Medical Debt - Not Getting Better
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A Good Day To Advocate for Better Healthcare
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Medical Debt - Update
People with health insurance may now represent the majority of debtors American hospitals struggle to collect from, according to medical billing analysts. This marks a dramatic change from just a few years ago, when people with health insurance represented only about one in 10 bills hospitals considered “bad debt”. Here is an analysis of the situation and here is a link to the Guardian news report.
In 2018, just 11.1% of hospitals’ bad debt came from insured “self-pay” accounts, or from patients whose insurance required out-of-pocket payments, according to Kodiak Solutions. By 2022, the proportion who did not or could not pay their bills soared to 57.6% of all hospitals’ bad debt.
Kodiak Solutions has access to hospital transactions for more than 1,800 hospitals across the US, a little less than one-third of all hospitals in the country. It was able to perform the analysis by looking at this in-house database.
The cost of healthcare in the US is a perennial political concern – it eats up more than 18% of gross domestic product, far more, and often for worse health outcomes, than in other peer democracies. As much as 31% of the cost of US healthcare is driven by the administrative costs and 2/3 of that is for billing/claims/denials/ etc. , according to the American Hospital Association. 25% of what we spend is WASTE.
Medical debt and its impact on Americans’ lives is an issue of increasing political rancor. A recent investigation by KFF Health News and NPR found more than 100 million Americans have medical debt of some kind, debt which often forces families to make heart-wrenching sacrifices.
In part, those sacrifices are driven by hospitals’ extraordinary collection practices. Hospitals refer patients to aggressive debt collectors, use state courts to garnish wages, place liens on people’s homes and report debt to credit agencies, which can drastically worsen future job and housing prospects. Although there are some attempts to rein in these practices, billing analysts say they do not address the core issue – health plans designed by insurers which force hospitals to become debt collectors as well as load consumers up with large copays and huge deductibles even for employer sponsored plans.
Deductibles have come under particular scrutiny as the share of workers subject to high deductibles has risen in the last decade. There is not a single definition for a high-deductible health plan, but typically such plans require a payment of $1,000 or more before insurance kicks in for a single person – though costs can soar far above that. Because deductibles reset every year, they can be especially punishing for chronically ill patients – and they can be far more expensive than $1,000 a year.
Affordable Care Act plans can also have high deductibles. Federal regulations allow insurers on state exchanges to charge an individual as much as $9,450 out of pocket in 2024 – not including monthly premiums.
In fact, that same analysis above found that if a hospital was owed over $7500 it was pretty much unobtainium.
All of this is just another good reason for Universal Healthcare. Commercial Insurance is eating up 25% the cost of healthcare while charging a fortune for premiums and saddling consumers with high deductibles and copays. Universal Healthcare is designed to eliminate that - Let’s go with what makes sense.
ACTION
I know we tell our Members of Congress and Senators over and over to pass Universal Healthcare, but every day there is another good reason to demand it.
On your cellphone you can text SIGN PSFPQE to 50409 to send the message below or you can call/email them - their contact info is at the bottom of this note in the Resources section.
“I am your constituent and I know we all deserve a healthcare system that works for all of us. A recent analysis by Kodiak Solutions of hospital billing at about 1/3 of US hospitals found that now the most unpaid hospital debt is carried by people WHO HAVE HEALTH INSURANCE (57.6%). Just a few years ago it was 11.1%. These are people who have health insurance and can’t afford the deductibles. Those insurance companies who saddled us with deductibles in the thousands of dollars are also eating up about 25% of the entire US healthcare budget in needless overhead and and claims adjudications.
I strongly urge you to pass universal healthcare like, HR 3421, and end this madness. It will provide a system that covers all of us, cradle to grave, no copay or deductible and will save hundreds of billions EVERY YEAR, according to the Congressional Budget Office. Thank you.”
EXTRA CREDIT ACTION
An industry-friendly Medicare Advantage letter has officially launched in the Senate, circulated by Sens. Catherine Cortez Masto (D-NV), Tim Scott (R-SC), Gary Peters (D-MI), and Shelley Moore Capito (R-WV); you can find the Physicians for a National Health Plan (PNHP) response to their letter HERE.
Medicare Advantage is the Problem not the Solution
The deadline for signing this letter is one week from today—Wednesday, Jan. 24. It’s our job as activists to let our senators know that we do NOT want them to sign on. We encourage you to take a few minutes today to make sure your senators know where you stand on the so-called “Medicare Advantage” program.
EMAIL THEM HERE (super easy)
You can also call your senators’ offices by dialing the U.S. Capitol Switchboard at (202) 224-3121. A suggested script is below, but feel free to adjust it:
Hello, my name is [YOUR NAME HERE] and I’m a constituent of Senator [NAME]. I’m reaching out about the Medicare Advantage program. Currently, there is a letter circulating in the Senate led by Senators Cortez Masto, Scott, Peters, and Capito praising the program and asking for “stability,” which really means no changes that might protect seniors and people with disabilities.
I’m calling to urge the Senator to NOT sign on to this letter.
The Medicare Advantage program has a record of harming patients by delaying and denying care, and by restricting our choice of doctor. Insurance corporations have also been caught overcharging taxpayers by up to 140 billion dollars per year. Rather than uncritically promoting Medicare Advantage, we need Congress to reappraise the program and hold health insurers accountable for their plans’ shortcomings. Thank you for your time.
Thank you to PNHP
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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