美国国家公共电台 NPR--The story of a Kansas couple struggling to avoid bankruptcy over medical debt

The story of a Kansas couple struggling to avoid bankruptcy¹ over medical debt

Transcript²

In NPR's on-going investigation³ into medical debt with Kaiser Health News, we travel to Lawrence, Kan., to see how far one couple went to avoid bankruptcy.

A MART?NEZ, HOST:

Three out of every five American adults without health insurance have debt from medical or dental bills. That's according to a poll from the Kaiser Family Foundation. And one-quarter of these people think they will never be able to pay off that debt. Bram Sable-Smith with our partner Kaiser Health News takes us to Lawrence, Kan., to see how far one couple went to avoid bankruptcy.

BRAM SABLE-SMITH: Jeff King says he never got an estimate for how much the procedure to fix his heart rhythm would cost. And he did ask. He just knew he needed it sooner than later, so he got it done. A month later, he got $160,000 bill from the hospital. And because Jeff and his wife, Kareen, were uninsured, they were on the hook for all of that.

JEFF KING: We spent several weeks at that initial time, when we first got the bill, thinking that perhaps our only route is going to have to declare bankruptcy.

KAREEN KING: Oh, yeah.

SABLE-SMITH: The Kings have been on their own to find health coverage⁴ for pretty much their entire 42 years of marriage. Jeff spent most of that time as an evangelical pastor⁵ in his hometown of Osage City, Kan. The work almost never provided insurance for the family. The one exception was his last stint⁶ helming a congregation starting in 2015. The health plan costs $1,800 a month, and the congregation paid it all. Kareen remembers feeling unworthy.

K KING: We certainly had never come up with those kinds of premiums⁷ ourselves.

SABLE-SMITH: But Jeff left that job in 2018 when he says his views on eternal damnation and gay marriage became an issue. It was a painful time for him and Kareen.

K KING: I think we just feel like we're kind of thrown by the wayside a little bit, dismissed, deemed as a threat because my husband's views are more inclusive than some feel is theologically sound.

SABLE-SMITH: The Kings were trying to move on. For work, Jeff started a nonprofit providing spiritual guidance. For insurance, they initially⁸ got an Affordable⁹ Care Act marketplace plan. But, well, long story short, they lost that coverage.

J KING: So it put us in a real quandary¹⁰. And that's why we're trying to scramble¹¹ to find some kind of coverage to get us through.

SABLE-SMITH: The Kings chose something called a medical cost-sharing plan. It's sold as an alternative to insurance with roots in religious communities sharing medical expenses. It's not insurance, though. It offers fewer protections and will not necessarily cover bills. But the plans often have low premiums, so they've grown in popularity. The Kings said their plan would not cover preexisting conditions, like Jeff's heart issues, for the first two years. They knew it was a gamble, but...

J KING: At that time, my heart was cooperating. I hadn't had any trouble. It was all good, figured we'd get through the two years and - but I didn't make it.

SABLE-SMITH: And they ended up with that $160,000 bill. After months of negotiating the hospital's financial assistance program, Jeff's final tab was dropped to $40,000 - a lot less but still a lot of money for someone who spent his life as a small-town pastor. So Jeff did what 40% of Americans with medical debt do - he took on extra work. On top of running his nonprofit, Jeff became a hospice chaplain. We met up at his second job this June as he was driving out to a small graveyard¹² in the Flint Hills of eastern Kansas. On the way, we pass the family compound where Jeff built a church from the ground up.

J KING: This road going south, this is my family's farm. That blue house over there is where we raised our children.

SABLE-SMITH: They sold that house last year, though, and moved to a smaller home in Lawrence, Kan. They're hoping to use that money to fund their retirement¹³ since Jeff's decades of working as a pastor never came with 401(k). Instead, the home sale was helping¹⁴ pay his hospital bill. They'll pay $500 a month for over six years, basically a second mortgage. When we get to the graveyard in the late morning, the son is cooking. Jeff greets the family of a hospice patient who passed away and leads her graveside service.

J KING: We're here today to help remember and keep alive the stories about Carolyn.

SABLE-SMITH: On the ride home, Jeff says he actually feels pretty lucky. Sure, he and Kareen are putting off their retirement for a bit, but 3% of Americans with medical debt end up declaring bankruptcy. He's thankful he did not become one of them. I'm Bram Sable-Smith in Lawrence, Kan.

MART?NEZ: That story is from NPR's partnership¹⁵ with Kaiser Health News.

1 bankruptcy   

n.破产；无偿付能力

参考例句：

• You will have to pull in if you want to escape bankruptcy.如果你想避免破产，就必须节省开支。
• His firm is just on thin ice of bankruptcy.他的商号正面临破产的危险。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。

4 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

5 pastor   

n.牧师，牧人

参考例句：

• He was the son of a poor pastor.他是一个穷牧师的儿子。
• We have no pastor at present:the church is run by five deacons.我们目前没有牧师：教会的事是由五位执事管理的。

6 stint   

v.节省，限制，停止；n.舍不得化，节约，限制；连续不断的一段时间从事某件事

参考例句：

• He lavished money on his children without stint.他在孩子们身上花钱毫不吝惜。
• We hope that you will not stint your criticism.我们希望您不吝指教。

7 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

8 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

9 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

10 quandary   

n.困惑，进迟两难之境

参考例句：

• I was in a quandary about whether to go.我当时正犹豫到底去不去。
• I was put in a great quandary.我陷于进退两难的窘境。

11 scramble   

v.爬行，攀爬，杂乱蔓延，碎片，片段，废料

参考例句：

• He broke his leg in his scramble down the wall.他爬墙摔断了腿。
• It was a long scramble to the top of the hill.到山顶须要爬登一段长路。

12 graveyard   

n.坟场

参考例句：

• All the town was drifting toward the graveyard.全镇的人都象流水似地向那坟场涌过去。
• Living next to a graveyard would give me the creeps.居住在墓地旁边会使我毛骨悚然。

13 retirement   

n.退休，退职

参考例句：

• She wanted to enjoy her retirement without being beset by financial worries.她想享受退休生活而不必为金钱担忧。
• I have to put everything away for my retirement.我必须把一切都积蓄起来以便退休后用。

14 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

15 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。