said his 67-year-old widow.
The new research is being published in Cancer, the cancer society’s medical journal. In an accompanying editorial, the society’s president repeated the organization’s call for action to fix holes in the health care safety net.
“The truth is that our national reluctance to face these facts is condemning thousands of people to die from cancer each year,” Dr. Elmer Huerta wrote.
Hard numbers linking insurance status and cancer deaths are scarce, in part because death certificates don’t say whether those who died were insured.
Annual cancer death tollAn Associated Press estimate — based on hospital cancer deaths in 2005 gathered by the U.S. Agency for Healthcare Research and Quality information and other data — suggests that at least 20,000 of the nation’s 560,000 annual cancer deaths are uninsured when they die. Experts said that estimate sounds reasonable.
That’s around 4 percent of the total cancer death toll. One reason is that most fatal cancers occur in people 65 or older — an age group covered by the federal Medicare program. Another is that more than 80 percent of adults under 65 have some form of coverage, including private insurance or the Medicaid program for the poor, according to various estimates.
Some are enrolled in Medicaid or other programs after diagnosis, when the condition worsens and their finances erode. But such 11th hour coverage can be too late; early detection is the key to catching many cancers before they’ve grown beyond control, experts said.
“Insurance makes a big difference in how early you are detecting disease,” said Ken Thorpe, an Emory University health policy researcher.
In the new study, researchers analyzed information from 1,500 U.S. hospitals that provide cancer care. They focused on nearly 600,000 adults under age 65 who first appeared in the database in 1999 and 2000 and who had either no insurance, private insurance or Medicaid.
Plight of uninsuredResearchers then checked records for those patients for the five years following. They found those who were uninsured were 1.6 times more likely to die in five years than those with private insurance.
More specifically, 35 percent of uninsured patients had died at the end of five years, compared with 23 percent of privately insured patients.
Earlier studies have also shown differences in cancer survival rates of the uninsured and insured, but they were limited to specific cancers and certain geographic areas.
The new findings are consistent across different racial groups. However, the fact that whites have better survival rates cannot be explained by insurance status alone, said Elizabeth Ward, the study’s lead author.
The researchers were not able to tell if the numbers were influenced by patients’ education levels, or by other illnesses.
Experts said the study also hints at problems with quality of care after diagnosis: such as whether the patient got the appropriate operation from a high-quality surgeon, whether the tumor was thoroughly evaluated by a high-quality pathologist, and whether there was access to needed chemotherapy and radiation.
Blaming quality of care “The differences that we see in outcomes after people are diagnosed, even among those with early stage disease, suggests that problems with quality of care may be an important reason,” said Dr. John Ayanian, professor of medicine and health care policy at Harvard Medical School. He didn’t participate in the cancer society study.
The study makes an even stronger statement about the role insurance plays in the timing of screenings and how that can raise the likelihood of a late-stage diagnosis, experts said.
A Kaiser Family Foundation survey last year of 930 households that dealt with cancer found that more than one in four uninsured patients delayed treatment — or decided not to get it — because of the cost.
Such was the case of Edward Hicks.
The retired laborer, had surgery for colorectal cancer in 2005 and was thought to be clear of the disease. Chemotherapy was suggested after the surgery, but he didn’t get it.
In February of this year, his wife grew worried when he lost energy and appetite. In April, he told her he felt a lump in his stomach.
Hicks, who lived in Fort Meade, Fla., couldn’t get an appointment with a specialist, but a family doctor checked him into a hospital and specialists saw him in late May. They said he was terminal but that chemotherapy might extend his life a little, his wife said.
She was able to get donated chemotherapy drugs from a pharmaceutical company, but it took time to arrange the treatments, which didn’t start until mid-June. Meanwhile, her husband’s health deteriorated. In July, after just a few treatments, he stopped the chemo, saying it was too hard. He died on Aug. 21, at age 64.
Friends and family told Peggy they believe he would have lived longer had he got chemo earlier, when he was stronger. She doesn’t agonize over that, she said, trusting in God’s will.
But the devil’s in her mailbox — she is facing a $21,000 hospital bill and other costs from his death.
© 2007 The Associated Press. All rights reserved.
URL: http://www.msnbc.msn.com/id/22332573/
© 2007 MSNBC.com
Patients with no insurance twice as likely to die within 5 years
The Associated Press
ATLANTA - Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.
People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.
The research by scientists with the American Cancer Society offers important context for the national discussion about health care reform, experts say — even though the uninsured are believed to account for just a fraction of U.S. cancer deaths. An Associated Press analysis suggests it is around 4 percent.
Those dealing with cancer and inadequate insurance weren’t surprised by the findings.
“I would just like for something to be done to help someone else, so they don’t have to go through what we went through,” said Peggy Hicks, a Florida woman whose husband died in August from colon cancer.
Edward Hicks was uninsured, and a patchwork health care system delayed him from getting chemotherapy that some argue might have extended his life.
“He was so ill. And you’re trying to get him help and you can’t, you can’t,” said his 67-year-old widow.
The new research is being published in Cancer, the cancer society’s medical journal. In an accompanying editorial, the society’s president repeated the organization’s call for action to fix holes in the health care safety net.
“The truth is that our national reluctance to face these facts is condemning thousands of people to die from cancer each year,” Dr. Elmer Huerta wrote.
Hard numbers linking insurance status and cancer deaths are scarce, in part because death certificates don’t say whether those who died were insured.
Annual cancer death tollAn Associated Press estimate — based on hospital cancer deaths in 2005 gathered by the U.S. Agency for Healthcare Research and Quality information and other data — suggests that at least 20,000 of the nation’s 560,000 annual cancer deaths are uninsured when they die. Experts said that estimate sounds reasonable.
That’s around 4 percent of the total cancer death toll. One reason is that most fatal cancers occur in people 65 or older — an age group covered by the federal Medicare program. Another is that more than 80 percent of adults under 65 have some form of coverage, including private insurance or the Medicaid program for the poor, according to various estimates.
Some are enrolled in Medicaid or other programs after diagnosis, when the condition worsens and their finances erode. But such 11th hour coverage can be too late; early detection is the key to catching many cancers before they’ve grown beyond control, experts said.
“Insurance makes a big difference in how early you are detecting disease,” said Ken Thorpe, an Emory University health policy researcher.
In the new study, researchers analyzed information from 1,500 U.S. hospitals that provide cancer care. They focused on nearly 600,000 adults under age 65 who first appeared in the database in 1999 and 2000 and who had either no insurance, private insurance or Medicaid.
Plight of uninsuredResearchers then checked records for those patients for the five years following. They found those who were uninsured were 1.6 times more likely to die in five years than those with private insurance.
More specifically, 35 percent of uninsured patients had died at the end of five years, compared with 23 percent of privately insured patients.
Earlier studies have also shown differences in cancer survival rates of the uninsured and insured, but they were limited to specific cancers and certain geographic areas.
The new findings are consistent across different racial groups. However, the fact that whites have better survival rates cannot be explained by insurance status alone, said Elizabeth Ward, the study’s lead author.
The researchers were not able to tell if the numbers were influenced by patients’ education levels, or by other illnesses.
Experts said the study also hints at problems with quality of care after diagnosis: such as whether the patient got the appropriate operation from a high-quality surgeon, whether the tumor was thoroughly evaluated by a high-quality pathologist, and whether there was access to needed chemotherapy and radiation.
Blaming quality of care “The differences that we see in outcomes after people are diagnosed, even among those with early stage disease, suggests that problems with quality of care may be an important reason,” said Dr. John Ayanian, professor of medicine and health care policy at Harvard Medical School. He didn’t participate in the cancer society study.
The study makes an even stronger statement about the role insurance plays in the timing of screenings and how that can raise the likelihood of a late-stage diagnosis, experts said.
A Kaiser Family Foundation survey last year of 930 households that dealt with cancer found that more than one in four uninsured patients delayed treatment — or decided not to get it — because of the cost.
Such was the case of Edward Hicks.
The retired laborer, had surgery for colorectal cancer in 2005 and was thought to be clear of the disease. Chemotherapy was suggested after the surgery, but he didn’t get it.
In February of this year, his wife grew worried when he lost energy and appetite. In April, he told her he felt a lump in his stomach.
Hicks, who lived in Fort Meade, Fla., couldn’t get an appointment with a specialist, but a family doctor checked him into a hospital and specialists saw him in late May. They said he was terminal but that chemotherapy might extend his life a little, his wife said.
She was able to get donated chemotherapy drugs from a pharmaceutical company, but it took time to arrange the treatments, which didn’t start until mid-June. Meanwhile, her husband’s health deteriorated. In July, after just a few treatments, he stopped the chemo, saying it was too hard. He died on Aug. 21, at age 64.
Friends and family told Peggy they believe he would have lived longer had he got chemo earlier, when he was stronger. She doesn’t agonize over that, she said, trusting in God’s will.
But the devil’s in her mailbox — she is facing a $21,000 hospital bill and other costs from his death.
© 2007 The Associated Press. All rights reserved.
URL: http://www.msnbc.msn.com/id/22332573/
© 2007 MSNBC.com
Monday, December 17, 2007
Erin Go Brrrrrrrrrrr
Friday, I got cleared to go forth and exercise, which was lucky since I had signed up for the Celtic Five Miler which was the next day.
It's not that I enjoy running in the freezing cold on hills, I don't. It's that this race always has the most awesome premiums. Gorgeous celtic designs on Brooks running gear. And cheap. I had already paid for the jacket and I couldn't very well wear the jacket without running the race. So Lead Legs Kevin and I hiked up to Baltimore for the privilege of running in sub-arctic temperatures.
It turned to be a pretty morning, clear and COLD. And a fair number of both the tri team and the tri club were there. I had a good time. It felt good to run. And I wasn't last, I was second to last, but I wasn't last. And that was fine considering all that had gone on in the weeks before, and that I stopped at the car to divest one of my fourteen layers of clothes. And I'm finally on the board with the USAT challenge.
It's not that I enjoy running in the freezing cold on hills, I don't. It's that this race always has the most awesome premiums. Gorgeous celtic designs on Brooks running gear. And cheap. I had already paid for the jacket and I couldn't very well wear the jacket without running the race. So Lead Legs Kevin and I hiked up to Baltimore for the privilege of running in sub-arctic temperatures.
It turned to be a pretty morning, clear and COLD. And a fair number of both the tri team and the tri club were there. I had a good time. It felt good to run. And I wasn't last, I was second to last, but I wasn't last. And that was fine considering all that had gone on in the weeks before, and that I stopped at the car to divest one of my fourteen layers of clothes. And I'm finally on the board with the USAT challenge.
People who run faster than me.
Monday, December 10, 2007
All the king's horses
Last Friday, I went back to see the ortho since my progress in PT had pretty much stopped. I opted for surgery and signed release forms to both rip it free under anesthesia and to arthroscopically excavate the scar tissue. The expectation was that the shoulder wouldn't give under anesthesia enough to make a difference and the surgery was pretty likely. This was kind of rushed given the holidays coming up. If I waited until after the holidays, it would continue to hurt and freeze more. If I did it right before the holidays missing a bunch of PT, it would re-freeze and I would enjoy a third visit to the hospital. I was scheduled for surgery 3 days later and tacked on to the list of patients for that day.
Tuesday, I went in to the hospital.
New Boy took me, maybe to make up for the last time. It was a point of honor. He was very sweet the whole time.
Last time I was at the surgery center, this time I was at the hospital. Given the choice, I would go to the surgery center instead of the hospital. Overall, the surgery center just seemed cleaner and the staff of a higher calibre. Although the hospital didn't make me pay in advance so there's something to be said for that, but they made me take a pregnancy test (???!) so whatever.
After contending with a nurse(?) of dubious competence (she dropped needles on the floor and didn't wash her hands), meeting with the most fabulous anesthesiologist ever, and fending off the deadly antibiotic, I went under expecting to wake up with a new set of scars.
Turns out they were able to wrench it free so no new scars. I was in the OR for a total of like 20 minutes. The ortho came out and gave the news to New Boy and said he'd be able to see me soon. Well apparently I was a little cranky about not eating breakfast and as I'm wont to do when anesthesia isn't involved, once I've skipped a meal I will continue to sleep until someone wakes me up and forces me to eat. So I didn't come out for close to 2 hours. This made New Boy a little nervous.
I was concerned because at first my shoulder was worse. It was tight, inflamed, and cranky. Couple that with us getting snow right after the procedure and I had lost all faith. My PT, the Dr, and Jopoppa all told me to quit whining and ride it out. It's been a couple weeks and it seems better now. I can even wash my hair and put it in a ponytail.
Tuesday, I went in to the hospital.
New Boy took me, maybe to make up for the last time. It was a point of honor. He was very sweet the whole time.
Last time I was at the surgery center, this time I was at the hospital. Given the choice, I would go to the surgery center instead of the hospital. Overall, the surgery center just seemed cleaner and the staff of a higher calibre. Although the hospital didn't make me pay in advance so there's something to be said for that, but they made me take a pregnancy test (???!) so whatever.
After contending with a nurse(?) of dubious competence (she dropped needles on the floor and didn't wash her hands), meeting with the most fabulous anesthesiologist ever, and fending off the deadly antibiotic, I went under expecting to wake up with a new set of scars.
Turns out they were able to wrench it free so no new scars. I was in the OR for a total of like 20 minutes. The ortho came out and gave the news to New Boy and said he'd be able to see me soon. Well apparently I was a little cranky about not eating breakfast and as I'm wont to do when anesthesia isn't involved, once I've skipped a meal I will continue to sleep until someone wakes me up and forces me to eat. So I didn't come out for close to 2 hours. This made New Boy a little nervous.
I was concerned because at first my shoulder was worse. It was tight, inflamed, and cranky. Couple that with us getting snow right after the procedure and I had lost all faith. My PT, the Dr, and Jopoppa all told me to quit whining and ride it out. It's been a couple weeks and it seems better now. I can even wash my hair and put it in a ponytail.
Tuesday, November 27, 2007
Resting during recovery
Winter conditioning started this week.
After being woken up by a fox early monday morning, it took everything I had to guilt myself out of bed and go. I hadn't run all weekend and was looking forward to this for a long time, which got me out of bed. I was house-sitting for a woman from the boathouse and I couldn't find her blender, so I missed out on my protein shake, but settled for scarfing down a banana and one of those salty/sweet "granola" bars. They really are addictive. A quarter of my daily calories in like 3 salty sweet tablespoons of goodness.
I had purposely fought to get into the M/W/F section since I really liked the coach. I was nervous about being able to row the whole time and justify my slot. Thankfully, the coach had us doing 5 minute build intervals with 2 minute rest sessions. With a few modifications, I was mostly able to keep up, but it was frustrating to basically have to re-learn how to erg and to have such bad output.
The workouts go like this:
You row indoors on a rowing machine (erg)
You row for one minute at 18 strokes per minute (spm), the next minute for 20 spm, then 22, etc., until you've rowed for five minutes. Then you have a two minute rest session where you can either paddle through, rowing at a super easy pace for two minutes, or completely stop rowing. Last year after a season of triathlons and running, I preferred to paddle through and log as many meters as possible. This year, I am working just to finish the five minute sets.
The next five minute set, you start one higher than the last set, so you row the first minute at 20, the next at 22, etc.
Last year, I could row comfortably at a 30 or a 32, this year, I'm struggling to hold a 26.
Pre-surgery, mybiggest problem was rushing the slide, which is basically coming back up to stroke again too quickly. On the water, you stroke to move the boat, and sort of glide, then stroke again. If you're late, it's like flooring the accelerator then slamming on the brakes. If you're early, it's like driving with the parking brake on.
This year, I'm not rushing since I need the recovery to rest to keep up.
It was good to be back, but incredibly frustrating not to be able to perform the way I want to.
And don't even get me started about the winter holiday challenge. I've had to delete all the emails about it to remove the temptation to push too hard and ruin my recovery. 100,000 meters in a month isn't hard, is it?
Our workout:
5/2
18, 20, 22, 24, 26
20, 22, 24, 26, 28
22, 24, 26, 28, 30
20, 22, 24, 26, 28
18, 20, 22, 24, 26
2 sets of 10 crunches, 2 2 sets of planks for 1', 1 set of planks for 1' on each side, 1 set of 10 crunches.
Even not being able to do the planks, my abs are sore.
After being woken up by a fox early monday morning, it took everything I had to guilt myself out of bed and go. I hadn't run all weekend and was looking forward to this for a long time, which got me out of bed. I was house-sitting for a woman from the boathouse and I couldn't find her blender, so I missed out on my protein shake, but settled for scarfing down a banana and one of those salty/sweet "granola" bars. They really are addictive. A quarter of my daily calories in like 3 salty sweet tablespoons of goodness.
I had purposely fought to get into the M/W/F section since I really liked the coach. I was nervous about being able to row the whole time and justify my slot. Thankfully, the coach had us doing 5 minute build intervals with 2 minute rest sessions. With a few modifications, I was mostly able to keep up, but it was frustrating to basically have to re-learn how to erg and to have such bad output.
The workouts go like this:
You row indoors on a rowing machine (erg)
You row for one minute at 18 strokes per minute (spm), the next minute for 20 spm, then 22, etc., until you've rowed for five minutes. Then you have a two minute rest session where you can either paddle through, rowing at a super easy pace for two minutes, or completely stop rowing. Last year after a season of triathlons and running, I preferred to paddle through and log as many meters as possible. This year, I am working just to finish the five minute sets.
The next five minute set, you start one higher than the last set, so you row the first minute at 20, the next at 22, etc.
Last year, I could row comfortably at a 30 or a 32, this year, I'm struggling to hold a 26.
Pre-surgery, mybiggest problem was rushing the slide, which is basically coming back up to stroke again too quickly. On the water, you stroke to move the boat, and sort of glide, then stroke again. If you're late, it's like flooring the accelerator then slamming on the brakes. If you're early, it's like driving with the parking brake on.
This year, I'm not rushing since I need the recovery to rest to keep up.
It was good to be back, but incredibly frustrating not to be able to perform the way I want to.
And don't even get me started about the winter holiday challenge. I've had to delete all the emails about it to remove the temptation to push too hard and ruin my recovery. 100,000 meters in a month isn't hard, is it?
Our workout:
5/2
18, 20, 22, 24, 26
20, 22, 24, 26, 28
22, 24, 26, 28, 30
20, 22, 24, 26, 28
18, 20, 22, 24, 26
2 sets of 10 crunches, 2 2 sets of planks for 1', 1 set of planks for 1' on each side, 1 set of 10 crunches.
Even not being able to do the planks, my abs are sore.
Tuesday, November 20, 2007
More soapbox time
And a word to the wise ...
http://articles.moneycentral.msn.com/Banking/YourCreditRating/WhyMedicalDebtsShouldntCount.aspx?page=all
Why medical debts shouldn't count
For many, the road to ruined credit is pockmarked with medical collections, often for tiny amounts or billed in error. The truth is that medical debt rarely indicates whether a borrower is high risk.
By Liz Pulliam Weston
It's a good thing Greg Hilfman of Los Angeles has health insurance because an unpaid medical bill has sent his blood pressure soaring.
Hilfman's wife was in a hospital two years ago for pancreatitis, and Hilfman said she was treated by a "cadre" of doctors and specialists. All but one submitted bills to their insurer, Blue Cross of California, in time to get paid.
Six weeks ago, however, a woman from a neurologist's office contacted Hilfman, explaining that the office "didn't have the right address for Blue Cross" and thus hadn't submitted the bill within the one-year period required for reimbursement. She demanded that Hilfman cough up $540.
Hilfman was furious. He'd never heard of the doctor and insisted he'd seen no bill or any indication there was a problem with payment. Now he's worried he'll have to pay a bill that should have been covered by insurance or risk damage to the couple's credit reports.
"How is this fair?" he asked. "They can say anything they want (to the credit bureaus), and I have no recourse."
Tiny debts with huge impacts Hilfman is right to be concerned. The Your Money message board is littered with complaints from folks whose otherwise pristine credit was sabotaged by a medical collection. Sometimes their records were besmirched over absurdly small amounts that nonetheless had big impacts on credit scores.
Poster "sunny_light," for example, recently discovered a medical-collection account for just $7.
"I pulled my credit report last week and found out," sunny_light wrote. "I promptly paid the collections people. But now my credit score is down by like 80 points."
Medical collections are surprisingly common, at least according to a 2003 Federal Reserve study of consumer-credit reports. Nearly one in three consumers (31%) with a credit report had at least one collection account reported, and more than half of those were medical collections.
The amounts owed weren't substantial: 36.5% of the medical collections were for $100 or less, and 86% were for $500 or less.
Medical collections make up half of all collection accounts:
Collection type
% of collection accounts
Median amount owed
Medical
52.2
$142
Utility
22.7
$199
Government
2.3
$199
Creditor*
5.8
$587
Other**
16.9
$116
All
100
$156
Source: Federal Reserve
*Includes large retailers, banks and finance companies
**Includes smaller retailers, law firms, individuals and educational institutions
Yet any collection account is considered a major negative to lenders and to the credit-scoring formulas they use. Though the impact of a collection on your scores fades over time, it will shave off points for as long as the negative mark remains on your report -- typically seven years.
Your chances of having your credit ruined by a medical bill are soaring for a variety of reasons:
More people are uninsured or underinsured. The U.S. Census Bureau counts nearly 45 million uninsured Americans. An additional 16 million or so are underinsured, with too little coverage to protect them from catastrophic medical expenses. Medical costs have been rising at a much higher rate than inflation, and those without insurance are often charged more than those with coverage (read "How to survive your hospital bills" for details). Thus a single accident, illness or emergency-room visit can easily result in an impossible-to-pay bill for many uninsured and underinsured families.
Medical-debt collection has become big business. An unpaid or disputed bill is more likely to wind up on your credit report because of a sea change in the way medical bills are treated.
"The reporting of medical debt (to credit bureaus) is becoming much more common," said Travis Plunkett, a spokesman for the Consumer Federation of America. "Medical-debt reporting has become more professionalized."
Get your insurance claims paid
Good records, detailed claims and persistence will help you get your money faster and avoid problems.
A decade ago, most hospitals did their own collections or assigned them to a collector who worked on contingency, collecting a portion of what was owed. Smaller providers typically handled collections in-house. Only the largest companies tended to report collections activity to the credit bureaus -- and then only after repeated collection attempts had failed.
Today, physicians groups and other small providers are more likely to outsource their collections to agencies that use negative credit-report entries as a tool to urge patients to pay.
Meanwhile, an increasing number of for-profit hospitals and even some nonprofits regularly sell their bad debts for 2 or 3 cents on the dollar rather than try to collect the money themselves. So-called debt purchasers buy huge portfolios of debt, and one of the first things they do is post the collections on the consumers' credit reports.
"Health-care-debt buying did not exist" 10 years ago, said Michael Klozotsky, an analyst for Kaulkin Ginsberg, which tracks debt-collection trends. In 2005, purchasers bought at least $3 billion of bad medical debts, and the market seems to be growing 11% to 15% a year.
Continued: Confusion abounds
Medical billing is a mess. Even when a consumer is covered by insurance, confusion abounds. Doctors and hospitals often insist the consumer is ultimately responsible for the bills, saying medical providers bill insurers only as a courtesy. Yet frequently the providers have agreements with insurers and government agencies to accept discounted reimbursement as payment in full; the providers aren't supposed to pursue patients for payment.
Meanwhile, insurers are constantly changing what's covered and by how much, and providers move in and out of covered networks. Providers also claim some insurers deliberately drag their heels on reimbursements, adding to the chaos and uncertainty.
"Insurance companies are often contributing to the false reporting of medical debt," the Consumer Federation's Plunkett said, as tussles over payment increasingly get turned over to collection agencies.
Medical debt is no predictor of risk Even when medical debts are legitimately owed and left unpaid, though, some experts question whether they belong on credit reports.
There's no question that medical bills pose huge risks for the finances of many families. Medical problems were cited as a factor in nearly half of the bankruptcies studied by Harvard University professor Elizabeth Warren (.pdf file).
Still, many mortgage lenders who specialize in serving low-income communities have discovered that discarding medical debts often gives them a better picture of a borrower's true creditworthiness, said Michael Stegman, the director of policy for the MacArthur Foundation's program on human and community development.
"If all their other credit accounts are in good shape, or they haven't established credit but they've had no delinquencies on their rent," Stegman said, "the fact you have a bad medical debt or an outstanding judgment over a medical bill is not a good predictor of default."
One such lender, Self Help of Durham, N.C., has a 1% default rate on its mortgages, which public-policy director David Beck said is comparable to mainstream lenders that use credit-scoring formulas that take medical debt into account.
"Our experience has been that medical debt isn't generally reflective of a borrower's ability or willingness to repay," Beck said.
It's not clear that these lenders' experiences with low-income borrowers can be extended to the population in general, but it's time to find out. Credit-scoring companies such as Fair Isaac, the creator of the leading FICO scoring formula, should research whether medical debt really is predictive or not.
In a bind? 4 tips Personally, I think we could solve much of the problem of unfair medical-debt reporting by excluding all collections under $100 from credit reports. I also think medical debts should be treated differently, with shorter statutes of limitation on collection and reporting (say, four years instead of the current seven), to reflect the fact that medical bills are a fundamentally different kind of debt from credit cards and auto loans.
Unless that happens, here's how to reduce the chances of your credit getting run over by medical debt:
Bird-dog your medical bills. Don't assume your health-care provider and your insurance company will eventually work it out. Follow up on every bill or claim with an unpaid balance. If a debt remains after more than a month or two, ask your provider and your insurer what the problem is and what you can do to help.
Negotiate if you're uninsured. As I discussed in "How to survive your hospital bills," you may be able to qualify for charitable assistance that could reduce or eliminate your bills. Even if you don't qualify, you should try to get the amount you're charged reduced to what an insurer or government agency would pay.
Get payment agreements in writing. If you don't have insurance and want to make payments, make sure your agreement is in writing. One Your Money message boardcontributor agreed to pay her health-care provider $50 a month to pay off a $1,600 bill. No agreement was signed, however, and the provider recently started demanding $150 a month.
Try to talk your way out. If despite your best efforts a medical bill lands on your credit report, you have a couple of options. One is to dispute the bill with the credit bureaus as "not mine"; sometimes collection agencies won't bother to verify the disputed account, and it will fall off your reports. Option two is to negotiate with the collection agency to remove the account from your credit reports in exchange for payment.
Get your insurance claims paidGood records, detailed claims and persistence will help you get your money faster and avoid problems.
Ideally, you'd get that promise in writing before you pay anything, but sunny_light managed to sweet-talk a collection agency rep into clearing a credit report after sending the $7.
"I called that collection agency woman again and talked and talked and talked to her with lots of 'please' . . . and then it was quiet for a while so I thought she hung up . . . but then she said she was looking at my file . . . and finally she said 'normally we don't do this' and then she told me to check my report in about 30-45 days," sunny_light wrote. Two weeks later, sunny_light checked, "and the $7 medical bill (paid) has been removed from all three credit reports . . . and my credit scores went back up!!"
Columns by Liz Pulliam Weston, the Web's most-read personal-finance writer and winner of the 2007 Clarion Award for online journalism, appear every Monday and Thursday, exclusively on MSN Money.
Published Nov. 19, 2007
http://articles.moneycentral.msn.com/Banking/YourCreditRating/WhyMedicalDebtsShouldntCount.aspx?page=all
Why medical debts shouldn't count
For many, the road to ruined credit is pockmarked with medical collections, often for tiny amounts or billed in error. The truth is that medical debt rarely indicates whether a borrower is high risk.
By Liz Pulliam Weston
It's a good thing Greg Hilfman of Los Angeles has health insurance because an unpaid medical bill has sent his blood pressure soaring.
Hilfman's wife was in a hospital two years ago for pancreatitis, and Hilfman said she was treated by a "cadre" of doctors and specialists. All but one submitted bills to their insurer, Blue Cross of California, in time to get paid.
Six weeks ago, however, a woman from a neurologist's office contacted Hilfman, explaining that the office "didn't have the right address for Blue Cross" and thus hadn't submitted the bill within the one-year period required for reimbursement. She demanded that Hilfman cough up $540.
Hilfman was furious. He'd never heard of the doctor and insisted he'd seen no bill or any indication there was a problem with payment. Now he's worried he'll have to pay a bill that should have been covered by insurance or risk damage to the couple's credit reports.
"How is this fair?" he asked. "They can say anything they want (to the credit bureaus), and I have no recourse."
Tiny debts with huge impacts Hilfman is right to be concerned. The Your Money message board is littered with complaints from folks whose otherwise pristine credit was sabotaged by a medical collection. Sometimes their records were besmirched over absurdly small amounts that nonetheless had big impacts on credit scores.
Poster "sunny_light," for example, recently discovered a medical-collection account for just $7.
"I pulled my credit report last week and found out," sunny_light wrote. "I promptly paid the collections people. But now my credit score is down by like 80 points."
Medical collections are surprisingly common, at least according to a 2003 Federal Reserve study of consumer-credit reports. Nearly one in three consumers (31%) with a credit report had at least one collection account reported, and more than half of those were medical collections.
The amounts owed weren't substantial: 36.5% of the medical collections were for $100 or less, and 86% were for $500 or less.
Medical collections make up half of all collection accounts:
Collection type
% of collection accounts
Median amount owed
Medical
52.2
$142
Utility
22.7
$199
Government
2.3
$199
Creditor*
5.8
$587
Other**
16.9
$116
All
100
$156
Source: Federal Reserve
*Includes large retailers, banks and finance companies
**Includes smaller retailers, law firms, individuals and educational institutions
Yet any collection account is considered a major negative to lenders and to the credit-scoring formulas they use. Though the impact of a collection on your scores fades over time, it will shave off points for as long as the negative mark remains on your report -- typically seven years.
Your chances of having your credit ruined by a medical bill are soaring for a variety of reasons:
More people are uninsured or underinsured. The U.S. Census Bureau counts nearly 45 million uninsured Americans. An additional 16 million or so are underinsured, with too little coverage to protect them from catastrophic medical expenses. Medical costs have been rising at a much higher rate than inflation, and those without insurance are often charged more than those with coverage (read "How to survive your hospital bills" for details). Thus a single accident, illness or emergency-room visit can easily result in an impossible-to-pay bill for many uninsured and underinsured families.
Medical-debt collection has become big business. An unpaid or disputed bill is more likely to wind up on your credit report because of a sea change in the way medical bills are treated.
"The reporting of medical debt (to credit bureaus) is becoming much more common," said Travis Plunkett, a spokesman for the Consumer Federation of America. "Medical-debt reporting has become more professionalized."
Get your insurance claims paid
Good records, detailed claims and persistence will help you get your money faster and avoid problems.
A decade ago, most hospitals did their own collections or assigned them to a collector who worked on contingency, collecting a portion of what was owed. Smaller providers typically handled collections in-house. Only the largest companies tended to report collections activity to the credit bureaus -- and then only after repeated collection attempts had failed.
Today, physicians groups and other small providers are more likely to outsource their collections to agencies that use negative credit-report entries as a tool to urge patients to pay.
Meanwhile, an increasing number of for-profit hospitals and even some nonprofits regularly sell their bad debts for 2 or 3 cents on the dollar rather than try to collect the money themselves. So-called debt purchasers buy huge portfolios of debt, and one of the first things they do is post the collections on the consumers' credit reports.
"Health-care-debt buying did not exist" 10 years ago, said Michael Klozotsky, an analyst for Kaulkin Ginsberg, which tracks debt-collection trends. In 2005, purchasers bought at least $3 billion of bad medical debts, and the market seems to be growing 11% to 15% a year.
Continued: Confusion abounds
Medical billing is a mess. Even when a consumer is covered by insurance, confusion abounds. Doctors and hospitals often insist the consumer is ultimately responsible for the bills, saying medical providers bill insurers only as a courtesy. Yet frequently the providers have agreements with insurers and government agencies to accept discounted reimbursement as payment in full; the providers aren't supposed to pursue patients for payment.
Meanwhile, insurers are constantly changing what's covered and by how much, and providers move in and out of covered networks. Providers also claim some insurers deliberately drag their heels on reimbursements, adding to the chaos and uncertainty.
"Insurance companies are often contributing to the false reporting of medical debt," the Consumer Federation's Plunkett said, as tussles over payment increasingly get turned over to collection agencies.
Medical debt is no predictor of risk Even when medical debts are legitimately owed and left unpaid, though, some experts question whether they belong on credit reports.
There's no question that medical bills pose huge risks for the finances of many families. Medical problems were cited as a factor in nearly half of the bankruptcies studied by Harvard University professor Elizabeth Warren (.pdf file).
Still, many mortgage lenders who specialize in serving low-income communities have discovered that discarding medical debts often gives them a better picture of a borrower's true creditworthiness, said Michael Stegman, the director of policy for the MacArthur Foundation's program on human and community development.
"If all their other credit accounts are in good shape, or they haven't established credit but they've had no delinquencies on their rent," Stegman said, "the fact you have a bad medical debt or an outstanding judgment over a medical bill is not a good predictor of default."
One such lender, Self Help of Durham, N.C., has a 1% default rate on its mortgages, which public-policy director David Beck said is comparable to mainstream lenders that use credit-scoring formulas that take medical debt into account.
"Our experience has been that medical debt isn't generally reflective of a borrower's ability or willingness to repay," Beck said.
It's not clear that these lenders' experiences with low-income borrowers can be extended to the population in general, but it's time to find out. Credit-scoring companies such as Fair Isaac, the creator of the leading FICO scoring formula, should research whether medical debt really is predictive or not.
In a bind? 4 tips Personally, I think we could solve much of the problem of unfair medical-debt reporting by excluding all collections under $100 from credit reports. I also think medical debts should be treated differently, with shorter statutes of limitation on collection and reporting (say, four years instead of the current seven), to reflect the fact that medical bills are a fundamentally different kind of debt from credit cards and auto loans.
Unless that happens, here's how to reduce the chances of your credit getting run over by medical debt:
Bird-dog your medical bills. Don't assume your health-care provider and your insurance company will eventually work it out. Follow up on every bill or claim with an unpaid balance. If a debt remains after more than a month or two, ask your provider and your insurer what the problem is and what you can do to help.
Negotiate if you're uninsured. As I discussed in "How to survive your hospital bills," you may be able to qualify for charitable assistance that could reduce or eliminate your bills. Even if you don't qualify, you should try to get the amount you're charged reduced to what an insurer or government agency would pay.
Get payment agreements in writing. If you don't have insurance and want to make payments, make sure your agreement is in writing. One Your Money message boardcontributor agreed to pay her health-care provider $50 a month to pay off a $1,600 bill. No agreement was signed, however, and the provider recently started demanding $150 a month.
Try to talk your way out. If despite your best efforts a medical bill lands on your credit report, you have a couple of options. One is to dispute the bill with the credit bureaus as "not mine"; sometimes collection agencies won't bother to verify the disputed account, and it will fall off your reports. Option two is to negotiate with the collection agency to remove the account from your credit reports in exchange for payment.
Get your insurance claims paidGood records, detailed claims and persistence will help you get your money faster and avoid problems.
Ideally, you'd get that promise in writing before you pay anything, but sunny_light managed to sweet-talk a collection agency rep into clearing a credit report after sending the $7.
"I called that collection agency woman again and talked and talked and talked to her with lots of 'please' . . . and then it was quiet for a while so I thought she hung up . . . but then she said she was looking at my file . . . and finally she said 'normally we don't do this' and then she told me to check my report in about 30-45 days," sunny_light wrote. Two weeks later, sunny_light checked, "and the $7 medical bill (paid) has been removed from all three credit reports . . . and my credit scores went back up!!"
Columns by Liz Pulliam Weston, the Web's most-read personal-finance writer and winner of the 2007 Clarion Award for online journalism, appear every Monday and Thursday, exclusively on MSN Money.
Published Nov. 19, 2007
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