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The Nuanced Truth About Hillary Clinton's Hospital Story

April 08, 2008 12:17 PM

The tragic story Sen. Hillary Clinton, D-NY, has been maligned for sharing about Trina Larae Bachtel, 35 -- who lost her son and her own life -- has some truth to it.

But it is also not as starkly illustrative of the problems with the U.S. health care system as Clinton has relayed to audiences on the stump.

This does not make the loss of Trina Bachtel and her stillborn son Tray Dean Hutton any less tragic. Nor does it take away from the fundamental issue -- that tens of millions of Americans lack health insurance and this often has disastrous consequences.

But here are the facts of the case.

It's a conclusion that is neither a dismissal of the story altogether, as some in the media have done following the remarks of one hospital administrator in the New York Times Saturday, nor is it a declaration that the story, as Clinton told it, was true, as the Clinton campaign would want it.

**

Clinton was first told the sad story of Trina Bachtel by an Meigs County Ohio sheriff’s deputy, Bryan Holman.

The moment Holman shared the anecdote with Clinton was captured on video, and you can watch it HERE.

“I’d like to tell you the story of a young woman I know that didn’t have health insurance," Holman said. "She worked in a little pizza place around here and she was pregnant, worked for minimum wage. She went to the hospital. And the hospital told her she needed $100 up front, which she didn’t have of course didn’t make a lot of money . So they had billed her a couple of times for it. And uh, after getting pregnant she went back, like I say, she went back again, they told her she needed $100 she didn’t have. So they refused to see her because she had a bill and stuff and been there before."

"So she went to another local hospital," he says. "And they seen her and stopped her labor and told her to come back in two days. Well, before she got back within those two days her baby died. So they life-flighted her to Co - to a hospital in Columbus and within 15 days she died. And they come to find out that they had misdiagnosed what the problem was. And it was a smaller hospital, didn’t have the needs to take care of what she needed at that time."

The larger point, says Holman to Clinton: "her family and them think that if she'd had good insurance and stuff and she was taken care of at the first hospital of course that had the medical means to take care of her that her and her baby of course would still be here. Its just you know the health insurance thing really needs to be addressed for people who you know work for minimum wage and different things.”

Said Clinton: "I hear so many stories like that. People without insurance are more likely to be die than people with insurance."

**

Clinton immediately began telling the story to make an argument for universal health care. Her campaign did not try to check its accuracy before she did so.

In Terre Haute, Indiana, Clinton said that in Ohio “a deputy sheriff told me about a young woman who worked at the pizza parlor there and she worked for minimum wage, she didn’t have any insurance. She got pregnant, went to the hospital — and I don’t blame the hospital. The hospital said, ‘We can’t take any more charity care. You have to give us $100 before we can examine you.’ She didn’t have $100. Went back another time, they told her the same thing.”

When Bachtel went back to the hospital, Clinton said, she did so “in an ambulance. And they worked hard to stabilize her, and she lost her baby. Then they airlifted her to Columbus to the medical center, and for 15 days they tried to save her life, and she died.”

Clinton in telling the story shared with her by Holman conflated the first hospital where Bachtel was denied here, with the second, where she lost her child, which was O’Bleness Memorial Hospital in Athens, Ohio.

O'Bleness Memorial Hospital took issue with the story, since she'd been making it sound as if the hospital where Bachtel died was the same one where she'd allegedly been denied care.

With that factual error noted in the New York Times, some in the media portrayed the story in such a way as to imply that none of it was true.

Some of it was accurate. The tragic death of Trina Bachtel and her son. The fears of a poor pregnant woman and her lack of immediate access to quality health care because she didn't have health insurance.

But some of the story Clinton shared was not accurate.

**

In addition to Clinton conflating the first and second hospitals, Holman -- who heard Bachtel's story second-hand -- got some key details wrong.

First, years ago, Bachtel was told she needed to pay $100 before she would be seen by a doctor not because they wanted the money up front, but because she owed the clinic money.

Second, this did not happen at a hospital, but at a private physicians' clinic. Specifically, Holzer Clinic in Gallipolis, Ohio. Hospitals are legally not permitted to deny care to anyone. The rules are quite different for clinics.

Holzer Clinics Inc. is a private series of clinics (not to be confused with Holzer Hospitals). Holzer Clinic Inc. has nine offices throughout southeastern Ohio and West Virginia. They take in about 500,000 patient visits a year, including more than 100,000 Medicaid patients a year and maybe 25,000 patients with no insurance.

Holzer Clinics Inc. tries to work with patients who accrue medical debts. But there are times when a patient mounts up debts and the clinic system believes he or she needs to make more of an effort.

When that happens, the patient enters an "advanced payment status." Before the doctor will see the patient at this private clinic, he or she is asked to pay $100. If the patient says he cannot pay, he or she is counseled to go to a hospital emergency room.

This is what happened to Trina Bachtel, who at the time had no health insurance.

There are exceptions. Doctors at Holzer Clinics Inc will see patients in "advanced payment status" if, for instance, they have been referred out of an emergency room, if they've since gone onto Medicaid, or if they're receiving workers compensation. Cancer patients in chemotherapy, and pregnant patients will be seen whether or not they pat the $100.

**

Which brings us to the third point: when Bachtel was told she needed to pay the $100 before the visit -- and court records show that she'd owed thousands of dollars to the Holzer System -- she was not pregnant.

Bachtel got pregnant and in 2007 suffered through a difficult pregnancy, suffering from preeclampsia, characterized by high blood pressure and the presence of protein in the urine, effecting 5-8% of all pregnancies.

At that time she had health insurance.

For whatever reason, she thought that she would need to pay Holzer Clinics Inc. $100 and she did not go to the clinic.

"She was told she had to have $100 upfront and that's why she never went there when she got pregnant," one of her family members told me.

Later she went to O’Bleness Memorial Hospital when it was an emergency.

Her son was stillborn there on August 1, 2007. She was airlifted to OSU Medical Center in Columbus, where she died two weeks later.

**

It is all sad. It is all tragic. The family is grieving, and the renewed scrutiny of it all by the media -- prompted by Sen. Clinton using the ancedote -- is bringing them back to those dark days last August.

Those are the facts. A young woman lost her life and the life of her child. But no hospital or clinic denied her coverage as a pregnant woman. She had insurance when she died.

What are we to learn from the tragic story of Trina Bachtel?

- jpt

April 8, 2008 | Permalink | Share | User Comments (104)

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I had my own experience, similar to that. Jake is correct, the facts around the story do no erase the struggles of millions who are uninsured.

I don't want to live in a country where people have to hold bake sales to get cancer surgery!!!

Posted by: Catriley | Apr 10, 2008 5:14:58 PM

To the poster who stated: "Everyone in this country should have FREE medical insurance."

Young lady, there is no such thing as FREE - it always has to be paid for by the taxpayers - the only money the government has is yours and mine and when they haven't got enough they simply print some more. And they never, ever have enough.

As for the story itself and HRC - before she ever repeated one word of what Holman told her she should have had someone in her campaign fully, and I fully, vet the story. She got it wrong and then repeated the same error. The MSM has attempted to justify the story as "partially" correct - that isn't going to cut it. The media and the Clinton campaign both lied and now they are attempting to justify their error with the rationale that "at least part of the story is true."

There appears to be no honest and impartial media in existence in this day and age. And that includes the weather people.

Posted by: dharper | Apr 9, 2008 4:15:55 PM

At what point did Obama address Sen. Clinton's story about the young woman? He hasn't. So how is this a knock against Sen. Obama?

Everytime Hilary "misspeaks" is it somehow Obama's fault? Some people are just born stupid.

Some of you, both Obama and Clinton supporters, treat the election like its supporting your favorite sports team: All or nothing. Grow up and vote in the best interests of your children, morons.

Get rid of Bush policies. Support so-called radicals like Ron Paul who want to get rid of the Fed, income taxes and preemptive wars. Throw your support behind whichever candidate becomes the nominee and let's get this country back to being the best in the world.

Posted by: J Smith | Apr 9, 2008 3:50:47 AM

So tragic and pathetic death of a 7 month pregnant pizza shop worker just because of not able to pay only $100 bill or lack of health insurance.Its so inhumanly act.

Posted by: Kaushik | Apr 9, 2008 3:41:22 AM

So many people miss the point. The reason that healthcare is in such a bad state is that unscrupulous lawyers are suing doctors for malpractice.

I am not an advocate of limiting the payment that a legitimately injured patient can receive, but if the amount that a lawyer can make for pursuing a claim was a fixed feee, regardless of the payout, it would stop many of the lawsuits in their tracks.

Does anyone believe that Hillary a liar (oops, lawyer) by trade would limit the payout of fellow liars (oops, lawyers)?

Doctors are paying out hundreds of thousands of dollars (per doctor) on insurance premiums each year

How much would you charge, if in order to make one dollar, you had to generate more than $300,000 to cover office expenses and malpractice insurance?

Hillary's system will bankrupt the country, because she is only trying to address syptoms of the disease while ignoring the root cause.

When Hillary originally proposed this system, she (and others) pointed to the Canadian (bankrupt) model for nationalised healthcare as a shining example.

Those who don't know Hillary, vote for Hillary.

Posted by: Ron | Apr 9, 2008 12:55:55 AM

And folks, it is shameful that the entirety of this thread is filled with partisan bickering over candidates. THE STORY IS ABOUT TRINA and TRAY. Have some respect. I don't care if Clinton says she's been to Mars.

I care if the memory of Trina Bachtel and Tray Hutton are being ignored so that you can fight over your candidates or your politics.

Have you no shame?

Posted by: BigKahuna | Apr 9, 2008 12:22:05 AM

Christa, who states you were her friend, please help me get the story straight. Feel free to email me at bigkahunareports@hotmail.com and keep up with the story at www.noquarterusa.net.

i'm not done with this story until its told fully.

Posted by: BigKahuna | Apr 9, 2008 12:07:33 AM

People don't seem to focus on the one true main point, that this woman would be alive if everyone had health care all the time. She wouldn't have been in debt and would have gotten the care she needed immediately. The details are really pretty darn irrelevant and are just distracting from the real problem. Every American needs good, free health care like most of the civilized countries of the world.

Posted by: Judy | Apr 8, 2008 10:46:15 PM

Im sorry, But this is my BEST FRIENDS FAMILY we are talking about here;; If you dont mind, Stop "gossiping" it isnt the truth. This reminds me of some high school rumor that everyone seems to think is the "truth" OH MY GOD. this is someones family you are talking about here, LEAVE IT BE unless you know the truth.

Posted by: Christa | Apr 8, 2008 10:34:26 PM

THE FIRST ENTIRE WEEKEND THE STORY BROKE, NOBODY MENTIONED A SHERIFF HAD TOLD HILLARY THE STORY. IT WAS, HILLARY IS ATA IT AGAIN!!!
THE OMISSION WAS DELIBERATE AND JAKE TAPPER KNEW EXACTLY WHAT HE WAS DOING.
PEOPLE WHO ACCUSE HILLARY OF NOT REPORTING THE TRUTH FAIL TO REPORT THE TRUTH THEMSELVES
THAT WAS DELIBERATE,MR JAKE TAPPER. I THINK YOU FEEL WHAT CHRIS MATHEWS FEELS RUNNING UP HIS LEG... SICKENING

Posted by: TJ | Apr 8, 2008 10:00:14 PM

Remember Obama's story about the captain in Afghanistan? That wasn't vetted and only ABC got the name of the captain and claimed that the story checked out. Except nobody else was able to. We know ABC is one of the most pro-Obama networks around (Jake Tapper in particular). Why doesn’t that surprise me: the media goes into conniptions about Clinton’s anecdotes and gives Obami a free pass. The point is, the anecdote highlights the need for universal health insurance. For whatever reason, the woman who died believed she needed $100 to see a doc and that was the fundamental problem – it is irrelevant whether she owed the clinic money. And to all the bloggers questioning Clinton’s motive and statements, I hope that you will never be in the same situation as that most unfortunate mother.

Posted by: alee25 | Apr 8, 2008 9:24:09 PM

This is a tragic story. What surprised me is that Hillary Clinton, who presents herself as one of the leading experts in the US on health care, did not see some of the inconsistencies in this story. Did she not know that it would be illegal for the hospital not to see this patient as reported above. This makes me question not only her truthfulness but her competence as well.

Posted by: Steve | Apr 8, 2008 8:07:16 PM

Forget about the heathcare system for a moment. What's more interesting is that Clinton believed the officer and used that story in her speech. She didn't even verify it. She had no qualms about telling an anectodal story in her speech. She wasn't an anonymous poster at a forum or blog. She said it in a speech. Politicians distort the truth when they're elected, but they try to present themselves as cleanly as possible before being elected. If that's how she is now, what is she going to be like if elected?

Posted by: Imus | Apr 8, 2008 6:17:23 PM

Lazy journalism!

Posted by: russell | Apr 8, 2008 5:24:21 PM

This story ALWAYS had some truth to it. The hospital never claimed otherwise. The reason it asked the Clintons to stop using it was the problem parts it still has.

Posted by: kravitz | Apr 8, 2008 5:10:18 PM

Thanks for reporting on this and clearing it up in a way that makes sense. I am a physician, and it seemed obvious that what was said by Senator Clinton could not be true, and that what the press reported on after they "investigated" was also not the full or accurate story. This explanation doesn't make it less tragic, but does let us know that the system works the way it is supposed to at the current time...and by that I just mean to reinforce that it is against federal law for any hospital to deny emergency care to any person at any time. That would have been even more tragic.

Posted by: Audrey | Apr 8, 2008 4:56:41 PM

Firefighter:

No. Hillary hasn't completely achieved this goal yet B U T
what she DID accomplish was to get health care for over 6,000,000 children...and that was a strong beginning.

Which is why I say:

GIVE'EM HELL, HILLARY!!!!

Posted by: questioner | Apr 8, 2008 4:54:52 PM

Angela,

Hillary did try to pass Universal Health Care and she did fail. She is however the only one in this country to make a serious attempt. There is no guarantee that things will change with health insurance regardless of who wins the election. I do know that Hillary is a fighter and she will NOT give up. The feeling I have with Obama is that he will roll over when faced with confrontation. As for those who don't "need" health insurance that argument doesn't fly. There are those who may claim not to "need" car insurance but for the sake of everyone else they must have it. I don't want to pay for those who aren't willing to carry health insurance just as I don't want to pay for those who won't carry car insurance.

Posted by: Firefighter | Apr 8, 2008 4:25:39 PM

Every emergency department in the country must evaluate and stabilize an emergent patient, regardless of their citizenship, ability to pay, credit score, past due bills, or any factor. (look up EMTALA) That is NOT to say that if you show up with a sprained ankle or a cold that you will necessarily be treated...those are not emergent conditions and with home care you will do just fine.

Ms Clinton's account of the facts in this case is an excellent example of "truthiness" - rather than actual facts, its a gut reaction, the emotion that drives the discourse. If anything, this shading of facts is a real turn off. I don't want a POTUS to be carefully packaging facts to get me to feel a certain way.

Posted by: Cliff | Apr 8, 2008 3:52:23 PM

What I find infuriating about all of this is that ALL of the candidates have lied and overstated events that have occured, but it is the Obama supporters who refuse to believe that he has lied or mis-represented the facts. I mean lets get real, the man lived his life, made many statements regarding his history and much of it was fabricated, or should I say he simply overstated the facts. Did anyone ask him to verify his own story??? You will NEVER get the complete truth from a politician, so get over yourselves and vote for the person that has the best platform. If we waited until we had an Honest Abe again, we would not have a President for many years.

Posted by: Karen | Apr 8, 2008 3:42:50 PM

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