Lawyer best remedy for S.F. General bill
Supervisor Yee, struck by a car in 2006, knows insured patients’ pain all too well
There’s often a feeling among regular San Franciscans that their leaders at City Hall just don’t get it, that they can’t empathize with regular residents’ everyday frustrations.
But when it comes to the recent revelation that San Francisco General Hospital doesn’t contract with private health insurance companies and regularly sticks privately insured patients with huge bills, the second in line to the mayor’s seat understands patients’ anger all too well.
That’s because he was one of them.
For Norman Yee, president of the Board of Supervisors, Dec. 26, 2006, was supposed to be a fun night of salsa dancing at the nowshuttered Glas Kat. He’d parked his car and was walking in a crosswalk at Fourth and Bryant streets on a green light to reach the club.
As is often the case with lifechanging moments, the memories years later are choppy. He remembers hearing “a big old bang” and then remembers not being able to move.
The big old bang was the sound of a car barreling into him. His body flew up onto the hood, struck the windshield and then rolled back down onto the pavement. He couldn’t get up.
“I heard an ambulance coming,” recalled Yee, who was a school board member at the time. “I remember them cutting off my clothes to see what happened.”
What happened was bad. A severed artery. A cracked skull. Nerve damage. Crushed vertebrae.
“There are two rods holding my neck up,” he said in an interview in his City Hall office the other
“I said ... ‘Who’s paying for this? Now I’ve got a couple hundred thousand dollars worth of bills.’ I knew I needed professional help.” Norman Yee, President of S.F. Board of Supervisors
day. “That’s my neck — two rods.”
He explained that the injury is the reason he often appears stiff. The rods allow him to bend his neck so he can look down, but not bend it back so he can look up. He still has nerve damage and often mixes up the feelings of hot and cold. He’s left handed, and injuries to his left arm mean he can only write a couple of sentences before feeling fatigued.
The ambulance took him to S.F. General, where he was in and out of consciousness for a while, and doctors thought he might be paralyzed. It took days for the feeling to return to one finger, and more time for him to wiggle his other fingers and toes.
Yee, known for being placid and unemotional, said with a laugh that the first thing he said to his wife when he came to was that she needed to move his car, which was still parked near the club. He didn’t want to get a hit with a big towing bill.
But a towing bill would have been the least of his worries. He showed me a light blue folder filled with old paperwork, mostly from S.F. General but also from Kaiser, which insured him back then and still does. He’d stayed about two weeks at the city’s lone trauma center and another two weeks at Kaiser’s hospital on Geary Boulevard.
He faced another five grueling months of recovery at home, during which he had to buy a walker, a wheelchair and stair railings. The trauma, he said, was compounded when the bills started arriving — more each week, it seemed.
“This is $4,000, this is $8,000, this is $3,000, this is $1,000,” Yee said, shuffling through the old paperwork. “They freaked me out when I got them — what is going on here?
“I said, ‘Oh my God, I’ve almost been killed, and now I’ve got a couple hundred thousand dollars worth of bills. Who’s paying for this?’ ” he continued. “I knew I needed professional help.”
Yee hired Dale Minami, one of the city’s best known personal injury attorneys. (He also co-founded the Asian Law Caucus and helped overturn the 40-year-old conviction of Fred Korematsu for refusing an order during World War II to report to a Japanese internment camp.)
The details of Yee’s case are fuzzy 12 years later, and Minami said he purged the files years ago. But he said he “negotiated a very, very steep reduction for Supervisor Yee.” Kaiser ended up paying most of the bill, Minami said.
Yee also recovered a little money from the car’s driver, who was underinsured, and a larger amount from his own auto insurance policy, Minami recalled. He said the whole thing took about 18 months to resolve.
Minami and his law partner, Mark Fong, have handled hundreds of cases of patients treated at S.F. General who later received bills they couldn’t afford. The hospital, which doesn’t contract with any private insurance company, has long charged the full rack rate and billed patients for whatever the insurance companies won’t pay.
“Part of the irony is San Francisco General has a great trauma center,” Minami said. “In a way, you want to go there. But if they’re going to charge you the full freight, then you have to make that difficult decision about your physical health versus your financial health. That’s cruel to make people do that.”
Fong said the full rack rates the hospital charges privately insured patients are inflated. The rates are approved annually by the Board of Supervisors — yes, including Yee — and the mayor.
“You can’t blame them for wanting to recoup as much money as possible, but the way they’ve gone about it is so heavy-handed as to be ridiculous,” Fong said.
Since the hospital’s billing practice came to light, the hospital and mayor have agreed to halt what’s called balance billing for 90 days while they come up with a long-term plan. They’ve also paused outstanding bills from patients treated before the 90-day halt began. It’s unclear what will happen to those bills after the 90 days are up.
Hospital brass have said they intend to educate patients better about their billing practices, set an out-of-pocket maximum for patients, expand who can qualify for charity care and start contracting with some private insurance companies.
Though Yee can empathize with other patients facing financial frustrations, he doesn’t seem motivated to become a champion of the cause. The collision did prompt him to become a pedestrian safety advocate, but he said it never occurred to him other trauma victims might be facing similarly big bills.
“My whole energy was on trying to get well,” he said. “I wanted to forget about it as much as possible.”
Does he want to take the lead on fixing the billing problem now? Not really.
“Some of my colleagues are looking into it,” he said.
That’s mainly Supervisor Aaron Peskin, who called a hearing on the matter set for 10 a.m. Thursday in Room 263 at City Hall.
So does Yee have any advice for S.F. General patients going through this billing hell now?
He sure does. “Get a lawyer.”