In July 2007, Carrie Barrett went to the emergency room at Methodist University Hospital, complaining of shortness of breath and tightness in her chest. Her leg was swollen, she’d later recall, and her toes were turning black.Given her family history, high blood pressure and newly diagnosed congestive heart failure, doctors performed a heart catheterization, threading a long tube through her groin and into her heart.
Her share of the two-night stay: $12,019.Barrett, who has never made more than $12 an hour, doesn’t remember getting any notices to pay from the hospital. But in 2010, Methodist Le Bonheur Healthcare sued her for the unpaid medical bills, plus attorney’s fees and court costs.Since then, the nonprofit hospital system affiliated with the United Methodist Church has doggedly pursued her, adding interest to the debt seven times and garnishing money from her paycheck on 15 occasions.
She soon learned that the rumors held some truth. Medicaid, the government program that provides health care to more than 75 million low-income and disabled Americans, isn’t necessarily free. It’s the only major welfare program that can function like a loan. Medicaid recipients over the age of 55 are expected to repay the government for many medical expenses—and states will seize houses and other assets after those recipients die in order to satisfy the debt.
“The folded american flag from her father’s military funeral is displayed on the mantel in Tawanda Rhodes’s living room. Joseph Victorian, a descendant of Creole slaves, had enlisted in the Army 10 days after learning that the United States was going to war with Korea.To hear more feature stories, see our full list or get the Audm iPhone app.After he was wounded in combat, Joseph was stationed at a military base in Massachusetts. There he met and fell in love with Edna Smith-Rhodes, a young woman who had recently moved to Boston from North Carolina. The couple started a family and eventually settled in the brick towers of the Columbia Point housing project. Joseph took a welding job at a shipyard and pressed laundry on the side; later, Edna would put her southern cooking skills to use in a school cafeteria.
In 1979, Joseph and Edna bought a house in Boston’s Dorchester neighborhood for $24,000. Just a few years after they moved in, Joseph died of blood-circulation problems. But by leaving that house to his wife and children, its mortgage satisfied by his life-insurance payout, he died believing that he had secured a legacy for his family, which, in just a few generations, had lifted itself out of slavery, segregation, and poverty to own a piece of the American dream.
“The takeaway is that we have a history that so many Chicagoans are really not aware of that has really shaped the city and shaped the racial politics of the city. It shaped the economy of the city. In order to move forward and address issues that confront us in terms of poverty and racial discrimination, we have to have a common understanding of what happened in the past,” said Duke University’s Bruce Orenstein, the study’s project director who is doing a documentary series on Chicago’s housing segregation.That past has roots 100 years ago with white people not understanding that they created black ghettos, he said.”
South Carolina hospitals are using a loophole in state law to scoop millions of dollars a year from the pockets of the poorest of patients. It mostly takes place outside the courts and the public eye.
A law originally written to help state and local governments collect debts is being used to seize tax refunds from people with past-due medical bills. The S.C. Department of Revenue does the legwork, and the cash flows straight into the coffers of some of the region’s largest health care companies.
The deep and persistent racial wealth divide will not close without bold, structural reform. It has been created and held in place by public policies that have evolved with time including slavery, Jim Crow, red lining, mass incarceration, among many others. The racial wealth divide is greater today than it was nearly four decades ago and trends point to its continued widening.