level-1"> (Top) 1 United States 2 Medical debt in other countries 3 Medical debt in bankruptcy 4 Settlement of medical debt Toggle Settlement of medical debt subsection 4.1 Public programs 4.2 Financial assistance by organizations 4.3 Debt negotiation 4.4 Debt forgiveness 4.5 Debt consolidation 5 See also 6 References Toggle References subsection 6.1 Citations 6.2 Sources 7 Further reading Toggle the table of contents Medical debt 2 languages Español Српски / srpski Edit links Article Talk English Read Edit View history Tools Tools move to sidebar hide Actions Read Edit View history General What links here Related changes Upload file Permanent link Page information Cite this page Get shortened URL Print/export Download as PDF Printable version In other projects Wikimedia Commons Wikidata item Appearance move to sidebar hide From Wikipedia, the free encyclopedia Debt incurred by individuals due to health care costs The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject. You may improve this article, discuss the issue on the talk page, or create a new article, as appropriate. (January 2019) (Learn how and when to remove this message) Medical debt refers to debt incurred by individuals due to health care costs and related expenses, such as an ambulance ride or the cost of visiting a doctor. Medical debt differs from other forms of debt because it is usually incurred accidentally or faultlessly. People do not plan to fall ill or hurt themselves, and healthcare remedies are often unavoidable; medical debt is often treated with more sympathy than other kinds of debt resulting in advice that people ought not try to convert it to credit card debt.[1] United States [edit] Percentages of persons in families with selected financial burdens of medical care: United States, January–June 2011. From National Health Interview Survey. Medical debt is an especially notable phenomenon in the United States. According to a 2019 poll from the Pew Research center, American citizens are much more worried about health care issues as a top public matter and concern, especially medical expenses, rather than the economy and terrorism.[2] In less developed nations those on low income in need of treatment will often avail themselves of whatever help they can from either the state or NGOs without going into debt, and in most developed countries public coverage of healthcare costs are comprehensive. But in the US, even when the patient has insurance coverage, including coverage under the Patient Protection and Affordable Care Act of 2010, considerable medical costs remain the patient's responsibility. Consequently, medical debt has been found by a 2009 study to be the primary cause of personal bankruptcy.[3][4] One of the surveys that has been conducted by the Kaiser Family Foundation showed that the amount of debt incurred by individuals for health care costs is likely to cause personal bankruptcy. The study, which involved adults with employer-sponsored insurance, found that while 20% of those surveyed have been approached by agencies, almost 9% of people declared their bankruptcy due to the health expenses.[5] A 2007 survey found about 70 million Americans either have difficulty paying for medical treatment or have medical debt.[6] According to research done in 2019, especially adults who are between 18–64 years and those lacking health insurance coverage are familiar with medical financial hardship in the US.[7] It is estimated that up to 200 billion dollars of medical debt is owed in the United States; the state that owes the lowest amount of medical debt is Hawaii at 2.3%.[8] Studies have found people are most likely to accumulate large medical debts when they do not have health insurance to cover the costs of necessary medications, treatments, or procedures—in 2009 about 50 million Americans had no health coverage.[3] However, about 60% of those found to have medical debt were insured.[6] Health insurance plans rarely cover all health-related expenses; for insured people, the gap between insurance coverage and the affordability of health care manifests as medical debt. As with any type of debt, medical debt can lead to an array of personal and financial problems—including having to go without food and heat plus a reluctance to seek further medical treatment.[6][9] Aggressive debt collecting has been highlighted as an aggravating factor.[10] A study has found about 63% of adults with medical debt avoided further medical treatment, compared with only 19% of adults who had no such debt.[11] In the United States, one of the largest concerns of medical debt stems from high medical costs.[12][13] For example, in a 2011 study of fees paid to physicians for office visits and hip replacement procedures across the United States and several other wealthy countries, the patients in the United States paid 27% more for office visits and 70% more for hip replacement procedures.[13] Similarly, the United States charges an average of $75,345 for a heart bypass operation whereas the same operation in other wealthy countries, such as the Netherlands and Switzerland, costs $15,000 to $36,000 on average.[14] In general, data has shown that individuals in the United States pay nearly double the amount of money on healthcare in their lifetime than those in other wealthy countries.[15] As these healthcare costs continue to rise, a lack of insurance or insurance that does not cover all fees causes a rise in out-of-pocket expenses.[16] In addition, those with medical debts may increase in the future due to increasing patient cost-sharing and rising health care costs.[17] Medical debt is consuming Americans, in fact, it is the number one cause of bankruptcy, because more than 60% of Americans deplete their savings due to some unexpected healthcare cost. [18] Passage of the Patient Protection and Affordable Care Act (PPACA), sometimes described as Obamacare, is associated with a reduction in medical debt, by helping lower income persons obtain comprehensive health insurance or qualify for Medicaid coverage.[19] According to a study conducted in 2012 by Demos, it was determined that among indebted households 62% cited out-of-pocket medical expenses as a contribution to their debt.[20] As these medical fees continue to rise and out-of-pocket expenses continue to grow, Americans are at much higher risk of falling into medical debt whether insured or not.[21] In May 2023, President Biden publicly discouraged all Americans from using medical credit cards to pay for their medical bills due to the credit cards' high interest rates.[22] Medical debt in other countries [edit] The threat of unmanageable medical debts is less common for those in Western Europe, Japan and Australia. A 2019 study of health provision carried out for the Los Angeles Times reported in the United Kingdom, Sweden, France, Germany and Japan about 2.8% of citizens struggled with high medical bills compared to about 16.6% of Americans.[23] In the same year, a World Health Organization analysis of the spending of patients in 36 countries found that only 1 household in 90 in the Netherlands risked facing prohibitive medical expenses.[24] According to another report by the Los Angeles Times, countries such as the United Kingdom and Canada that have state-funded health provision, and Germany and the Netherlands where private insurers have tight limits on the amount of patients may be charged, few people struggle to afford medical expenses. Research based on available data from 2018 indicated that the amount of unaffordable health care by individuals in the USA (7.4%) was considerably higher than European states such as France where only 1.9% of people faced concerns regarding medical bills, Germany (2.4%), the UK (1.4%), the Netherlands (1.1%), and non-European countries such as Australia (3.2%) and Japan (2.6%). The study found that although health care expenses are cheaper in other countries in comparison with the US, such countries faced difficulties such as overcrowding in UK hospitals and long waiting lists in Canada.[25] Medical debt in bankruptcy [edit] Medical debt is considered as a non-priority unsecured debt in Chapter 7 bankruptcy. In other words, medical debts are paid only after assets are applied to the debt of creditors who hold priority debt, and thus medical debts are often discharged in their entirety at the conclusion of the bankruptcy process. If the bankrupt estate has sufficient assets such that a part of the medical debt is repaid through bankruptcy, any remaining outstanding medical debt that is included in the bankruptcy case will be discharged. Share of Debtors Citing Specific Contributors to Their Bankruptcy: United States, 2013–2016.[26] Reasons Cited as Contributors to Bankruptcy (A) Very Much Agree, % (B) Somewhat Agree, % (A) + (B) Very Much or Somewhat Agree, % Medical-related reasons Medical expenses 37.0 21.5 58.5 Medical problems causing work loss 27.9 16.5 44.3 Either of above 44.2 22.3 66.5 Change in family size such as birth or death 13.7 7.9 21.6 Any of above 50.1 21.4 71.5 Other reasons Income loss (including persons with medically related work loss) 61.5 16.3 77.8 Unaffordable mortgage or foreclosure 29.2 15.8 45.0 Spending/living beyond means 17.2 27.2 44.4 Student loans 14.3 11.1 25.4 Divorce/separation 18.5 5.9 24.4 Tried to help friends/relatives 12.7 15.7 28.4 US bankruptcy filings the last five years.[27] Business Non-business Total 2022 13,481 374,240 387,721 2021 14,347 399,269 413,616 2020 21,655 522,808 544,463 2019 22,780 752,160 774,940 2018 22,232 751,186 773,418 Number of personal and business US bankruptcy filings by year.[27] Settlement of medical debt [edit] Public programs [edit] In order to tackle the issue, an advocacy organization, Physicians for a National Health Program thinks of a special program which would enhance insurance coverage for Americans. Under that single-payer health care system, Medicare for All is advocated for the resemblance of the health care services with that work in Canada, where all individuals are free to consult a doctor generally without paying a bill at all.[28] The survey has demonstrated that 56% of citizens supported that national plan in 2019.[29] Financial assistance by organizations [edit] The PAN Foundation is considered to be "an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic and rare diseases with the out-of-pocket costs for their prescribed medications" and the non-profit organization has provided approximately 1 million patients those are underinsured with a financial aid equaling to $3 billion since 2004.[30] Apart from that, the national organization "providing free, professional support services and information to help people manage the emotional, practical and financial challenges of cancer", CancerCare has provided $39.7 million as a financial assistance to reportedly 24,767 people in order to help with treatment-related medical costs.[31] Debt negotiation [edit] According to Dr. Marty Makary, the professor of health policy and management at Johns Hopkins Bloomberg School of Public Health and a surgeon at the Johns Hopkins Hospital, debt negotiation is achievable before, during and after the health care services in the process of a high costing of medical expenses.[32] On the other hand, the issue of inaccuracy is common in the health care sector related to the price of services and in case of any inaccuracy is better to be reviewed before the negotiation process. Dr. Carolyn McClanahan, the founder and director of financial planning at Life Planning Partners, says that patients should double-check whether they received all the services for which they are billed. America's Debt Help Organization encourages patients to check the medical bills for the common mistakes such as double billing, fraudulent charges and coding (typo) errors with the insurance company as the first course of action before going into the debt negotiation process.[32] Debt forgiveness [edit] In 2016 John Oliver forgave $14.9 million of medical debt on his Last Week Tonight show. The debt was purchased for just $60,000 through a company named "Central Asset Recovery Professionals" (or CARP, a pun on the bottom feeding fish) which Oliver said had cost just $50 to create. After the purchase he reportedly received a portfolio offering the names, current addresses and Social Security numbers of about 9,000 people which was sent to the RIP Medical Debt organization in order to have the debt forgiven.[33] In 2018, two local women from the Finger Lakes region in New York partnered with the nonprofit RIP Medical Debt after fundraising for the purpose of debt collection for debt forgiveness. The nonprofit looks for bundled packages of debt from first or third party agencies which the group negotiates to purchase at discounted prices (pennies on the dollar). The two women initially raised $12,500 and used this money to purchase $1.5 million of medical debt through RIP Medical Debt, which was then forgiven.[34] Debt consolidation [edit] Debt consolidation may be an option for those who carry medical debt on credit cards, by providing a reduced interest rate.[35] See also [edit] Wikimedia Commons has media related to Private medical debt statistics. Charge description master Financial toxicity Health care in the United States Health care systems by country Health economics Health insurance International comparisons Underinsured References [edit] Citations [edit] ^ Alderman, Lesley (June 5, 2009). "When Medical Bills Outpace Your Means, Seize Control Swiftly". The New York Times. Retrieved June 22, 2009. ^ "Public's 2019 Priorities: Economy, Health Care, Education and Security All Near Top of List". Pew Research Center - U.S. Politics & Policy. January 24, 2019. Retrieved April 27, 2020. ^ a b "Medical Debt Huge Bankruptcy Culprit—Study: It's Behind Six-In-Ten Personal Filings". CBS News. June 5, 2009. Archived from the original on June 8, 2009. Retrieved June 22, 2009. ^ Himmelstein, David U.; Thorne, Deborah; Warren, Elizabeth; Woolhandler, Steffie (August 2009). "Medical Bankruptcy in the United States, 2007: Results of a National Study". The American Journal of Medicine. 122 (8): 741–746. doi:10.1016/j.amjmed.2009.04.012. ISSN 0002-9343. OCLC 1480156. PMID 19501347. S2CID 25720725. See full text. ^ Kaiser Family Foundation. "Kaiser Family Foundation/LA Times Survey of Adults With Employer-Sponsored Health Insurance," Page 10. Accessed April 27, 2020. http://files.kff.org/attachment/Report-KFF-LA-Times-Survey-of-Adults-with-Employer-Sponsored-Health-Insurance ^ a b c Heavey, Susan (August 20, 2008). "Consumers Face Rising Medical debt: Survey". Reuters. Retrieved June 22, 2009. ^ Yabroff, K.R., Zhao, J., Han, X. et al. Prevalence and Correlates of Medical Financial Hardship in the USA. J GEN INTERN MED 34, 1494–1502 (2019). ^ Rakshit, Shameek; Rae, Matthew; Claxton, Gary; Amin, Krutika; Cox, Cynthia (February 12, 2024). "The Burden of Medical Debt in the United States". Kaiser Family Foundation. Retrieved April 18, 2024. ^ Kalousova, Lucie; Burgard, Sarah A. (June 2013). "Debt and Foregone Medical Care". Journal of Health and Social Behavior. 54 (2): 204–20. doi:10.1177/0022146513483772. ISSN 2150-6000. OCLC 38543580. PMID 23620501. S2CID 22679080. ^ O'Teele, Thomas P.; Arbelaes, Jose J.; Lawrence, Robert S.; Baltimore Community Health Consortium (July 2004). "Medical Debt and Aggressive Debt Restitution Practices: Predatory Billing Among the Urban Poor". Journal of General Internal Medicine. 19 (7): 772–778. doi:10.1111/j.1525-1497.2004.30099.x. ISSN 1525-1497. OCLC 41390549. PMC 1492479. PMID 15209592. ^ Daly, Rich (October 21, 2005). "Working-Age Americans Bear Brunt of Medical Debt". Psychiatry Online. Retrieved June 22, 2009.{{cite news}}: CS1 maint: deprecated archival service (link) ^ "The Burden of Medical Debt" (PDF). kaiserfamilyfoundation.files.wordpress.com. Retrieved December 9, 2018. ^ a b Laugesen, Miriam J.; Glied, Sherry A. (September 1, 2011). "Higher Fees Paid To US Physicians Drive Higher Spending For Physician Services Compared To Other Countries". Health Affairs. 30 (9): 1647–1656. doi:10.1377/hlthaff.2010.0204. ISSN 0278-2715. PMID 21900654. ^ "Why Are U.S. Health Costs The World's Highest? Study Affirms 'It's The Prices, Stupid'". www.wbur.org. March 13, 2018. Retrieved December 9, 2018. ^ "How do healthcare prices and use in the U.S. compare to other countries?". Peterson-Kaiser Health System Tracker. Retrieved December 9, 2018. ^ Doty, Michelle (August 2005). "Seeing Red: Americans Driven into Debt by Medical Bills" (PDF). Retrieved December 8, 2018. ^ Yabroff, K. Robin; Zhao, Jingxuan; Han, Xuesong; Zheng, Zhiyuan (2019). "Prevalence and Correlates of Medical Financial Hardship in the USA". Journal of General Internal Medicine. 34 (8): 1494–1502. doi:10.1007/s11606-019-05002-w. PMC 6667570. PMID 31044413. ^ "4 Surprising Facts You Didn't Know About Healthcare Debt". Medical Economics. April 23, 2019. Retrieved April 18, 2024. ^ Sanger-Katz, Margot (April 21, 2016). "Obamacare Seems to Be Reducing People's Medical Debt". The New York Times. Retrieved April 18, 2024. ^ "How Employment Credit Checks Keep Qualified Workers Out of a Job". Demos. Retrieved October 3, 2013. ^ "Survey: 79 Million Americans Have Problems with Medical Bills or Debt". The Commonwealth Fund. Retrieved April 27, 2020. ^ Levey, Noam (May 4, 2023). "Biden administration warns consumers to avoid medical credit cards". NPR. ^ Levey, Noam N. (September 12, 2019). "Americans' struggles with medical bills are a foreign concept in other countries". Los Angeles Times. Retrieved April 27, 2020. ^ "Can people afford to pay for health care?" (PDF). World Health Organization. December 11, 2019. Retrieved April 27, 2020. ^ Gooch, Kelly (September 13, 2020). "Americans struggle more with medical debt than people in other countries, LA Times reports". Beckers Hospital Review. Retrieved April 27, 2020. ^ Himmelstein, David U.; Lawless, Robert M.; Thorne, Deborah; Foohey, Pamela; Woolhandler, Steffie (March 2019). "Medical Bankruptcy: Still Common Despite the Affordable Care Act". American Journal of Public Health. 109 (3): 431–433. doi:10.2105/AJPH.2018.304901. ISSN 0090-0036. PMC 6366487. PMID 30726124. Scroll down for table, or go here. ^ a b "Bankruptcy Statistics [Updated For 2024]". Debt.org. ^ Konish, Lorie (February 5, 2019). "Medicare for All could take center stage in the 2020 election. Here's what it means". CNBC. Retrieved April 27, 2020. ^ "Poll: Majorities Favor a Range of Options to Expand Public Coverage, Including Medicare-for-All". The Henry J. Kaiser Family Foundation. January 23, 2019. Retrieved April 27, 2020. ^ "About PAN". PAN Foundation. Retrieved April 27, 2020. ^ "Free professional support for anyone affected by cancer". CancerCare. Retrieved April 27, 2020. ^ a b Konish, Lorie (November 10, 2019). "137 million Americans are struggling with medical debt. Here's what to know if you need some relief". CNBC. Retrieved April 27, 2020. ^ "For His Latest Trick, John Oliver Forgives $15 Million in Medical Debt". www.nytimes.com. June 6, 2016. Retrieved June 6, 2016. ^ Bump, Bethany (December 3, 2018). "Upstate NYers medical debt mysteriously paid off". www.timesunion.com. Retrieved December 3, 2018. ^ Ryan, Joan S. (2012). Personal financial literacy (2nd ed.). Mason, Ohio: South-Western/Cengage. ISBN 978-0-8400-5829-4. OCLC 755108694. Sources [edit] Klozotsky, Michael (April 23, 2013). "Oklahoma Governor Signs Medical Debt Collection Bill". InsideARM.com.{{cite web}}: CS1 maint: deprecated archival service (link) Further reading [edit] Wikimedia Commons has media related to Private medical debt statistics. Lucas Phillips (October 25, 2020), "New England churches buy up, forgive $26.2 million in medical debt", Boston Globe, US v t e Medical harm Concepts Adverse effect Adverse drug reaction Health care fraud Iatrogenesis Informed consent Involuntary treatment Medical law Medical malpractice Medical error Medical ethics Never event Patient abuse Patient safety Pharmaceutical fraud Primum non nocere Quackery Unnecessary health care Economic and financial concerns Medical debt Balance billing Financial toxicity Medication costs Political abuse Drapetomania Sluggish schizophrenia Compulsory sterilization Medical torture Pharmacological torture Physician gag law The Protest Psychosis Political abuse of psychiatry in Russia in the Soviet Union in the United States Related concerns Hospital-acquired pneumonia Hospital-acquired infection Iatrogenic anemia Medical resident work hours Physician supply Drug pollution List v t e Debt Instruments Bonds Corporate Debenture Government Municipal Loans Business loan Consumer lending Loan shark Interest-only Mortgage Negative amortization Payday loan Predatory lending Usury Vendor finance Management Bankruptcy Consolidation Management plan Relief (history) Restructuring Debt snowball method Debtor-in-possession (DIP) financing Negative equity Financial literacy Loan guarantee Collection · Evasion Bad debt Charge-off Compliance Debt bondage Debt crisis List Debt overhang Debtors' prison Default Sovereign default Distraint Garnishment Insolvency Interest Interest expense Interest rate Promissory note Phantom debt Strategic default Tax refund interception Markets Consumer Corporate List Corporate debt bubble Diplomacy Government debt List Government budget balance Unfunded mandate Medical Municipal Venture Buyer Deposit account Fixed income Money market Securitization Economics Consumer leverage ratio Debt deflation Debt-to-GDP ratio Debt-to-income ratio List of countries by household debt Debt monetization Global debt External List Internal Odious debt Leverage Retrieved from "https://en.wikipedia.org/w/index.php?title=Medical_debt&oldid=1359903899"