The pundit class collapsed back in its chair last week, exhausted and spent, from a furious wonk-off session over Bernie Sanders’s rhetoric on medical bankruptcies. The Washington Post’s in-house political fact-checking apparatus assigned a devastating three Pinnocchios to Sanders for saying 500,000 people a year go bankrupt from medical bills. The Sanders camp complained, and the Post’s Grand Factmaster Glenn Kessler pushed back. Wonks stranded on the periphery of the action, like Megan McArdle, joined the fray, arguing that medical bankruptcies are actually much less common than Sanders asserts, because how can you tell whether medical debt was the precipitating event in a bankruptcy if sometimes people get unnecessary cosmetic dermatology? Checkmate.

The episode was a good reminder of the dangers of Wonk Brain, which leads sufferers to fight viciously over questionable methodology and imprecise rhetoric while ignoring the bleeding obvious and the obvious bleeding. Americans face rapidly ballooning health-care costs; get pursued into financial ruin for the crime of getting sick; and get sicker and die because the price of health care is too high to pursue it at all. The precise number of people who go bankrupt because of a medical bill matters far less than the fact that medical bankruptcy is a real danger in the United States in a way that it simply isn’t in other developed countries. You don’t have to have a degree in economics to figure that out; you just have to have ever looked at a hospital bill.



Or read the newspaper, because lately, they are filled with tales of chicanery from those same hospitals. On Monday, a Kaiser Health News report detailed the University of Virginia hospital system’s heartless pursuit of poor patients who owe them money. The hospital has sued its patients 36,000 times over six years, for as little as $13.91, with devastating consequences. The hospital has garnished wages and put liens on houses, levying high interest on delinquent patients. It sued its own employees for unpaid bills around 100 times a year.



It’s not just happening at UVA, though they are particularly aggressive. Last week, The New York Times reported on Carlsbad Medical Center in New Mexico, which has sued many more of its patients for unpaid medical bills than nearby hospitals; even the county judge who hears the cases was sued. In June, ProPublica published a story on Methodist Le Bonheur Healthcare Hospital in Memphis, which filed 8,300 lawsuits against patients in five years.



These hospitals are outliers in their communities, pursuing cases more aggressively than other hospitals do; some don’t file lawsuits against patients at all. These particularly aggressive hospitals are only known about because reporters have highlighted their practices. How many more of the 6,210 American hospitals are suing their patients? And, in turn, how many Americans have been sued by their hospitals? We don’t know, but it’s at least thousands.

