KHN and NPR have launched a project to understand how widespread medical credit is in the United States. Here are the most important steps of that year-long investigation:
- The problem is big. Too long. According to a KFF survey conducted for the project, more than 100 million people, 41% of them adults, are in debt due to medical or dental bills. Much of that debt is hidden in credit card balances, in plans to pay hospitals and other medical providers, and in loans taken by patients from friends and family. Hospitals, some of them nonprofit or public university systems, often fuel the problem by shutting down patient loans or selling loans to collecting agencies.
- Millions of lives are being lost due to debt. Nearly half of adults on healthcare loans say they have had to make hard sacrifices. The most common are reducing costs on food, clothing and other basic household items. But millions of Americans are also taking on extra work, settling retirement bills, leaving their homes, or delaying education for themselves or their children. Debt is deepening racial inequality and preventing patients from being cared for.
- Healthcare loans are difficult to repay. The KFF survey found that one in eight people with a healthcare loan owes $ 10,000 or more. And while most debtors expect to pay it off, 18% say they don’t believe they will ever pay it off.
- Debt and illness are linked. Debt is more common among low-income and uninsured Americans, but the strongest prediction of whether a community will have high medical debt is how sick its inhabitants are. This is according to the Urban Institute, which analyzed county-level debt data for this project: 100 U.S. counties have the highest levels of chronic disease, with about a quarter of adults having medical debt on their credit record, compared to 10 in less than 1 healthy county. Check out this interactive graphic to learn more.
- Patient debt is widespread for a reason. The KHN-NPR investigation found that despite more people having health insurance – as a result of the Affordable Care Act – medical debt is widespread. There is a reason: over the past two decades, health insurers have shifted costs over patients while at the same time the medical industry has steadily increased the cost of medicines, procedures and treatments through higher discounts. The 2010 Healthcare Act did not regulate it.
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