- Medical debt, one of the disgraces of the world’s most expensive health care in the planet’s wealthiest nations, has spiked during the Covid-19 pandemic. A consumer finance firm recently found that its 22 million members carry $45 billion in bills owed to providers and in collections. With the coronavirus also staggering the economy, bankrupting medical debt is only likely to skyrocket as the nation’s 30 million jobless exhaust their finances and lose health insurance from their work.
- Health insurance offers one of the few widely available means for ordinary folks to try to protect themselves and their loved ones from seeing their finances destroyed by illness or injury. But new U.S. Census data, describing a time before the pandemic, shows that “the first three years of President Trump’s tenure were a period of contracting health insurance coverage,” the Washington Post reported. “The decreases reversed gains that began near the end of the Great Recession and accelerated during early years of expanded access to health plans and Medicaid through the Affordable Care Act — the sprawling law that was a signature domestic achievement of President Barack Obama and has been derided by Republicans, including Trump, ever since.” Just under 30 million Americans were uninsured — 1 in 10 of us, with the numbers rising by several million over the last several years of the Trump term.
Health care persists as one of the top concerns for voters as they consider candidates this fall — not just for the presidency but up and down the ballot.
But beyond the crafted speeches over four nights for each party and looming past the repeated talking points of the candidates and their hand-picked supporters, voters will confront issues of huge gravity — some well known and others maybe less so.
Voters keep sending Republicans — in statehouses, Congress, and the White House — a clear message: Americans want affordable, accessible health insurance, most notably as offered under the GOP-loathed Affordable Care Act, and especially for the poor and working poor via Obamacare’s expansion of Medicaid.
This issue, if anything, may be rising in importance to the U.S. electorate as the Covid-19 pandemic rages without check and millions of Americans wrestle with pervasive joblessness that wiped out many people’s health insurance coverage.
Just weeks after voters in red Oklahoma backed a state constitutional amendment to expand Medicaid and narrowly defied the opposition of powerful GOP politicians who have dominated their state, residents of the “Show Me” state of Missouri showed up in force to approve Missouri’s expansion of the program coverage, by a 53% to 47% margin.
It’s the price and cost problem, stupid. That’s a fictitious but new tattoo that voters might want politicians to take up as they consider the many major problems with the American health care system, especially as yet more medical billing outrages surface.
Marshall Allen, a reporter for ProPublica, the Pulitzer Prize-winning investigative site, posted about a doozy: It’s about almost $1 million in charges that a hospital group sought to saddle a new mom with, even as she wrestled with pregnancy complications and an ailing premature baby.
That mom also happened to be an emergency room nurse. And the chain that flubbed her medical bill was her own employer: Dignity hospitals. That’s a Christian medical enterprise that describes itself as the fifth largest health system in the nation and has as its motto, “Hello, human kindness.” As Allen reported, it’s worth noting this, too, about Dignity:
Critics have attacked Sen. Bernie Sanders for his proposal to wipe out $81 billion in medical debt, including by changing rules around debt collection and bankruptcy. He also called for “replacing the giant credit reporting agencies with a ‘public credit registry’ that would ignore medical debt when calculating credit scores,” reported the New York Times.
Well, there he goes again, with interesting but hard to execute ideas, critics replied to Sanders’ medical debt idea, dissecting it to pieces.
But dig into some of the news articles and important realities flare up. Even his critics concede that medical debt has become a nightmare for too many Americans, contributing in unacceptable fashion to family stress and anxiety and, more importantly, adding to the nightmare of medical bankruptcy.
The University of Virginia Health System — an enterprise that racked up an $87 million operating profit on revenue of $1.7 billion in the fiscal year ending in June and that holds stocks, bonds and other investments worth about $1 billion — has become the latest institution to get a journalistic blaming and shaming for extreme debt collection practices that would make proud Inspector Javert in Les Miserables.
The independent, nonpartisan Kaiser Health News Service and the Washington Post deserve credit for their investigation into UVA avariciousness. As KHN reported of the state operation:
The Grand Old Party may have just won the dictionary definition of a Pyrrhic Victory. That’s because Republicans’ decade-long assault on the Affordable Care Act his finally showing predictable results, with the share of Americans lacking health insurance increasing for the first time in 10 years.
The rate and number of people without health insurance increased from 7.9%, or 25.6 million, in 2017 to 8.5%, or 27.5 million, in 2018, officials reported.
The nation’s children got a kick in the face, too, with almost half a million more youngsters uninsured in 2018 versus 2017 — a decline attributable mostly to a reduction in the number of kids covered by safety net programs like Medicaid and the Children’s Health Insurance Program aka CHIP.
It may be bad for the blood pressure. But to understand a key reason why Americans seethe when talking about medical bills and medical costs, just start perusing a timely new magazine report on hospitals and debt collection.
The Atlantic article — “What Happens When You Don’t Pay a Hospital Bill” — details the horrors and frustrations experienced by Joclyn Krevat, an occupational therapist in New York. She sought medical care for what she thought was a nasty case of flu. She, instead, suffered from a severe heart inflammation — and ended up undergoing a costly and physically draining heart transplant.
Weak, sick, and on the brink, Krevat still was hounded by out-of-control debt collectors — cruel men and women who not only lack hearts of their own but who engage in relentless, often ridiculous tactics (like trying to connect on social media, just to harp on patients there about their bills) to wring pennies out of those with illness and injury, reported writer Olga Khazan.
Praise be: Churches nationwide are leaping in with their congregations’ blessing and financial support, putting up small sums to buy up and wipe out one of the huge shames of the American health care system: patients’ medical debt.
The faithful work with RIP Medical Debt, a nonprofit organization based in Rye, N.Y., that provides the know-how to many kinds of donors to help eliminate bills that can crush patients and their loved ones for a lifetime, the Kaiser Health News service reported. Roxie Hammill wrote how this all works in modern medicine:
Doctors, hospitals, health insurers, and Big Pharma have become so abusive to patients with their billing and pricing that they may have accomplished what many consider a political impossibility ̶ angering Democrats and Republicans in Congress as well as the White House, pushing them all toward bipartisan legislation and executive actions.
Don’t bet on the exact outcome of the latest stirrings. They’re grist for a surge in coverage by the New York Times (click here), Washington Post (here), Wall Street Journal (here), Kaiser Health News (here), Modern Health Care (here), Stat (here), and Pro Publica (here). The stories point out that the partisan divide is too great for Congress and the White House to get near serious work on big health care-related issues like improving the Affordable Care Act.
So, instead, as the articles report, lawmakers are taking varying approaches to attack medical billing, particularly so-called surprise bills (out-of-pocket charges patients get hit with when they get medical services from providers outside their health insurance networks) and balance billing, when medical providers chase patients for charges above what they’ve already recouped from insurers. Health reporters have drilled down on stories about such billing outrages. Drug and hospitals prices also are big targets.