Someone run the ROI for me: is $335,000 over 3.5 years enough to save 300 jobs?

For context: I'm not aware of any law "requiring" them to pursue medical debt in court, and while the targeting may not be intentional, the impact is clearly disproportionate in certain communities.

They did. When @stlpublicradio.bsky.social covered our research, WashU gave this statement. They emphasized their overall charity care & denied "targeting" anyone.

So grateful for your support in sharing this, Dr. Chino! Excited to share more from STL soon.

11/ I owe enormous gratitude to the Center for Social Development at WashU & @moconsumer.bsky.social for their encouragement, insight, and belief in the project, especially Dr. Michael Sherraden, Chris Leiker, Sandra Padgett, & Ed Weisbart. This work wouldn't have been possible without them.

10/ The pattern is clear: tax-exempt, mission-driven institutions suing low-income, mostly Black communities over small sums. We hope this research contributes to a more equitable system.

Read the full study here: ja.ma/3In6gkj

#MedicalDebt #HealthEquity #STL

9/ These lawsuits weren't filed by hospitals, but by university-affiliated physician groups, raising serious questions about institutional values, charity care, and community impact.

8/ Wage garnishment orders were even issued against employees of local hospital systems and against the universities themselves.

7/ The burden wasn't equally shared:
🔹 Majority-Black ZIP codes represent 22% of the region's population, but they accounted for:
🔸 41% of lawsuits
🔸 47% of total judgments
🔸 48% of wage garnishments

6/ Here's what we found:
🔹55% of lawsuits led to judgments
🔹87% of those were default judgments (the patient didn’t appear)
🔹The average judgment: just under $2,000
🔹The smallest: $104

5/ We carried out this work independently and without funding. No grants, no institutional affiliation — just a Google spreadsheet, a lot of late nights, and a few social workers committed to uncovering and understanding the issue in our community.

4/ That discovery became a years-long project. With my co-authors Kathryn Koch and @mollywm.bsky.social we tracked and analyzed 973 lawsuits between January 2020 and May 2023. Our findings were just published in @jamanetworkopen.com.

3/ Curious and concerned, I turned to Missouri's court database, Case.net. I found not just a few lawsuits, but hundreds — mostly filed by physician groups affiliated with SLU, and also WashU. I decided then to start building a dataset.

2/ I'd spent years helping patients navigate complex billing & financial assistance systems, but I had never seen someone taken to court. I couldn't understand how this aligned with the Jesuit values I'd been taught at SLU...