Say that, like many young adults, you lost health insurance coverage on your parents' plan once you turned 23. The entry-level job you have doesn't pay you enough to afford the health insurance plan they offer. But you're not worried -- you're young and healthy. What can go wrong?

One day, you're crossing the street when a guy driving a Ford Gargantua with a cell phone welded to his ear runs the red light. You try to get out of the way, but he clips your leg and peels off, leaving you bleeding on the pavement. You didn't get his plate number, and nobody else did, either.

The ambulance comes and takes you and your smashed leg to the nearest hospital, St. John's. They're supposed to be a charitable sort of place, you've heard, so you don't worry about the money yet. While you wait on your back for a surgeon to take a look-see, a pretty young woman comes by with paperwork. You tell her that you don't have coverage and don't make much money. She tells you not to worry, and hands you some forms to fill out so the hospital will forgive some or all of what it's going to charge you for hurriedly fixing your leg and discharging you the moment you can get up on crutches.

Two days later, your roommate picks you up outside the hospital; your leg hurts like hell in its cast, you're hungry, and you just want to sleep. You diligently filled out the paperwork, so you're not worried yet.

Unbeknownst to you, the hospital's accounting department, like most, has decided to charge you four times what they would charge the insurance company of someone with coverage. It doesn't matter that you have no way to pay the thousands of dollars they've decided you owe them ... because they don't have to deal with you.

Early the next Saturday morning, you're sleeping in a Vicodin-induced near-coma when the phone rings. Your roommate answers it.

"May I speak with Mr. John Smith?" the UCB agent asks your roommate.

"Uh, no, he's asleep; we're all trying to sleep here. Can I take a message?"

"Are you his wife?"

"Uh, no I'm not."

"Then tell him Laura at UCB needs to speak with him about a private business matter. It's urgent. Please have him call 860-4747 as soon as possible."

Your roommate is thinking that, since this is 8 a.m. on a Saturday, perhaps this is an emergency of some kind. "Could you please tell me what this is about? John's really sick, and it might be a while before he can make a call."

The agent's tone turns arrogant. "If you're not his wife, I'm not required by law to tell you any more than I have. Tell Mr. Smith he needs to call us immediately."

"About 'a private business matter', huh? Convince me you're not a telemarketer."

"I don't have to, young lady. What you have to do is get John on the phone."

"Well, then, guess what? I don't have to give him any messages from a bogus freakin' telemarketer calling us at 8 a.m. on a Saturday. Put us on your do-not-call list and go away."

Your roommate hangs up, rolls over, and goes back to sleep.

But UCB calls again on Monday, then on Tuesday when you're awake. They're rude, persistent, threatening, and have a scary amount of your personal information. They don't accept your explanation that you haven't any money.

The next week, they call your manager at work, and demand to know how much you make, how many hours you work, how long you've been there. They get very rude with your manager when he refuses to tell them anything. Your manager angrilly calls you, and tells you to take care of the problem, or else....

United Collections Bureau is a Toledo, OH-based collections agency that specializes in collections for healthcare providers. They operate in Ohio, Arizona, Florida, Michigan, and will soon be in other states.

In some instances, hospitals contract with them to handle medical billing in its entirety. In other cases, hospitals and doctors with an in-house billing department will sell them patients' bills -- and their personal information -- at a discount. In theory, a doctor or hospital who has set up a payment plan with a patient will wait until the patient has actually defaulted on payment before selling them over to UCB, but in practice the selloff happens almost immediately because doctors and hospitals really don't want to deal with unpleasant matters like trying to get broke patients to pony up money for wildly-inflated medical bills.

UCB does everything they can within the boundaries of the law to lever and threaten money out of debtors. They intimidate and harass relatives and housemates and have no compunctions about calling you or your manager at your workplace. They will outright lie to you over the phone to gather information or to make threats.

Having dealt with UCB agents on several occasions for several unfortunate roommates, I feel certain that if the law allowed them to send baseball bat wielding goons to your front door to collect payment, they would do so without a single qualm.

In short, they are the very antithesis of what doctors are supposed to do. Doctors are supposed to heal and cure; UCB and their ilk will be glad to break you and make you sick if that means they get paid.

So, why are doctors and hospitals so willing to employ their services? Because UCB's sales department works hospitals and doctors with elan, telling them how easy their services are to use and how cost-effective they are. UCB sales executives sit on the boards of many HMOs, and chances are good they play golf with the board of directors of your local nonprofit hospital.

Given that UCB sits on HMO boards, chances are good that they help set insurance and medical prices, thus ensuring their own revenue stream will keep going up, up, and up and that doctors and hospitals will have an ever-increasing supply of people who can't afford insurance and have a hard time paying their bills.

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