Pay Dirt

My Family Is Furious I Won’t Pay My Brother’s $200,000 Hospital Bill

Years ago, I pleaded with him to get health insurance. Now I’m being ostracized due to his carelessness.

hospital bed
Photo illustration by Slate. Photo by Getty Images Plus and Spoon Graphics.

Pay Dirt is Slate’s new money advice column. Have a question? Send it to Athena and Elizabeth here. (It’s anonymous!)

Dear Pay Dirt,

After his furlough five years ago at 55, my brother refused to get health insurance. He could afford it; he simply chose not to—mostly because of an ignorant penny-wise/pound-foolish decision to cut “nonessentials,” but also from an arrogant conception of being “tough.” I told him this was an insanely bad decision and that he was needlessly leaving himself open to catastrophe. I even offered to pay half of it (roughly $1,200 year) if he’d just sign up. I also told him, explicitly, that I would not compromise my own retirement if something terrible did happen.

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You guessed it: Disaster struck. Some uninsured kid T-boned him. Fortunately, his area has excellent emergency rescue and health care, so despite serious injuries, he survived and will recover. But he now has more than $200,000 in hospital bills. His only asset is his home, which he’ll likely need to sell … then rent a flop, return to work at 60, and grind like a dog until the day he dies … all because he refused to invest $200 a month for health care coverage.

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I have declined the expected appeals for help and am now ostracized. This mess was completely and easily avoidable, and though I could discharge his entire debt, doing so would seriously endanger my own financial health. At 62 and out of work myself, I’m not doing that. But do I have a financial and ethical obligation to help?

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—Exasperated

Dear Exasperated,

I think it’s appalling that anyone in this country could face $200,000 worth of hospital bills because they had the temerity to get hit by car, but for now at least, we’re stuck with the terrible health care system we have, and it’s not as if your brother doesn’t know how it works. He made a decision not to purchase health insurance and not from a place of financial hardship, which would be much more forgivable.

You have no financial or ethical obligation to help. But we’ve all had family members and friends who’ve done boneheaded things we’ve warned them not to do and suffered the consequences. We often help them anyway, and if you’re inclined to do that, you can do so without putting yourself at risk. You are not a break-glass-in-case-of-emergency fund, and your brother needs to understand that. Medical bills are often negotiable, and creditors would rather have a long-term payment plan than a patient who files for bankruptcy, so consider that even if he has to sell his house, the end result is not necessarily a flop of a rental, or as you put it, “working like a dog till he dies.” If you want to engage, offer to help with those logistics first rather than writing him a check.

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Dear Pay Dirt,

I’m an eighth grader with a very clear plan for high school, and I could see myself maybe getting into a top college. My parents make more than the financial aid threshold at colleges I’ve looked at, but they never started a college savings account or even thought about paying for college someday. When I asked them why they didn’t save for college, they got defensive and got mad at me. They said that we could barely afford the house we are living in (they also own two rental houses) and that our cars (all paid off) are too expensive.

My parents aren’t transparent with money, so I don’t know what their other expenses are like. They’ve now banned talking about paying for college from our house, often talk about “poor people taking money from the hard workers,” and say we will figure out how to pay when I get into college. I have no money saved due to never having gotten an allowance, them regifting birthday gifts, and spending gift cards I’ve gotten on themselves. What do I do?

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—Can’t Cough Up Cash for College

Dear Can’t Cough Up Cash for College,

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I was in a similar situation when I was your age because my parents had not saved money for college, either. But in their case, they had not gone to college themselves and didn’t take it for granted that my brothers and I would. But it saddens me that your parents believe, and are presumably teaching you to believe, that poor people take money from hard workers. Being poor is not a moral failing, and it’s certainly not a crime.

I work in a white-collar job now that I have largely because I went to college, and while I work hard, I don’t really know what it’s like to work the way my dad did, doing a lot of manual labor and for far more hours than the standard 40-hour workweek. I’d guess your parents might not understand it either, and a lot of the poor people they’re judging are working multiple very difficult jobs for not enough money. I hope you get to go to a wonderful school where you meet people who come from families that struggled. And I hope your parents meet their parents because the idea that poor people don’t work hard is simply not true.

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But about your situation: I had to make decisions independently of my parents and their circumstances, and it sounds like you may have to as well. So I’ll tell you what a particularly helpful guidance counselor told me: If you have to, you can file for financial aid as an emancipated minor. It’s a lot of work and you’ll need someone who’s navigated the process to help you. But if it’s clear that your parents really aren’t going to support you, know that it’s an option.

I would bet, however, that your parents are just trying to put the issue off. You’re in eighth grade, and won’t be applying for another couple of years, at the earliest. If you need reassurance to feel good about the situation, do some research into how you’d do it by yourself if you had to. Study the different types of aid, how loan repayment works, and what options state versus private schools offer. It’ll make you feel good that you’re well-informed and have a Plan B.

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Dear Pay Dirt,

Last year, my 75-year-old father had a series of strokes. He divorced my mother years ago, has been living alone for the past 30 years, and I am his only living child. What I thought would be a couple weeks of me helping him figure out his health derailed into a dementia diagnosis. This must have been occurring much longer than we realized, because his financial situation was not good, with many missed bills, taxes left unpaid, and unopened mail all over his house. I brought him back across the county to live temporarily with my family until I could find nearby assisted living or nursing home care.

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It has now been five months, and the situation has become untenable. He can’t seem to use anything on his own, and he’s broken or destroyed countless appliances or other items in the house. I’m essentially afraid to leave him alone and feel so swamped with maintaining a household and meeting the needs of a parent, two children, my marriage, and my own health.

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But one of the biggest issues is financial. He has a reliable monthly income with a pension, Social Security, and VA health care. I have access to his accounts, and I’ve been able to get his finances back in order, but he has not contributed to any expenses in our household at all, as we had initially agreed upon. On multiple occasions, I’ve brought him my receipts and asked for his portion. But he gets upset and tells me he has no money, and if I show him his account statements to prove that he can contribute, he accuses me of “taking his money.” He also says things like, “I’ve only been here two weeks, so I can’t owe you that.” I am not sure how to handle any of this this. Because I am jointly on his account, I could transfer the expenses to my account, but his adamancy that I’d be “stealing” from him gives me pause. I had to put my own work on hold to care for him and have brought no income into my own household, and I’ve had to dip into my savings to cover his expenses.

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What do I do? Do I simply reimburse myself for what I’ve paid for his expenses using my access to his account and file away the receipts for his records? Do I set an ultimatum and force him to leave? Or should I respect his wishes and let this go? When I was a kid, he skipped out on child support many times, leaving my mom and us kids to live paycheck to paycheck and to go without basics at times, even heat.

—Overwhelmed and Going Broke

Dear Overwhelmed and Going Broke,

I am so sorry this is happening to you. Being a caretaker unexpectedly is extremely hard and stressful, especially when you have to put your own life on hold to do it, but your father’s dementia diagnosis adds another layer of difficulty.

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It’s clear that your father is not really equipped to make material decisions about his finances by himself. He’s also in a place where it’s likely that he knows what’s happening to some extent, and is probably terrified and resentful because he’s not completely in control. So when he accuses you of stealing his money, it’s because he’s upset about what’s happening generally and in the moment can’t understand what you’ve been doing on his behalf. I know this is easier said than done, but you have to try not to take it personally. It’s not really about you.

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If you’re going to be his primary caretaker (and it sounds like it’s moving in that direction), I think you need some way to formalize the fact that you’re effectively the custodian of his financial affairs. If he has trouble remembering how long he’s been staying with you, he is simply not going to be capable of making these decisions by himself. And if you’re concerned that any money you remove from his accounts to cover his expenses will be viewed as inappropriate, you should find an intermediary—another family member, an impartial third party, or someone who can help you figure out, at a remove, what’s reasonable. You shouldn’t be dipping into your own savings to take care of him when he does have some income that’s expressly designed for that purpose.

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Dear Pay Dirt,

I have a simple schedule for high school graduation gifts: $100 for close family friends where I know the graduate well, $50 for close friends where I don’t know the graduate (we have moved around a lot), and $25 for more casual relationships but where I want to acknowledge the graduate. I only have two nieces, and the oldest graduates this year. I was thinking $200.

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Here’s where it gets cloudy. When my oldest kid graduated a few years ago, her aunt and uncle gave her $50. It would not bother me in the least to give my niece the higher amount, because I’m not a bean counter. But my youngest kid is also graduating this year, so I worry that I might make things weird with my husband’s brother. We are all doing fine financially, but I wouldn’t want him to feel that he has to give a larger gift to my daughter because I gave a larger gift to his daughter. (They have many older nieces and nephews, and I assume they have created their own schedule over the years.) Should I proceed and do what I want (give $200), or should I rein it in and give only $50, to keep things even?

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—I’m the Fun Aunt!

Dear I’m the Fun Aunt,

There’s a very good chance no one in the family is analyzing these things that much. The only person familiar with your graduation gift schedule is probably you. And people are generally not resentful of anything that looks like generosity. I think you can be generous toward your niece, and I doubt it’ll make anyone feel weird. If anything, that’s money toward at least one textbook Mom and Dad don’t have to buy now. Everyone wins!

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But make sure you’re not keeping score either. If your brother-in-law gives your daughter a smaller amount, keep in mind that that’s what you anticipated, given their earlier gifts. And in the meantime, enjoy the fact that you’re able to contribute that much to a happy occasion in your niece’s life. She certainly will!

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—Elizabeth

More Advice From Slate

My 2-year-old son is very attached to me (his mother). I don’t see any problem with this, but some family members (and even my spouse/his dad) have encouraged me to be less accommodating of him to push him away. I could use an outside perspective.

My son spends a few hours each week in day care (and enjoys it!), but I am his primary caretaker while my spouse works. He is happy to spend time with other family/friends if I am not around. If I am there, he wants to be with me. He prefers that I feed him, dress him, put him to bed, and play with him constantly. Sometimes I can talk him into letting others do these things, but usually he’ll melt down if I don’t. If someone else is caring for him and he starts to melt down, I usually step in to calm him.

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As further complication: I think he may have a low-level sensory processing disorder. His verbal skills are advanced, and he’s hitting his milestones, but he has strong opinions about food textures and clothing, and he often needs a lot of help to calm down for sleep. He rarely expresses interest in cuddling (and only with me), doesn’t know when he’s hungry, and has had some potty issues. I tend to accommodate his preferences because he seems truly distressed if I don’t. But he also is cooperative when I draw a firm boundary. His doctors aren’t too concerned about these things because he is hitting his milestones.

My mom said that I need to stop laying down with my son at bedtime to help him calm down. I usually sing to him and rub his back or hold his hand until he falls asleep. She says I’m spoiling him and preventing him from learning how to soothe himself. I think she’s jealous and frustrated because he doesn’t want to cuddle with her at bedtime. I understand her feelings, but I also don’t think it’s all that weird that a 2-year-old wants his mama all the time. Is it? Is it spoiling to let a child choose his food, clothes, and bedtime routine?

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