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Kari Fiotti moved back to Omaha, Neb., in 2009 after a decade living in Italy. She had divorced her husband and returned to the U.S. to start a new life.

Then, Fiotti, 44, took a pricey fall.

"When I came back, I fell and I broke my wrist without insurance," she says.

Her doctor, she says, rejected her offer to make partial payments. So, like millions of Americans, her debt — which had grown to $1,640 with interest and fees — was turned over to collectors.

Fiotti soon learned how hard they would try to collect her unpaid bills.

Court records show that the collectors sued Fiotti, but that she didn't show up in court for the hearing about her case.

In May of last year, Fiotti suddenly realized, "My bank account's at zero and I'm like, whoa, what's going on?"

Debt collectors had seized her bank account because she didn't have enough to cover the debt. Fiotti says she was stunned. "You're taking everything that I have," she says. "You're not just taking a portion of it, you're taking my livelihood."

Fiotti says she was doing clerical work making about $10 an hour. She had a kid in college and no savings. She says she had to overdraw her checking account just to take out $50 to buy groceries. In the end, a friend put Fiotti in touch with a lawyer, and she now has the debt behind her.

This story was co-published by NPR and ProPublica, an investigative journalism organization.

For more on this story:

Read the ADP report on wage garnishment. The nation's largest payroll services provider released its report after studying 2013 payroll records for 13 million employees, at the request of ProPublica.

From NPR: Millions Of Americans' Wages Seized Over Credit Card And Medical Debt

From ProPublica: Unseen Toll, Wages Of Millions Seized To Pay Past Debts

From ProPublica: Old Debts, Fresh Pain: Weak Laws Offer Debtors Little Protection

If you have firsthand experience being sued over a debt, NPR and ProPublica would love to hear from you. Use this form to send a tip confidentially. A reporter may follow up with you.

This week, NPR and ProPublica are reporting on a striking change in the way debt collectors pursue people in this country. On the heels of the worst recession in generations, 1 in 10 working Americans between the ages of 35 and 44 is getting his or her wages garnished. That means their pay is being docked — often over an old credit card debt, medical bill or student loan.

But just how much money can collectors legally seize from people's wages and bank accounts? The answer is more than you might think.

In about half the states in the country, collectors can seize 25 percent of your paycheck. In all but a handful of states, they can take everything in your bank account.

An Explosion Of Wage Garnishment Cases

In recent years, debt collectors have been filing millions of lawsuits against working Americans that are resulting in wage garnishments. That's according to an analysis by the payroll services company ADP.

Those who fall into this system find their futures determined by laws that consumer advocates say are outdated, overly punitive and out of touch with the financial reality faced by many Americans.

Lawyers and judges involved in these cases say it's common for people who are sued by debt collectors to not show up in court to defend themselves. They say some people seem to just stick their heads in the sand, while others get overwhelmed or just confused by the court documents.

The debtor's absence makes it easier for collectors to garnish wages and seize bank accounts.

The Law's Silence On Bank Seizures

Federal law regulating debt collection is silent on perhaps the most punishing tactic of collectors: It doesn't limit or prohibit them from cleaning out debtors' bank accounts.

State laws, while often more comprehensive, vary significantly. Only a handful, for instance, automatically protect a minimum amount of funds in a debtor's account.

When garnishment protections do exist, the burden is usually on debtors to figure out if and how the laws protect their assets.

"In an awful lot of states, the information that the employee gets is going to be very, very confusing," says William Henning, a law professor at the University of Alabama and chairman of a committee drafting a model state law on wage garnishment.

Back in 1968, when lawmakers passed the landmark Consumer Credit Protection Act, it specifically limited how much of a debtor's pay could be seized. But it made no mention of bank account garnishments. As a result, a collector can't take more than 25 percent of a debtor's paycheck, but if that paycheck is deposited in a bank, all of the funds can be taken.

Carolyn Carter, director of advocacy at the National Consumer Law Center, says the lawmakers didn't address bank seizures because they simply weren't common at the time. In today's collection environment, she said, "the wages that are deposited in a bank account become suddenly much more vulnerable than anyone realized."

Since the late 1960s, debt collection has changed in other ways that lawmakers couldn't have anticipated. Today, buying old debt is an industry in itself. And big debt-buying firms hire teams of lawyers to crank out lawsuit after lawsuit seeking to collect. Carter says it's time for lawmakers at the state and local level to revisit and reform existing laws.

'I Honestly Dread Paydays'

Like any American family living paycheck to paycheck, Conrad Goetzinger and Cassandra Rose hope that if they make the right choices, their $13-an-hour jobs will keep the lights on and put food in the fridge and gas in the car.

But every two weeks, the Omaha, Neb., couple is reminded of a choice they didn't make and can't change: A chunk of both of their paychecks disappears before they see it, seized to pay off old debts.

Twice, debt collectors have scooped every penny out of Goetzinger's bank account and even attempted to take his personal property.

“ It makes you feel hopeless that you're working for no reason and that you're never going to be able to succeed.

- Cassandra Rose

For Goetzinger, 29, it's the consequence of a laptop loan he didn't pay off after high school; for Rose, 33, it's a reminder of more than $20,000 in medical bills racked up while uninsured. The garnishments, totaling about $760 each month, comprise the single largest expense in their budget.

"I honestly dread paydays," Goetzinger says, "because I know it's gone by Saturday afternoon, by the time we go grocery shopping."

On a recent evening after Rose got her 11- and 12-year-old daughters upstairs to bed, the couple explained that the children need dental work. They need some crowns on their teeth. "I don't want my daughter walking around with a big silver tooth," Goetzinger says. "When you have to choose between keeping the power on for the rest of the week and getting teeth done, unfortunately, teeth falls to a lower priority."

Rose puts it this way: "It makes you feel hopeless that you're working for no reason and that you're never going to be able to succeed."

William Reinbrecht, a Nebraska attorney who represents people who are getting their wages garnished, says often there are other debts waiting in line. So when one gets paid off, the next garnishment kicks in.

"It's a little like debtors prison," he says. "It makes a subclass of people that are crushed by all of this, and they can't, no matter how hard they work, improve their economic position."

Are Working-Class Americans Being Asked To Pay Too Much?

For most workers, the unexpected loss of a quarter of their wages would make life difficult. For low-income workers, it can be particularly devastating.

The Consumer Expenditure Survey, produced by the Bureau of Labor Statistics, reports that, for a worker with annual wages between $20,000 and $30,000, the average amount spent on basic costs such as housing, transportation, food and health care is about $26,000. The average income for that population is also about $26,000.

A recent survey by the Federal Reserve asked thousands of consumers whether they could afford an emergency expense of $400. Less than half of respondents said they could without borrowing money or selling something. Nearly 20 percent said they could think of no way they might cover such a cost.

So how did the federal lawmakers in 1968 set 25 percent as the allowable limit for garnishments? Like many laws, it was the result of closed-door compromise.

At the time, House Democrats argued that debtors could often afford to lose very little.

"For a poor man — and whoever heard of the wage of the affluent being attached? — to lose part of his salary often means his family will go without the essentials," argued Rep. Henry Gonzalez of Texas, in a speech on the House floor.

In the end, the House version of the consumer protection bill limited garnishment to 10 percent of income. But the Senate's version didn't limit garnishments at all. When a compromise bill finally emerged from a committee of lawmakers from both houses, the limit was 25 percent. Forty-six years later, that's still the law in more than half of states.

The 1968 law did seek to protect the poorest workers, but did so by setting a standard tied to the minimum wage. Time has eroded what even then was a modest protection. The federal minimum wage in 1968 was $1.60; adjusted for inflation, that's $10.95 in current dollars. With $7.25 the current minimum wage, federal law only protects workers from garnishment if they earn under about $11,310 annually. Even for a wage earner without any dependents, that wage is beneath the poverty line.

The Law Demands That You Pay Your Debts

Robert Foehl, a general counsel for ACA International — a trade association for debt collectors, says collectors play an important role in the economy. And sometimes, he says, "a creditor might have no other avenue for recovering their debt except through a legal process" such as wage garnishment.

In St. Louis, Mo., Associate Circuit Judge Chris McGraugh has presided over many collections cases. He says people will admit, for example, that they ran up a big debt on a credit card and didn't pay it. And the judge says he tells them "the law demands that you pay your debts!"

But at the same time, McGraugh says, he still sees some serious problems.

He says lawyers for debt collectors will sometimes ask for delays or continuance on cases if they see a debtor is taking time off from work to show up in court. They will do that several times over weeks or months until the person finally gives up and doesn't come to court anymore, allowing the debt collector to get a default judgment against the debtor.

McGraugh says he also finds payday loan cases unsettling because the court ends up enforcing a triple-digit interest rate that the person can never escape.

"You're talking about a person who takes out $200 and years later ends up with a $4,000 debt running at an interest of 200 percent." McGraugh says he finds those cases "egregious."

McGraugh says before he became a judge in 2012, he practiced all kinds of law, from car accident injury cases to death penalty defense. And he thought he knew the legal system pretty well.

"I had practiced law for 25 years. I had no idea something like that was occurring, and as such, I don't think most people know that that's occurring and this is allowed to happen," he says.

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These days, you don't have to be a model — or a real housewife of reality TV — to have a personal stylist. You can get one online, for a reasonable monthly fee. The services, in which clothes are picked out for you and sent in the mail, are catching on among the time-starved and the fashion-challenged. Like my editor, Uri Berliner.

"Most days I couldn't even tell you what clothes I have on, what color they are," he says.

NPR's Uri Berliner shows off the results of his clothing experiment with Trunk Club.

Source: NPR

Credit: Colin Marshall

To try for a more memorable look, Uri got an account on Trunk Club. On the site, a quiz for members starts with a question about your current style level — clueless, confident or aficionado. Then you choose stores where you already shop and photos that match the look of clothes you currently wear. You're then paired with a personal stylist. Uri's was Emily Kindt, who followed up with a phone call. Uri explained he would need the clothes to kind of go together, since he wouldn't be able to piece them together on his own.

"I can't see, oh, I should wear this shirt with these pants or these shoes would look good with that. That, to me, is like understanding how to build a rocket ship that goes to Jupiter," Uri says.

Not to be left out, I signed up for a women's service called Stitch Fix. The founder and CEO is Katrina Lake.

"As women get busier and busier, I think the idea of going to a mall or even going to your nearby boutique is a daunting proposition," Lake says. "There's so much inventory out there and it's hard to figure out what exactly you should be getting."

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Editor Uri Berliner and yours truly, Elise Hu, read notes from our personal stylists. Colin Marshall /NPR hide caption

itoggle caption Colin Marshall /NPR

Editor Uri Berliner and yours truly, Elise Hu, read notes from our personal stylists.

Colin Marshall /NPR

Stitch Fix also pairs you with a stylist to choose clothes for you. It costs $20 a box for the styling service. Lake says it harkens back to the days of a one-on-one experience with a store clerk you saw regularly.

"Think about what department stores used to be — a place of wonder, a place of community, and a place where you're building real human connections and relationships — all of that really is missing online," Lake says.

Stitch Fix, Trunk Club and services like them attempt to re-create personal shopping relationships of yesterday, powered by today's data analytics.

On Stitch Fix, you describe your style sensibilities with words like "preppy" or "romantic" or "edgy." You're presented a series of photos showing clothing and accessories in various styles. You rank those photos "love it, hate it, or like it." Just as Netflix gets to know your preferences based on which films you choose, Stitch Fix uses an algorithm to understand and predict your style preferences.

"It's still totally up to the stylist to make the selections for you. But if you say, for example, you're looking for a work dress, the algorithm is going to help her, to inform her, what work dress is likely to work for you, based on all of the information that we have," Lake says.

Customers seem to like this mix of algorithm and art. Stitch Fix had a customer waiting list for two years and now employs 550 stylists. Men's service Trunk Club just got acquired by longstanding retailer Nordstrom.

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Each Stitch Fix box comes with a guide for how to wear each piece that comes with your delivery. These are the items Elise received in her first box. Colin Marshall/NPR hide caption

itoggle caption Colin Marshall/NPR

Each Stitch Fix box comes with a guide for how to wear each piece that comes with your delivery. These are the items Elise received in her first box.

Colin Marshall/NPR

And as for our boxes of clothes, they arrived in the mail a few weeks after we signed up for styling services. Inside my box were five items and a personalized note from my stylist. "Have fun trying on all these great pieces. I'd love to style you again soon. XO, Layla," it reads.

Uri got a box filled with two shirts, two sweaters, a jacket, four pairs of pants, dress shoes and striped socks in a lovely shade of lavender.

The Seams

For 'Women In Clothes,' It's Not What You Wear, It's Why You Wear It

The Fast World Of Fast Fashion

Showing Off Shopping Sprees, Fashion 'Haulers' Cash In Online

All Tech Considered

Do These Pants Make Me Look ... ? Body Scans For A Better Fit

Do the clothes work? It matters, since you only pay for what you keep and send back what you don't. I kept three of my five pieces — earrings, a military style jacket and black, skinny jeans from a designer I hadn't heard of, but loved. For Uri, a noticeable look did emerge. He says all the feedback's been good.

"An improvement, a definite improvement," he says.

But his new threads will cost him. A button-down shirt from his trunk is $185.

"I have one of those from Old Navy that cost $25, probably," Uri says.

The shirts are going back. But he's keeping the shoes.

Big thanks to Uri Berliner for so generously being a good sport — and our model — for this piece. Also a thanks to our colleagues Don Gonyea, Matt Thompson and Lakshmi Singh for contributing their style takes for our audio piece.

personal shopping

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Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show.

But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago.

Thursday's results from the Census Bureau's survey of service industries join other recent cost indicators that "are quite a bit lower than what the folks at CMS were projecting," said Charles Roehrig, director of the Center for Sustainable Health Spending at the Altarum Institute, a nonprofit research and consulting outfit. "And they're lower than what we were expecting as well."

CMS is the Centers for Medicare & Medicaid Services, the government's main health care bookkeeper. Last week CMS projected that health-expenditure growth would accelerate to 5.6 percent this year from an estimated 3.6 percent in 2013.

But health and social spending as measured by the Census Bureau grew by only 3.7 percent from the second quarter of 2013 to the same quarter of 2014. Hospital revenue increased 4.9 percent during the same period. Revenue for physician offices barely budged, growing by only 0.6 percent. Medical lab revenue rose 1.9 percent.

The report is far from being the last word. It doesn't include spending on prescription drugs, which has been rising this year thanks to new very expensive medicines for hepatitis C.

And while the Census Bureau's year-over-year results for the second quarter show tame cost trends, the increase from the first quarter to the second was more substantial. Total health and social spending rose at an annual rate of more than 12 percent from first quarter to the next. If sustained, such acceleration would raise alarms and actuaries' blood pressure.

But some who follow costs closely don't think the pace will continue.

First, health spending suffered a mini-crash over the winter, as bad storms kept people away from caregivers. Hospitals and doctors billed less from January to March than they did last fall. Part of the second-quarter recovery may just have been catch-up, analysts said.

At the same time, many people covered through the health law's online marketplaces didn't sign up until close to the deadline at the end of March. Much of the spring increase may represent a one-time surge as those folks sought treatment for previously neglected conditions.

For those reasons, the year-over-year results for the second quarter may give a better indication of longer-term cost trends than the change from the first quarter to the second, Roehrig said.

Estimates vary, but no one disputes the idea that the Affordable Care Act's health insurance marketplaces and expansion of Medicaid for the poor have added millions of previously uninsured people to coverage rosters this year.

History and logic suggest that expanded coverage and an improving economy will boost long-term, national health expenditures from their average growth rate of 3.7 percent during the past five years. (That's spending by everybody — government programs, employer insurance, commercial plans and consumers paying out of pocket.)

But so far the speedup seems nowhere close to the near-double-digit rates in the early 2000s.

health costs

Updated at 2:30 p.m. ET

Here's a roundup of the latest developments on Ebola. We'll update this post as news happens.

White House press secretary Josh Earnest confirmed that the U.S. will conduct additional screenings of passengers arriving from the Ebola-infected region of West Africa. JFK, Newark, Chicago O'Hare, Dulles and Atlanta's Hartsfield airports will implement measures that would affect about 150 passengers a day.

The World Health Organization today also updated its Ebola figures, reporting a total of 8,033 cases and 3,879 deaths from the disease in West Africa.

In Spain, Teresa Romero Ramos, the nurse who was admitted to a hospital in Madrid after caring for an infected priest who'd returned from West Africa, reportedly told health authorities three times that she had a fever before she was placed in quarantine.

There were also reports that she may have become infected by touching gloves to her face while she was removing a protective suit she wore while caring for an Ebola patient.

Her dog, Excalibur, was euthanized, reportedly inside the apartment she lived in with her husband. The dog's body was then transported to an incinerator, reporter Lauren Frayer tells NPR's Goats and Soda blog.

Earlier, The Guardian reported:

"In a note distributed on social media by several animal protection organisations, Javier Limn Romero said health officials had asked for his consent to put down the dog Exclibur.

" 'I said no. And they told me that they would ask for a court order to enter my house and put him down,' Romero said in the note.

"The appeal was sent from Limn Romero's isolation ward in the Carlos III Hospital where his wife, Teresa Romero Ramos, is also in quarantine."

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This is an undated image released Wednesday by animal rights organization PACMA of a dog named Excalibur who is owned by Javier Limon and his wife, a nurse who was infected with Ebola in Madrid. Authorities said they planned to euthanize the dog as a precaution. AP hide caption

itoggle caption AP

This is an undated image released Wednesday by animal rights organization PACMA of a dog named Excalibur who is owned by Javier Limon and his wife, a nurse who was infected with Ebola in Madrid. Authorities said they planned to euthanize the dog as a precaution.

AP

A social media campaign to save the dog had been running with the Twitter hashtag #excalibur.

The Guardian newspaper cited the Spanish paper El Pais as saying that the nurse first contacted health authorities on Sept. 30. The Guardian writes:

" ... she complained of a slight fever and fatigue. Romero Ramos called a specialised service dedicated to occupational risk at the Carlos III hospital where she worked and had treated an Ebola patient, said Antonio Alemany from the regional government of Madrid. But as the nurse's fever had not reached 38.6C, she was advised to visit her local clinic where she was reportedly prescribed paracetamol [aspirin].

"Days later, according to the El Pas newspaper, Romero Ramos called the hospital again to complain about her fever. No action was taken.

"On Monday, she called the Carlos III hospital again, this time saying she felt terrible. Rather than transport her to the hospital that had treated the two missionaries who had been repatriated with Ebola, Romero Ramos was instructed to call emergency services and head to the hospital closest to her home. She was transported to the Alcorcn hospital by paramedics who were not wearing protective gear, El Pas reported."

Reuters quotes Spanish health authorities as saying today that another person being monitored in Madrid for Ebola had tested negative for the disease:

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Hospital workers attend a prayer vigil outside Texas Health Presbyterian Hospital on Tuesday. LM Otero/AP hide caption

itoggle caption LM Otero/AP

Hospital workers attend a prayer vigil outside Texas Health Presbyterian Hospital on Tuesday.

LM Otero/AP

"The man, a Spaniard who had travelled from Nigeria, was one of several people hospitalised after authorities confirmed on Monday that a Spanish nurse had caught the disease in Madrid.

"A second nurse was also cleared of Ebola. A third nursing assistant was hospitalised late on Tuesday for monitoring, a source at La Paz hospital said — bringing the number of people examined in hospital for Ebola to five, two of whom tested negative."

The chief medical officer at La Paz University Hospital, Dr. German Ramirez, was quoted in El Mundo as saying that Romero contracted Ebola when she touched her face with gloves she had used in the room where she was treating Manuel Garcia Viejo, a priest who had worked in Liberia. Viejo later died from the disease.

In Dallas, as we reported in another post, Thomas Eric Duncan, the man who traveled from Liberia and was the first person diagnosed with the disease in the U.S., has died at Texas Health Presbyterian Hospital.

Hospital officials say Duncan "succumbed to an insidious disease, Ebola," this morning.

In a statement, the hospital said: "He fought courageously in this battle. Our professionals, the doctors and nurses in the unit, as well as the entire Texas Health Presbyterian Hospital Dallas community, are also grieving his passing. We have offered the family our support and condolences at this difficult time."

Health officials are still watching a group of people who had contact with Duncan after he developed symptoms of the disease but before he was placed in isolation at the hospital.

Duncan first sought hospital care on Sept. 26 and was admitted on Sept. 28. Before his hospitalization, 10 of the 48 people being monitored had close contact with him and are being most closely watched. Since the first symptoms of the disease can begin in eight to 10 days after exposure, "this is a very critical week," said Dr. David Lakey, the Texas health commissioner. "We're at a very sensitive period when a contact could develop symptoms. We're monitoring with extreme vigilance."

In Omaha, Neb., a freelance cameraman, Ashoka Mukpo, who contracted Ebola in West Africa and is being treated at Nebraska Medical Center, will reportedly receive blood donated by Dr. Kent Brantly, who earlier survived the disease. Antibodies against Ebola in Brantly's blood could help Mukpo fight off the infection, officials say.

In Freetown, Sierra Leone, burial teams reportedly refused to collect bodies of Ebola victims in the capital and went on strike, apparently demanding more money, though officials there told The Associated Press that the situation has been "resolved."

The AP says: "In neighboring Liberia, health workers said they planned to strike if their demands for more money and safety equipment were not met by the end of the week."

And in Geneva, as NPR's Marilyn Geewax reports, the World Bank issued an estimate of the projected cost of the Ebola outbreak, saying it could reach $32.6 billion by the end of 2015 if the virus spreads significantly beyond worst-hit West Africa.

"The enormous economic cost of the current outbreak to the affected countries and the world could have been avoided by prudent ongoing investment in health systems-strengthening," World Bank President Jim Yong Kim said in a statement.

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