The American Way of Health Insurance: Incur Medical Debt & Lose Access to Care

October 7, 2022

Summary: The experience of a woman with breast cancer who loses her insurance perfectly illustrates the gaps and harms of our fragmented health insurance system. It’s a heart-rending plea for the US to adopt generous and efficient universal insurance as in wealthy countries around the world.

Medical debt ruined her credit. ‘It’s like you’re being punished for being sick’
NPR Shots
October 6, 2022
By Aneri Pattani

After a year of chemotherapy and radiation, doctors told Penelope Wingard in 2014 that her breast cancer was in remission. She’d been praying for this good news. But it also meant she no longer qualified for a program in North Carolina that offers temporary Medicaid coverage to patients undergoing active breast cancer treatment.

Wingard became uninsured. She’d survived the medical toll, but the financial toll was ongoing.

Bills for follow-up appointments, blood tests and scans quickly piled up. Soon, her oncologist said he wouldn’t see her until she paid down the debt.

“My hair hadn’t even grown back from chemo,” Wingard says, “and I couldn’t see my oncologist.”

Medical debt has sunk her credit score so low that she has struggled to qualify for loans, and applying for jobs and apartments has become a harrowing experience.

“It’s like you’re being punished for being sick,” Wingard says. …

Under the new [medical debt] policies, Equifax, Experian and TransUnion will remove from credit reports any paid debts or individual bills that were less than $500 and had gone to collections, even if unpaid. This doesn’t wipe out what people owe, but the idea is to remove the black mark of collections from their credit so they can more easily reach milestones like qualifying for a car or home loan ….

“Although the credit reporting companies have trumpeted this as a big change, the fact is they’re just removing the small stuff,” says Ryan Sandler, a senior economist with the Consumer Financial Protection Bureau. “They’re not maybe doing as good of a thing as their press releases would like you to believe.”

Wingard has worked as an after-school teacher and tutor, a COVID-19 contact tracer and a driver for a ride-hailing service, but none of those jobs has come with health insurance benefits. Wingard says she tried to buy private insurance on the marketplace several years ago, but her monthly premium would have been more than $200, which she can’t afford.

That left her on the hook for bill after bill after bill. Her credit report shows five pages of notifications from collection agencies representing doctor’s offices, hospitals and labs.

Nearly 20% with medical debt fear they’ll never pay it off.

Comment by: Jim Kahn

“It’s like you’re being punished for being sick.” I can’t get that thought out of my head.

When, when, when will our policymakers embrace the experience of dozens of countries around the world with universal insurance that doesn’t penalize people for getting sick? And that saves money in the process?

How much evidence do we need to collectively say, “American values” is no excuse for a fragmented, inequitable, punitive, harmful, and wasteful financing system?

When will we become sane and kind about how we pay for health care?