When staying alive means going bankrupt

Fisher stated repeatedly that she was not looking for any kind of handout for her sister. Seventeen years older than Aldrich, and Aldrich’s guardian after their mother died when Aldrich was 14, Fisher said, “I told Kathleen she had a part in this." She owed money for her treatment. But not any more than $7,000, they believed.

Aldrich and Fisher say they continued trying to work the problem out with Blue Shield, the medical group and the collection agency over the next year. But on July 24, 2006, the collection agency sued Aldrich, seeking nearly $20,000 in debts, attorneys’ fees, court costs and interest. The lion’s share of the total was the $15,239.52 that Santa Barbara Hematology claimed it was owed.

A short time later, Aldrich said, a sheriff’s deputy showed up with the paperwork to attach her wages from Santa Fe Mortgage, where she is the sole employee of owner Fred Bittle, a loyal supporter throughout her ordeal who pays Aldrich more than the going rate specifically so she can purchase health insurance. The prospect of having her $3,820 in monthly pay drastically reduced to satisfy the debt was nightmarish for Aldrich.

Her bank account already had been wiped out as a result of her unemployment and periods when her medical treatments had robbed her of the ability to work full time. She also had borrowed more than $15,000 from Fisher and another sister and had no way to repay the $7,000 she agreed that she owed other than a little at a time.

Nothing in the bank
“I have no savings,” said Aldrich. “I probably have 10 bucks saved. I live paycheck to paycheck.” Her No. 1 goal was to keep up with the premiums on her health insurance, and she remembers thinking, “I might as well quit my job if they’re going to garnish me because there’s no way I can make it.”

After consulting with an attorney, the sisters came away believing that the only solution was for Aldrich to declare bankruptcy. “He said, 'This is such an incredible mess that I don’t think you can afford the amount of money that it would take if we could ever figure it out,’” Fisher said.

Carissa Ray / msnbc.com Fred Bittle, Kathleen Aldrich's boss, "has always been there for me," Aldrich says. Bittle credits the flexibility of his small operation for being able to support Aldrich as much as he did: "The office is going to survive."

“I did not want to do that,” Aldrich said. “That is not how I was raised.” She tried to figure out how to pay the judgment, to avoid the blemish of bankruptcy any way that she could. “I was willing to drive a crappy car. I’m not very materialistic. I was even at one point looking to just rent a room somewhere to cut costs,” she said. It seemed hopeless.

So, swallowing a bit more of her pride, Aldrich borrowed $1,800 more from her sister to pay the legal and court costs for the bankruptcy. Her debts were discharged in U.S. Bankruptcy Court in April, including the $15,239.52 billed by Santa Barbara Hematology. In total, the medical group was paid more than $74,000 for Aldrich’s treatment, which got so expensive that her final round of chemo cost nearly $17,000, according to copies of billing records filed in court.

A familiar situation
Aldrich’s attorney did not respond to MSNBC.com’s request for an interview, but a well-known California lawyer who specializes in medical insurance cases said Aldrich’s experience is not unusual.

“We see it all the time in our practice,” said William Shernoff, who said insurance companies often leave patients on their own to deal with medical providers who bill too much. “None of these carriers go out of their way to help these people. They’re just looking after their own interests, and they don’t seem to have any consumer-friendly people out there trying to assist their customers. They take the first opportunity they can to get rid of any problems, especially if it’s going to cost them money.”

Shernoff doubts that a recent announcement by the California Department of Insurance that it will score Blue Shield and other big carriers on a "healthcare report card" will do much to help consumers.

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