JustHealth

The Executive Director of JustHealth, John Metz, was recently featured in an ABC-TV news broadcast about our health care crisis.   

Fifty percent or more of bankruptcies in the U.S. are caused by medical bills. The majority of those involve people who have health insurance. The ones with health insurance generally have larger unpaid medical bills than the uninsured. How can this be?

The ABC-TV Story 

If you've ever been stuck with a medical bill you thought your insurance was going to pay but didn't, you can count yourself among millions in the same boat.

And it's a boat that's sinking fast.

It's estimated that nearly 60 percent of all bankruptcies are because of medical bills. 

But what if the bill should have been paid by your insurance...but wasn't? 

Or the hospital charged you a rate virtually no one pays, all because you didn't know what you were entitled to? 

Most of the one-million Americans who went bankrupt because of medical bills last year were middle class homeowners who had medical insurance. ( View Video of Interview or Read More of transcript. You can also GET HELP NOW. )

John Metz is the Executive Director of "Just Health," a non-profit that helps people who get taken advantage of by hospitals, doctors and insurance companies.

"An insurance company saying that they'll pay doesn't mean that they'll actually pay. It's a battle that's raging every day all across America and the vast majority of people don't understand that they've been wronged."

Charles Croston went in for a routine procedure. He knew his providers were all under his insurance policy.

"But low and behold, they use a doctor who is not part of that system and he billed me separately and said I want $850."

Charles was never told the hospital could substitute his anesthesiologist with a doctor outside his plan.

He only figured it out on his way into surgery. Metz says he's not surprised.

"He's been given anesthetic. He's about to fall asleep. What's he going to do exactly? It's my belief that the responsibility lies with the providers. They have a duty to inform the patient in advance because there's not equality in knowledge."

Here's what we discovered most people don't know: Just because the hospital takes your insurance, doesn't mean you're covered.

Most hospitals contract with groups of doctors who are not their employees: Like anesthesiologists, radiologists and ER doctors.

Each can charge you separately for whatever amount they want. Bryan Sharp injured his eye and needed emergency treatment.

"They accepted my insurance at the time that i checked in."

But by the time it was all said and done, Bryan had bills...not co-pays or deductibles...but bills - totaling more than $19,000. Metz says it's a situation where providers are not being upfront with patients.

"If they wanna say look, you come to our hospital and we're going to squeeze every dime out of you that we can get. We're gonna charge you a million dollars for this stuff and if you don't like it, go somewhere else, well, at least that would be honest."

And if you don't have health insurance, or are caught in between having coverage, like Liz and Eric Kuhl - this gets so much worse. Metz says the results can be devastating.

"The consequences of not informing people, as you found in your own investigation, I see regularly, can be worse than the disease."

Not long ago, Eric went to the E.R. for kidney stones.

"I was just in really really excruciating pain."

One prescription, two CT scans and 45 minutes of treatment later he was back home. Bills arrived. Eric and his wife, Liz, paid them.

"The ER doctor, the hospital and a radiology service that read the CT scan."

But what they didn't expect was an enormous - and unitemized bill - from St. Joseph's Hospital - Catholic Healthcare West. Remember - Eric says he was only there about an hour and already paid all the doctors.

"I was so shocked when we got the bill. I was just like - unbelievable. It was over five thousand dollars. Five grand!"

To make it worse, the Kuhl's say the hospital sent it to collections before the bill was even due. John Metz says this wouldn't be the first time Catholic Heathcare West was accused of overbilling and this sort of conduct.

"Catholic Healthcare West was sued in California for virtually the same kind of conduct."

"This stuff is just wrongful."

Determined to help, the Kuhl's were on the line as Metz dialed the top dogs at St. Joseph's. First up, hospital president Linda Hunt. Metz gets transferred three times trying to get her on the phone.

"Linda Hunt please." "I'm trying to get through to Linda Hunt." "I need to speak to Linda about this situation."

Plenty of talk but no action. Nobody will put John and the Kuhl's through to Linda Hunt. And each person he speaks to will not answer John's question: "If you won't transfer me to Linda, do you have full and unfettered authority to resolve this situation?"

Next up: the head of billing, Jack Chapman.

Chapman is terse and cuts the Kuhl's off mid-sentence while they're trying to explain the situation. Chapman only wants the story in writing, so Metz jumps in.

"You're not willing at this point to look at the situation?"

Chapman says he's going to terminate the call, and hangs up. Finally - Metz calls the CEO of Catholic Healthcare West.

"I would like to speak to Lloyd Dean."

No luck and no Lloyd. But this time, the person on the phone seems willing to help. She takes down the pertinent information from John Metz and the Kuhl's and promises to pass the information along to Mr. Dean.

And it appears she just may have done that.

At the time of this story posting on ABC15.com, John Metz reports to us that Mr. Dean's office is in fact involved and that, as Metz says, "The ball is in the court of the guy where the buck stops."

Metz tells us that the CEO has indicated he's concerned. Metz and the Kuhl's have forwarded all of the paperwork that his office has requested. We'll let you know how this one gets resolved...

You can also go here to see John in a Live Video