Medical debt is a horror. Charity is a help. But get that health insurance, now.

Although Good Samaritans deserve a great holiday cheer for their part in paying for some of it, medical debt persists as a giant shame of the American health care system. Doctors, hospitals, insurers, Big Pharma, and other providers and suppliers need to step up to shrink the financial burdens of medical care that crush far too many patients and their loved ones.

Judith Jones and Carolyn Kenyon, two retired friends in Ithaca, N.Y., raised $12,500 that they donated to a charitable group. It buys bundled, past-due medical bills and forgives them to help those in need. That became a powerful gift, as RIP Medical Debt leveraged it, buying for a penny on the dollar or so, a portfolio of obligations exceeding $1.5 million.

That means that 1,300 New Yorkers, all around their state, received envelopes, just in time for the holidays, telling them that they no longer needed to pay nor to worry about debts they had incurred for medical services from 130 hospitals and their branches.

What? How can it be that medical providers and insurers, legendary for hounding patients for unpaid bills, can walk away with the equivalent of a biscuit, a pat on the head, and a pittance? As the New York Times reported of the work of RIP Medical Debt, the group targets “debts of people who earn less than two times the federal poverty level, those in financial hardship and people facing insolvency.”

The newspaper said:

 [The group] purchases the portfolios at a steep discount, a penny or less on the dollar. These bills have typically passed through several collection agencies and months or years of collections. The people, who do not know they have been selected, receive the debt relief as a tax-free gift, and it comes off their credit reports. … Through personal data associated with the debt accounts, they are able to target specific classes of people, such as veterans, to relieve their debts.

Donors have helped 250,000 patients be forgiven $434 million in medical debt, the newspaper reported. But that’s just “a fraction, though, of the more than $750 billion in past-due medical debt that [the group] says Americans owe.”

RIP Medical Debt got a big boost from John Oliver, the broadcast satirist. He not only showcased the   501(c)(3) charity, he also worked with HBO, which carries his show, to arrange a $60,000 donation to erase $14.9 million in medical debt for 9,000 patients.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care, especially as costs explode, notably for costly prescription medications that damage them when they turn out to be dangerous drugs.

It’s hard to fathom why Republicans — in the Trump Administration and while controlling Congress — have failed to heed the midterm beat-down they just took, and, instead, they’re persisting in an array of ways to slash at the Affordable Care Act and other attempts to provide health insurance to more rather than fewer Americans. The ACA also seeks to make medical care more efficient and less costly.

It’s true that health coverage isn’t the alpha and omega in preventing Americans from unacceptable and huge medical debt and medical bankruptcy. But the ACA recognized that all of us are a blink away from illness or injury that can be calamitous to all but the wealthiest. Americans have bought into the ideas that we need to share medical risks and costs, and that health care in the world’s wealthiest nation is a right not a privilege. Let’s be honest: We can’t even start to cover extreme medical costs with charity, whether through debt buy-backs or increasingly popular and too often dubious crowd-funding. We need to deal with the reality that medical services, notably for caring for conditions like cancer, can become so unaffordable that clinicians concede they are financially “toxic” for patients and their families.

Evidence is growing that Obamacare not only provides affordable coverage for big numbers of less affluent and even middle-class Americans, it improves their health and well-being — and it may be bending the ever-rising medical cost curve.

It’s worth repeating, especially as deadlines loom: A great way to rebuke political partisans is to reject their short-term, skinny, and association health coverage — knowing they may carry low monthly premiums but offer precious little real medical care, if needed — and, if you qualify, to sign up for ACA insurance on Obamacare exchanges.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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