Medical bills land hard-working family in an American nightmare

SUNNYSIDE, WA--Connie Vizcarra couldn't believe it when her husband, Alonso, called her at work one day last month to say a sheriff's deputy was in their driveway about to arrest him.

Alonso, a longtime farm laborer and permanent legal resident, had no criminal history. But he had not paid some past-due medical bills. And when he ignored an order to appear in court to explain himself, a collection agency persuaded a judge to issue an an arrest warrant.

That cold January morning at their modest manufactured home on a dirt road southeast of town, Alonso was handcuffed and taken to the Grandview city jail. Connie couldn't come up with the $800 bail.

The next morning, Alonso, who speaks little English, was shipped to the Yakima County jail, where he was booked for contempt of court. A judge ordered his release that afternoon. But immigration officials detained him for questioning.

Connie recalls arriving at the county jail with her son, Christopher, only to be told they had no record of her husband.

"Nobody could tell me where he was. It was a horrifying experience," she said.

Eventually, jail personnel found Alonso and he was released that evening.

A month later, Connie and Christopher are still wrestling with the fact that Alonso was arrested at all. Although it was legal -- he disregarded a court order, which put him in contempt of court -- the Vizcarras feel it's fundamentally unfair to jail someone because he doesn't have health insurance and had the bad luck to get sick. Alonso suffers from chronic foot problems and an enlarged prostate.

"We just want people to give us a chance to pay our expenses, but they all want to be paid at once," said Connie, 53, who works part-time as a home health nurse.

With medical debt of $3,054, the Vizcarras are a month behind on their $1,200 monthly mortgage payment and have been advised to consider filing for bankruptcy. They'd like to refinance, but can't because of the medical debt.

Their story is just one more sobering example of how easily working people can fall through the cracks of a broken health care system.

"It's getting worse for people like this all the time," said Kathleen O'Connor, a health care consultant and chief executive of Seattle-based CodeBlueNow!, a nonprofit agency advocating for health care reform.

O'Connor said that as more employees are having to pick up more of the cost of their health insurance, many decide just to drop it.

"Then a catastrophe hits and they're in big trouble," she said.

The Vizcarras haven't run into a medical catastrophe yet, but the thought of losing their home and not being able to send Christopher, 19, to college is just as bad, they say.

"Our American dream is going to pot," said Connie.

Of the 45 million Americans living without health insurance, experts estimate a third are being chased by collection agencies. Bankruptcy often becomes their only way out. Illness and medical bills lead to half of all personal bankruptcies in the United States, according to a first-of-its kind study published in 2005 by Harvard University's medical and law schools.

Consumer debt -- namely, credit cards -- has been the leading cause of bankruptcy since the 1980s, according to the Federal Reserve Bank.

Yakima bankruptcy lawyer Robert Royal said he sees medical bills grow as a component of credit card debt.

"It's a more common thing to do now, to put medical bills on a credit card," he said.

In Yakima County, about 44,000 people -- nearly one in five -- lack health insurance, according to the state Insurance Commissioner. Extrapolating from the national collections figures, it's conceivable that as many as 14,600 people in the county are in legal trouble over unpaid medical bills.

Lawyers for collection agencies say most people eventually pay and that only a handful end up in jail for contempt of court.

James Hurley represents Yakima Adjustment Service, one of the collection agencies that obtained a judgment for Sunnyside Community Hospital against the Vizcarras. He said that of the 24 bench warrants he seeks eacth against debtors of all kinds, four to six are related to health care.

Hurley said collection agencies give debtors "every opportunity" to work out a payment plan before seeking a contempt order, especially when the bills are medical. Hospital debt counselors, for example, try to qualify their patients for charity care before resorting to collection agencies.

Debtors jailed for contempt, Hurley said, have ignored notice after notice to pay. "Typically these people have really had their heads in the sand," he said.

Connie concedes that she didn't pay some bills over an extended period of time. With Alonso unable to find part-time work and her limited hours, they let the medical bills go in favor of necessities: food, the mortgage and utilities.

She also says she tried to consolidate the medical bills. "I kept up a constant dialogue with creditors. But whatever channel we took to get some help, we ended up not making any progress. We don't refuse to pay our medical bills."

Plus, her wages were already being garnished to pay the various medical creditors when Alonso was arrested. "It's blood from a turnip, that's what it is," she said.

Sunnyside hospital officials won't discuss the circumstances of specific patients. But they said the hospital doesn't turn an account over to a collection agency until it's well past three months due.

"We have a welfare coordinator who works with dozens of families every week," said spokesman Tom Lathen. "We explain things as best we can with families of any income. No one wins when a case goes to collection, and we try very hard to avoid it."

At one time, Connie had health insurance for her family from her employer, a nonprofit organization that she declined to name. The organization, she said, can only afford to give her two or three days of work a week as an in-home diabetes educator and licensed practical nurse. Her bachelor's degree, LPN license and 30 years of experience put her into a relatively high-wage category of $20 an hour.

"They have found that they can hire a medical assistant and give them some training and do the job I do" for less, she said.

Like many companies with part-time workers, Connie's employer offered a high-deductible health care plan to try to keep premiums down. Still, the $5,000 annual deductible and $900-a-month premium were too expensive for the Vizcarras, especially after Alonso got sick.

Their problems began about three years ago. Alonso was managing the irrigation system of a 1,000-acre vineyard when he was sidelined by arthritis and the inflammation of the tissue along the bottom of his feet, called plantar fasciitis. Doctors said he could not work long periods of time on his feet, devastating news for a farm worker.

He took Social Security early retirement at age 62, and began looking for part-time work to supplement his $534 monthly check.

Meanwhile, he needed a specialist to treat his prostate problem, and Connie also had to have some unexpected surgery. That's when the bills began to pile up. To name a few: $235 from Yakima Urology Associates, $2,450 from Sunnyside Community Hospital and $467 from Prosser Memorial Hospital.

The Vizcarras have too many assets to qualify for Medicare coupons or other programs for the needy. They don't want handouts, either. Alonso takes as much work as he can get from a friendly local rancher, and Connie is trying to increase her hours at work even if she has to accept a lower wage.

"This really should be an embarrassment to our government," she said. "I know I am not the first person in this situation and I won't be the last, but people really need to wake up and write their senators and congressmen."

Just days ago, Connie and Alonso signed an agreement with Yakima Adjustment Service to pay $100 a month toward their hospital bill. They're hoping a decent tax refund will finally help them break even.

* Leah Beth Ward can be reached at 577-7626 or lward@yakimaherald.com.