One of the headline news stories in the New York Times the other day was about the Providence hospital system, a ânon-profitâ organization required by law to provide free care to patients who make 300% below the poverty rate.
The deal they have with the IRS is that âin exchange for not paying taxes, they must provide free care to the poor in the communities they serve.â
Apparently, this is not whatâs happened, and theyâve been exposed for hounding patients into paying for their care after all (sans itemized bills, of course) and sending them to collections agencies. Many of the patientsâ credit scores are ultimately ruined. Doing this was, of course, illegal, but guess who paid for it? Absolutely no one⌠except for the victims. Doesnât this just seem to be the way things work lately?
My mother worked at Providence Hospital in Waco after training as a respiratory therapist in the â90s, her first truly middle-class job. She liked her work and was proud of what sheâd accomplished in learning an in-demand skill that could support herself and her daughters.
Still though, at least from what I can piece together from my memories, she was forced to take on debt to keep all the moving pieces together.
She switched jobs a couple of times as she moved up the ranks in reputation for her work, but in the spring of 1996, was fired, essentially scapegoated for a higher-upâs consistent mistakes with patients.
I first remember us getting several calls a day from collections agencies as a middle school student. In the beginning, Iâd dutifully and politely pass the phone to my mother when asked. Sheâd try to tell me to say she wasnât there, but Iâd just stare helplessly as I tried to get her to take it (Iâve never been a good or willing liar).
Soon, sheâd taught us to always say she wasnât available for one reason or another when anyone called asking for âMiss DeVriesâ (always pronounced the wrong way), as they were always collections agency representatives.
I was not comfortable with it at all. I hated lying, and I didnât understand why my mother couldnât just do what she was supposed to do so I wouldnât have to. One time when I told a bill collector that she was âin the showerâ he became aggressive. âI know youâre lying.â âNo, Iâm not!â I said nervously and hung up the phone. My heart raced for at least 15 minutes after that.
Now, I get it. And I wish I could apologize to my mom. She was literally doing the best she could, a realization that I think all parents hope their children have at some point in their lives.
Itâs not that she simply didnât feel like paying them back or was trying to chat anyone out of their money, which is what the cultural message was (and remains) about those who fail to repay their debts. But rent had to be paid, car payments had to be made, groceries had to be bought, and it would also be nice to give her kids some Christmas and birthday presents, which I now see she made a great effort to do.
I also see a few more layers of context at this point. First, the macro: our economy is built on debt; it enriches a lot of people and keeps things going, and keeps people spending on things they otherwise wouldnât be able to. If everyone decided to âbe responsibleâ and not use debt to buy anything, our economy would collapse, full stop. When people canât pay, we scold them, but if everyone ceased to use it because they canât pay, this would all be over.
A bit closer to home for me was the debt post-divorce.
I remember several tirades growing up from my father as he railed against credit cards and credit card companies. âThey want people to spend money they donât have so theyâll have to pay back even more money!â I didnât pay much attention since I didnât totally understand the concept of credit; I just knew he was against it.
Fortunately, for him, he could afford to eschew the system entirely. If things got tight, and they often did, he could always obtain âpersonalâ credit through his older family members, and was helped out in ways that counted for so much⌠ways in which I canât even imagine being helped myself.
How must my mother have felt seeing him being gifted several cars over the years, as well as the house where he lived (to be fair, half the house officially belongs to my sister and I, which is the only inheritance Iâll see) as she struggled to support us, even with child support, as debt collectors kept her own phone ringing more than ten times a day for years? Did she know about the shoebox full of âIOUsâ that my uncle once gave to my dad as a Christmas present, all his âdebtsâ forgiven? And how much was she kept up at night worrying about how she’d get everything paid for and about her daughters’ obvious discomfort with “covering” for her several times a day as if she were some sort of criminal?
Thinking about it inspires so much sadness and compassion.
Things got better when she married my stepdad, another respiratory therapist. Suddenly, we had money to spare. We moved to a nicer apartment, and got a better car, finally trading in the only new one my mother had bought years later.
But then, double-tragedy struck: Richard had a heart attack and needed bypass surgery. Right around the same time, the hospital they both worked at shut down from one day to the next for mismanagement and fraud. It declared bankruptcy, and, as far as I know, completely got away with having let go all of its workers at once, as well as not having paid the insurance premiums that had been taken out of their paychecks. Low and behold: the surgery wouldnât be covered by insurance after all, and they were both out of work. Back to square one.
They both got new jobs, but my mother was not the same. She started having some more serious health problems around this time, and they soon realized she couldnât work. And though she was fainting frequently, hitting her head and breaking her bones, she was rejected for disability benefits; âfallingâ isnât a disability, they said.
Our economy, after all, is not made to help people that arenât in optimal working condition. It doesnât matter if theyâre sick and canât work. Though she clearly couldnât work, the assumption was that she was a drug addict who was trying to live off the government because she didnât want to. No one gets lectured on âpersonal responsibilityâ more than those struggling to survive, it seems.
Iâve had much better luck than my mother. To start, I had a great mother who took care of me the way she never had been through a childhood of abuse so bad it was a wonder she even survived long enough to have us; I also had two great dads, and a grandmother who was often there to help fill in the gaps with our care (and payments for ballet classes and braces). My uncle, the one who forgave my fatherâs debts and gave him the house, paid for the college of his nieces and nephews in full, so I am mercifully not saddled with student debt.
I am saddled with debt now, though. Partially, itâs just life: itâs expensive. Sometimes you have to pay unexpected taxes, or travel to another country because your mother is dying, and those things can get you into just deep enough a hole that the âwhat the hellâ effect kicks in (whatâs a little more debt?). Itâs usually later that you realize your financial optimism was not a great position, and an endless string of independent contractor and freelancer gigs stop being as consistent as they once were. Savings are accumulated, then spent plus some for rainy days that come because gigs are, by definition, not that steady. A global pandemic hits.
But debt collectors donât stop calling. Money from the poor doesnât stop rolling endlessly up to those who have more money than they could ever spend. And we’re the ones who feel bad about it.