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Podcast: When Medical Debts Become an Impossible Burden

Keith Berry was first sued by Heartland's for-profit debt collection agency in 2009. Now he and his wife live paycheck to paycheck. (Steve Hebert for ProPublica)

When patients receive care at Heartland Regional Medical Center in St. Joseph, Missouri and don't or can't pay their bill, the nonprofit hospital uses its very own debt collection agency to file lawsuits against people and ultimately seize their wages.

Federal law allows creditors to garnish up to 25 percent of a person's paycheck to repay the debt, which for many is simply an impossible burden, ProPublica reporter Paul Kiel explains on the podcast. This is only exacerbated by the legal fees and interest tacked on after a suit is filed.

Nonprofits like Heartland comprise about 60 percent of American hospitals. They don't have to pay taxes -- essentially akin to a subsidy of several billion dollars -- and in return, these hospitals are supposed to care for those that don't have the means for insurance.

"What that means exactly is a little slippery," Kiel tells Editor-in-Chief Steve Engelberg. While these hospitals do have to offer reduced care, the law doesn't say how poor somebody has to be to get that care or how much the care has to be reduced. "So you see a large variation in the type of programs these hospitals offer."

And even though this process happens in the courts and is public, no one tracks how many hospitals sue their patients or how frequently, Kiel says. "That's one thing that we've been trying to bring to light ... hopefully that'll lead to more attention."

Listen to this podcast on iTunes, SoundCloud or Stitcher. For more of Kiel's reporting on wage garnishment, visit our series page.

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