The Nuanced Truth About Hillary Clinton's Hospital Story

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

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