In less than a week, voters in Kansas will go to the polls to decide who will represent them in the U.S. Senate. Their choice is between the incumbent finishing his first term in office after a career as an OB-GYN in rural Kansas and the pastor of a Protestant megachurch in Kansas City.
Last month, The New York Times waded into the race by publishing a piece that smeared Sen. Roger Marshall (R-KS) for the unspeakable crime of trying to collect unpaid medical invoices for his private practice. The story spun a doctor’s mundane efforts to stay afloat by simply seeking compensation for services provided as the callous persecution of the impoverished.
If the outlet genuinely cared about exposing the roots of American medical debt, it'd focus on the real perpetrators: big hospital systems, often composed of dozens of facilities that hide prices, gouge patients, all while exploiting loopholes in federal law to line their pockets.
USA Today did just that earlier this year, exposing how from 2010 to 2014, Virginia hospitals sued patients over 1 million times. Its reporting also found that tax-exempt hospitals, which get that privilege purportedly to support their charitable care, “accounted for over half the filings.”
In Colorado, UC Health similarly filed almost 13,000 lawsuits against former patients from 2019-2023. Many of the patients in question echoed their Virginia contemporaries' complaints: they “could not obtain prices in advance” and bills had ridiculously “inflated charges.”
A 2022 analysis by KFF found that two-thirds of hospitals sued patients. Some even own collection agencies. Others have gone after people’s homes to collect on past debts.
Yet these big hospitals, often tax-exempt, also enjoy access to federal grants and other reimbursement schemes for uninsured or underinsured patients. These benefits, combined with excessive and obscure care fees, have helped larger systems pull in billions in annual revenues and amass large endowments that would help them absorb the cost when patients can’t pay.
Unlike the big nonprofit hospitals, private practices like Sen. Marshall’s are on their own when patients don’t pay. And when OB-GYNs serving rural communities can't get paid by their patients, they don’t have the luxury of calling in government favors or pulling cash out of multi-billion-dollar endowments.
They simply go out of business, and their communities lose access to vital healthcare.
Private providers, many opened with dreams of serving their communities, have reported forgoing salaries to make ends meet before ultimately closing their doors. Their inability to compete with big hospitals has resulted in at least a 13 percent decrease in the number of private practice physicians over the past 14 years.
But instead of going after the hospital behemoths, The New York Times singled out a single rural OB-GYN. The reason seems obvious.
And the timing couldn’t be more curious. The stories highlighted by the Times go back sometimes more than 20 years, yet Sen. Marshall has been in the public eye for at least the last seven — including his first campaign and six years of his first term. Yet the Times’ crack investigative health reporter put it together just eight weeks before his reelection.
Within two weeks of the story, Adam Hamilton’s team was running an ad with a so-called victim of Marshall’s — in truth, a patient he had served who failed to prioritize paying him for the important service he provided.
The New York Times’ attack on Sen. Marshall is particularly vexing, considering his leadership on legislation designed to protect patients, improve healthcare price transparency, and lower costs. Last July, Sen. Marshall led a coalition of Republican senators in introducing the “Patients Deserve Price Tags Act,” which would require hospitals and other healthcare providers to publicly report the price of their services, empowering patients with accurate, up-front knowledge about their options. Many argue that hospitals’ opaque pricing schemes have allowed them to raise prices at rates far exceeding inflation, without prompting well-deserved backlash.
Yet, the same New York Times that covers healthcare deserts, analyzes rising costs, and exposes injustices is attacking one of the leading proponents of healthcare reform for a bit role in collecting medical debt years in the past, while giving a pass to big hospitals that do it on an industrial scale.
Americans deserve better healthcare and greater price transparency. They also deserve journalism that doesn't step over real stories en route to participation in political hit jobs.
John Czwartacki, former senior advisor at the White House Office of Management and Budget, is co-founder and principal of Public Policy Solutions.
Editor’s Note: The 2026 Midterms will determine the fate of President Trump’s America First agenda. Republicans must maintain control of both chambers of Congress.
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