![\"CT](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/CT-Mirror-Lamont-350x380.png\")
CT Mirror<\/strong> (2\/2\/23<\/a>)<\/em><\/p><\/div>\n Connecticut Gov. Ned Lamont proposed<\/a> on February 2 to purchase and forgive roughly $2 billion in medical debt owed by state residents. Along with similar proposals<\/a> in other jurisdictions, the plan offers desperately needed relief from stress and fear to thousands of people who are struggling to pay their current outstanding medical bills. Unfortunately, these programs will do nothing to prevent millions more Americans from falling into the country\u2019s healthcare financial meat grinder.<\/p>\n Meanwhile, three major credit reporting agencies have decided<\/a> to expunge paid-off medical debts and outstanding debt less than $500 from credit reports, and provide people a year’s grace period before adding new medical debt to credit reports.<\/p>\n Like the debt forgiveness proposals, these credit decisions follow a wave of national publicity about the horrors of healthcare debt. In recent years, major news outlets, including the New York Times <\/b>(e.g., 11\/8\/19<\/a>, 9\/24\/22<\/a>), Guardian<\/b> (6\/27\/19<\/a>), ProPublica <\/b>(e.g., 6\/14\/21<\/a>), National Public Radio<\/b> (13\/21\/22<\/a>), Kaiser Health News <\/b>(9\/10\/19<\/a>, 12\/21\/22<\/a>) and CBS<\/b> (4\/28\/21<\/a>) have dug into the nightmares faced by tens of millions of Americans\u2014both uninsured and with insurance\u2014as they try to pay for the treatments and medicines they need to lead healthy lives.<\/p>\n This New York Times<\/strong> headline (11\/8\/19<\/a>) could have just as easily run in 2003 as in 2019.<\/em><\/p><\/div>\n The stories are heartrending. Families\u2019 lives wrecked financially by bill collectors and lawyers. Sick and injured patients\u2019 health deteriorating due to mountains of debt and stress, with some providers even refusing follow up care until bills are paid. They highlight a set of corporate billing and collections policies and practices that turn a visit to a doctor or hospital into a years-long hell.<\/p>\n Such investigations touch on common themes, including hospitals suing patients en masse:<\/p>\n Hospitals layering large interest payments on top of already crushing debt, and collecting through tactics like garnishing wages and seizing bank accounts:<\/p>\n Hospitals threatening and taking patients\u2019 homes through liens and foreclosures:<\/p>\n Nonprofit hospitals failing to offer patients charity care, sometimes in violation of state law or the hospital\u2019s own internal charity care policies:<\/p>\n Patients skipping care or having providers refuse care due to debt:<\/p>\n The stories are compelling, consistent and comprehensive, exposing in detail the devastating consequences of a healthcare system that forces patients\u2014some uninsured, others with inadequate health insurance\u2014to assume unmanageable financial burdens for needed medical treatment. Based on analysis of large volumes of public records and interviews with dozens of victims, they include follow-up reporting on actions taken by hospitals in response to publicity, and legislative and legal actions in support of debtors. In short, everything good investigative journalism should be.<\/p>\n Except for one problem: The second example in each pair above is 20 years old.<\/i><\/p>\n The first examples are drawn from work by the New York Times<\/b>, Guardian<\/b> and Kaiser Health News <\/b>(KHN<\/b>, recently rebranded as KFF Health News<\/strong>), which recently teamed up with National Public Radio<\/b> for a series<\/a> called \u201cDiagnosis: Debt.\u201d Along with the 2019\u201320 \u201cProfiting from the Poor\u201d investigative series<\/a> published jointly by ProPublica <\/b>and MLK50: Justice Through Journalism, <\/b>these stories are part of a wave of recent medical debt coverage.<\/p>\n Wall Street Journal<\/strong> (3\/13\/03<\/a>)<\/em><\/p><\/div>\n The second quotes, indistinguishable in the suffering of the profiled patients and the issues addressed, are from 2003\u201304, including a Wall Street Journal<\/b> series by reporter Lucette Lagnado (3\/13\/03<\/a>, 3\/17\/03<\/a>, 4\/1\/03<\/a>, 6\/10\/03<\/a>). Lagnado\u2019s work began in Connecticut, where Paul Bass, editor of the weekly New Haven Advocate<\/b>, had dug into court records to reveal aggressive legal practices by Yale-New Haven Hospital in 2001. Lagnado spent months tracking down debtors and examining the same public records that form the basis for the latter-day stories.<\/p>\n Then as now, follow-up stories show embarrassed individual hospital systems forgiving the debts of people named in the stories and many other current debtors, then usually promising to reduce the ferocity of their collection tactics (Wall Street Journal<\/b>, 4\/1\/03<\/a>; New Haven Register<\/b>, 3\/19\/04<\/a>; ProPublica<\/b>, 7\/30\/19<\/a>; KHN<\/b>, 9\/10\/19<\/a>; ProPublica<\/b>, 9\/24\/19<\/a>).<\/p>\n MLK50<\/strong> (4\/28\/20<\/a>)<\/em><\/p><\/div>\n Lagnado\u2019s work in 2003 was recognized<\/a> at the time by the Annenberg School of Journalism at USC as one of three finalists for the 2004 Selden Ring Award for Investigative Reporting.<\/p>\n Sixteen years later, MLK50<\/b> founding editor Wendi C. Thomas won<\/a> the Selden Ring Prize for her series jointly published with ProPublica<\/b>. The two organizations shared a 2020 Loeb award<\/a> for local reporting and a bronze medal<\/a> from the Barlett & Steele Awards for Investigative Journalism, given by the Walter Cronkite School at Arizona State University. The same year, Kaiser Health News<\/b>\u2019<\/i> Jay Hancock and Elizabeth Lucas were Pulitzer Prize finalists<\/a> for investigative reporting for their healthcare debt work.<\/p>\n Medical debt, it turns out, is an evergreen problem, a perpetual source of torment for patients, prizes for reporters, and controversy over incremental, poll-tested policy changes that for two decades have failed to stem the flood tide of medical debt that is drowning millions of people. These gradualist approaches have, however, succeeded in deflecting attention from the only real solution to the problem\u2014a national health insurance system like Medicare for All that would cover everyone, all the time, without holes in coverage that lead to catastrophic personal debt.<\/p>\n Quinton White (Wall Street Journal<\/strong>, 4\/1\/03<\/a>)<\/em><\/p><\/div>\n Lagnado\u2019s 2003 series appeared during campaigns against abusive medical debt collection in several states, including Illinois, California, Washington and Connecticut, where Lagnado\u2019s initial iconic profile of Quinton White (Wall Street Journal<\/b>, 3\/13\/03<\/a>) chronicled his 20-year struggle with debt from his wife\u2019s treatment at Bridgeport Hospital.<\/p>\n White suffered nearly all the indignities hospitals impose on indebted patients. By the time Lagnado found him, White had seen the hospital attach a lien to his house and drain most of his bank account. Interest ballooned the debt; White had paid $16,000 of the original $18,740 over the years, but the Yale New Haven Health System, which had acquired Bridgeport Hospital in 1996, was pursuing him for an additional $39,000 in remaining principal, interest and fees.<\/p>\n Prompted by community outrage at the tactics described by Lagnado, and in a series<\/a> of reports from the nonprofit Connecticut Center for a New Economy (CCNE), local labor unions, a church-based grassroots movement, Yale University public interest lawyers and hospital patients built a campaign to take on Yale-New Haven and the statewide hospital industry.*<\/p>\n Four lawsuits, a series of demonstrations with hundreds of people, a grassroots lobbying campaign and ongoing media coverage yielded progress. The Connecticut General Assembly passed<\/a> a law cutting interest on medical debt to 5% and requiring hospitals to inform patients of available financial assistance and to stop collections against eligible patients. The law limited billing of uninsured patients to the actual cost of their care, and required hospitals to report on their collection activity. Under intense local pressure, Yale-New Haven Health went further<\/a> than the new state law, settling lawsuits by removing thousands of property liens and forgiving more than 20,000 accounts worth millions of dollars in outstanding debt.<\/p>\n The final lawsuit against Yale-New Haven was a class action focused on the practice of billing uninsured patients at wildly inflated \u201csticker prices\u201d. Filed a year and a half after Lagnado\u2019s first article, it was one<\/a> of dozens<\/a> brought against nonprofit hospital systems nationwide in 2004 by members of the Not-for-Profit Litigation Group, led by trial lawyer Richard \u201cDickie\u201d Scruggs, one of the lead attorneys in the 1990s tobacco litigation. From the middle of 2004 through 2005, Scruggs\u2019 firm drew blanket coverage across the US, with more than 200 local stories in more than 30 states, according to a search of the Nexis database.<\/p>\n New York Times<\/strong> (2\/16\/23<\/a>): Medical debt “began emerging as a much more striking issue last year.”<\/em><\/p><\/div>\n However, by the spring of 2006, Scruggs\u2019 suits had largely failed, and he would soon find himself in prison<\/a> for bribing a judge in an unrelated case. With local hospitals agreeing to policy changes in Illinois and Connecticut, medical debt coverage shrank.<\/p>\n The issue didn\u2019t go away, of course; it simply attracted less media attention. However, according to veteran New York Times<\/b> healthcare reporter Reed Abelson (2\/16\/23<\/a>), concern about medical debt appeared mysteriously in 2022: \u201cThe inability to afford medical tests and treatment, a perennial concern in the United States, began emerging as a much more striking issue last year.\u201d Perhaps Abelson, who has covered healthcare since 2002, forgot Jonathan Cohn\u2019s 5,000-word New York Times Magazine<\/b> essay (12\/19\/04<\/a>) from 2004, prompted in part by the Scruggs class action cases.<\/p>\n Telling the stories of millions of Americans whose lives have been ruined and even shortened by medical debt is an honorable exercise, and the spate of recent reporting does include a few new details. In particular, MLK50<\/b>\u2019s Wendi Thomas (6\/27\/19<\/a>) interviewed judges who decide debt cases, giving readers a new level of detailed, often chilling insight into the attitudes of people who sometimes casually help attorneys for hospitals and collection agencies destroy patients\u2019 families.<\/p>\n Judge Betty Thomas Moore ordered a woman whose 11-year-old nonverbal autistic son wears diapers and eats only pureed foods to pay $130 a month instead of $30. The judge reasoned that her son and his two older brothers “could sacrifice so that their mother could pay more.”<\/p>\n Beyond painful details and inspiring victories, most articles that offer a broader frame for the issue are plagued by bad habits common to corporate journalism: historical amnesia, a bias for treating individuals as \u201cconsumers\u201d with primary responsibility for their own problems, and ideological blinders.<\/p>\n NPR<\/strong> (4\/14\/22<\/a>): “There’s still the issue of consumers being able to afford to pay for healthcare. “<\/em><\/p><\/div>\n As they have for 20 years, most policy-focused stories about medical debt lean heavily toward regulatory initiatives or legislative actions to take the sharp edges off of debt collection, or offer advice on how to avoid or manage medical debt (NPR<\/b>, 4\/14\/22<\/a>; KHN<\/b>, 10\/17\/19<\/a>; KRWG<\/b>, 4\/6\/21<\/a>). To the extent that wrap-up stories acknowledge the need for Americans to be covered by health insurance, reporters assume the only way forward is to build on the supposed successes of the Affordable Care Act through tiny increments of change. They treat Medicare for All, or any other credible scheme to cover all Americans with comprehensive health insurance, as an impossibility for the foreseeable future.<\/p>\n Unfortunately, regulating medical debt collection tactics has an easily documented history of failure as healthcare policy. The 2003 Connecticut law, described by Lagnado (6\/10\/03<\/a>) as \u201ca breakthrough patient-protection bill,\u201d addressed several of the key issues highlighted in reporting on healthcare debt. Yet the federal Consumer Financial Protection Bureau (CFPB) reported<\/a> that as of December 2020, 10% of Connecticut adults whose accounts the agency tracks had medical debt on their credit reports, with an average balance of $1,407 and a median of $508.<\/p>\n The CFPB acknowledges that its data significantly understates the scale of the issue, because a lot of medical debt either never appears on credit reports, or is reported as general credit card debt. An analysis of the CFPB data shows that an average of 14% of American credit reports have medical debt on them. The Kaiser Health News<\/b>\/NPR<\/b> collaboration kicked off with the publication of a Kaiser Family Foundation poll<\/a> showing that 41% of adults in the US, or 100 million Americans, have medical debt.<\/p>\n So despite \u201cbreakthrough\u201d legislation and additional internal policy changes at the state\u2019s largest health system, people in Connecticut remain so burdened with medical debt two decades after a \u201cbreakthrough\u201d that public officials feel the need to publicize the problem and take action.<\/p>\n Meriden, Conn., Record Journal<\/strong> (12\/10\/22<\/a>)<\/em><\/p><\/div>\n In December 2022, US Sen. Chris Murphy (D.-Conn.), who was the Senate co-chair of the state\u2019s Public Health Committee when the 2003 law passed, held<\/a> a listening session on medical debt to allow people to air their suffering. Two months later, Connecticut\u2019s governor promised to spend public money to retire as much as $2 billion in residents\u2019 debts.<\/p>\n Murphy and his Senate colleague Chris Van Hollen (D.\u2013Md.) have introduced<\/a> the Strengthening Consumer Protections and Medical Debt Transparency Act, to \u201cprotect consumers from medical debt.\u201d Most of the proposal is lifted from 20-year-old laws in Connecticut and other states: capping interest at 5%, reporting on collection activity, determining the patient\u2019s insurance status before collecting, requiring itemized bills. The bill would also give patients an additional six months after providers have determined their insurance and charity care eligibility before facing aggressive collections tactics.<\/p>\n Similar laws in other states simply have not stopped medical debt from gnawing at the economic security and health of millions of families. In the CFPB analysis, Connecticut has only the 16th lowest percentage of credit reports with medical debt. The report includes a table of states that have policies to require hospital charity care or restrain aggressive collection tactics. Some of those states are among those with the lowest percentage of indebted patients; others, like New Jersey, Illinois, Maine and New Mexico, are not. Of course, what does line up with low levels of medical debt is health insurance. The CFPB study (3\/1\/22<\/a>) notes that \u201cmedical debt is also more common in the Southeastern and Southwestern US, in part because states in those regions did not expand Medicaid coverage.\u201d Indeed, 29 of the 30 states with the lowest percentage of credit reports with medical debt have adopted some form of Medicaid expansion.<\/p>\n These laws do ease some existing patients\u2019 terror and stress, by banning or reducing the use of horrifying tactics like wage garnishment, bank executions, foreclosure and even actual<\/a> arrests<\/a> for missing court dates. In the end, they don\u2019t eliminate that stress, and won\u2019t address the core failure of the US healthcare system to cover everyone with guaranteed health insurance.<\/p>\n Here’s a simple sentence you\u2019ll rarely read in corporate media: The Affordable Care Act has failed. Its only measurable effect has been to shift a small percentage of the population from being uninsured<\/i> to the ranks of the underinsured<\/i>.<\/p>\n According to the Commonwealth Fund, when the ACA passed in 2010<\/a>, 56% of American adults age 19\u201364 were covered for the entire year with insurance good enough not to consider them underinsured. In 2022<\/a>, 57% of Americans were similarly covered. After 12 years, millions of column inches and endless television news hours, there is little discernible difference in the core protections available to Americans against illness, injury, early death and, yes, medical debt.<\/p>\n The Commonwealth Fund underestimates the scale of underinsurance: 32% of adults who were \u201cinsured all year, not underinsured\u201d in 2022 reported problems getting access to healthcare because of cost. However, taking Commonwealth\u2019s definitions at face value, at the current rate of progress, every single American adult can expect to be \u201cinsured all year, not underinsured\u201d in about 515 years.<\/p>\n Fox Business<\/strong> (3\/3\/21<\/a>) notes that its advice to medical debtors is “sponsored by Credible\u2014which is majority owned by our parent, Fox Corporation<\/strong>.” Credible<\/a> is a “leading consumer finance marketplace” that “delivers a differentiated and personalized experience that enables consumers to compare instant, accurate pre-qualified rates from multiple financial institutions.”<\/em><\/p><\/div>\n Not to worry. Major media outlets have us covered for the next five-plus centuries. Most US news sources, medical self-help websites, and even credit-reporting agencies Experian<\/a> and Equifax<\/a> have an article or two filled<\/a> with<\/a> advice<\/a> for patients on fighting<\/a> back<\/a> against medical debt<\/a>.<\/p>\n If medical debt has crimped your reading budget, look for former ProPublica <\/b>reporter Marshall Allen\u2019s Never Pay the First Bill: And Other Ways to Fight the Healthcare System and Win<\/i><\/a> in your local public library. Or you can head over to his Allen Health Academy<\/a> website, featuring a self-help curriculum called \u201cThe Never Pay Pathway.\u201d For $3 a month, you get 16 videos on-demand, a certificate of completion and monthly newsletter. Coming soon, for $5 a month, you can get an app and a checklist for tracking your progress negotiating with your creditors, and for $7, companies get access to an employer-support forum, and workers who have debt (presumably because of the company\u2019s lousy health insurance) can join a Facebook<\/b> support group.<\/p>\n The guidance has changed little in two decades: Study your insurance plan if you have one, to understand your deductibles and copays. Review your bills for inaccuracies. If you\u2019re uninsured, apply for Medicaid or other public insurance programs, and ask your hospital for financial help. Fight your insurer if they don\u2019t pay what they\u2019re supposed to. Negotiate your total hospital debt down, bargain a lower interest rate, and set up a payment plan that you can afford. If you get sued, show up in court, prepared with a proposed payment plan. And so on.<\/p>\n If it works, this is good advice. Most hospitals still bill uninsured patients at inflated prices. The vast majority of medical bills do contain errors<\/a>. Patients frequently can negotiate to lower their total debt and interest rates dramatically and get on a payment plan. Hospitals do have charity care policies, however stingy or generous.<\/p>\n But consumer empowerment only goes so far. A study by Stanford Graduate School of Business professor Jeffrey Pfeffer found<\/a> that US adult workers already spend more than 13.7 million hours a week on the phone with their health insurance administrators. Some of that time is spent dealing with health insurance problems involving medical debt. However, most medical debt empowerment articles urge patients to research, review and negotiate discounted debt with hospitals, doctors and other providers.<\/p>\n KFF Health News<\/strong> (7\/1\/22<\/a>): ” Do not expect this to be an easy process.”<\/em><\/p><\/div>\n So, to \u201cget rid of medical debt\u2014or avoid it in the first place,\u201d according to the headline on a widely circulated story by NPR <\/b>reporter Yuki Noguchi (KHN<\/b>, 7\/1\/22<\/a>), patients must expect to spend even more time on the phone, studying bills, reading laws, regulations and policies, writing letters and going to court. In a nation where people have to work two or three jobs to make ends meet, it\u2019s not clear when they are supposed to find the time to read (assuming they\u2019re fluent in English), make phone calls, gather their personal information and trudge off to the hospital to prove they\u2019re worthily poor enough not to deserve torture.<\/p>\n For the story, KHN <\/b>and NPR <\/b>\u201cspoke with patients, consumer advocates, and researchers to glean their hard-won insights on how to avoid or manage medical debt.\u201d Noguchi walked patients through the US healthcare nightmare step by step, from subscribing to an insurance plan through fending off collections lawyers, with empowering advice for each step.<\/p>\n In real life, patients often can\u2019t shop for hospitals like groceries or a new appliance. Patients go where their doctors have admitting privileges, get treated in facilities that are in their insurance network, or wind up in whichever emergency room an ambulance takes them to. If, after shopping, their discounted bills still far exceed their ability to pay, then what? Without real wealth or a high income, uninsured and underinsured people have relatively few choices that actually protect them from healthcare debt.<\/p>\n Neither NPR <\/b>nor any other outlet offers data on the efficacy of consumer empowerment as policy. If every single \u201cconsumer\u201d dutifully followed every bit of advice, would the number of debtors shrink from 100 million to 10 million? 50 million? 95 million?<\/p>\n And when these tactics do \u201cwork,\u201d it\u2019s not clear how much help they provide. KFF\u2019s own survey (6\/16\/22<\/a>) found that half of American adults couldn\u2019t pay a $500 medical expense right away, and 19% would never be able to pay it off. In the end, if you can\u2019t afford $500, how valuable is bargaining a $30,000 debt down to $10,000?<\/p>\n Without comprehensive health insurance coverage, patients will wind up back in debt, or sicker and in more pain because they avoid care. MLK50<\/b>\u2019s Thomas (ProPublica<\/b>, 6\/27\/19<\/a>) framed her interviews with Memphis judges in part through the story of Raquel Nelson, who received treatment from the United Methodist Church-affiliated Methodist Le Bonheur Healthcare system. Methodist\u2019s lawsuit was Nelson\u2019s third time as a medical debt defendant.<\/p>\n “Is Your Town Next?” the New York Times<\/strong> headline (12\/29\/22<\/a>) gushes. But the subhead acknowledges it’s just “a short-term solution.”<\/em><\/p><\/div>\n This issue haunts reporting on what the New York Times<\/b> (12\/29\/22<\/a>) calls \u201ca new strategy to address the high cost of healthcare.\u201d RIP Medical Debt, a nonprofit<\/a> organization founded by former debt collections executives, is working with public and private institutions like churches, state and local governments, and even a local ABC<\/b> affiliate, using their own money to purchase<\/a> outstanding debt and retire it.<\/p>\n Most of this debt has already been written off as uncollectible by providers and sold to third party collectors, allowing<\/a> RIP to buy it at a few cents on the dollar. In Connecticut, Governor Lamont proposes<\/a> to give RIP Medical Debt $20 million in federal American Rescue Plan funds to retire up to $2 billion in debt.<\/p>\n Ohio State Rep. Michele Grim, quoted in the Times<\/b> story as a Toledo city councilor who helped organize a partnership between the city and RIP Medical Debt to cancel medical debts, told FAIR in a Zoom<\/b> interview:<\/p>\n This is the only country in the world that lets its citizens go bankrupt because of medical debt. States and locals see this as the simplest thing we can do, because we can\u2019t fix our broken healthcare system.<\/p><\/blockquote>\n Toledo internist John Ross<\/a>, a Franklin County Board of Health commissioner and past president of Physicians for a National Health Program, strongly supports the Ohio initiative, but also noted that ARP funding is a one-off. Without continued sources of financing, many of the current debtors whose debt will be forgiven, and thousands of others who lack adequate health insurance, will soon be burdened again by debt: \u201cThe next wave of debt is building as we speak.\u201d<\/p>\n RIP Medical Debt typically doesn\u2019t buy debt until patients, providers and insurers have had a chance to pursue other sources of payment. That process usually takes about 18 months, according to RIP Medical Debt CEO Allison Sesso. Thus, at its very best, the Times<\/b> \u201cstrategy to address high healthcare costs\u201d boils down to this: If<\/i> a local government scrapes together some money, and if<\/i> your local hospital is willing to work with RIP medical debt, indebted patients may only need to spend 18 months struggling with medical bills\u2014although once their current debts are paid, the next time they get sick, the cycle starts over. When the bar is low enough, even an unfunded possibility of limiting future torture to a year and a half looks like a victory.<\/p>\n RIP Medical Debt leaders understand the limitations of their model. In an email exchange with FAIR, CEO Allison Sesso wrote:<\/p>\n We know that RIP Medical Debt is not a holistic solution, but a stopgap that nonetheless provides a financial and emotional respite to our constituents. We understand both that debt relief matters to the individuals we help and that what we are doing is not fundamentally solving the problem.<\/p><\/blockquote>\n New York Times<\/strong> (2\/20\/20<\/a>): “It actually isn\u2019t much of a surprise that nonprofit hospitals are often more profitable than for-profit hospitals.”<\/em><\/p><\/div>\n In reality, local residents have already paid these debts many times over. Nearly 60% of acute care hospitals in the US are<\/a> private tax exempt \u201ccharitable\u201d organizations, whose mission statements typically include a commitment to caring for the poor, sick and injured. The \u201cmission\u201d entitles<\/a> them not to pay federal, state and local property, income or sales taxes.<\/p>\n In 2006, the Cook County assessor estimated<\/a> that nonprofit hospitals owned between $4.3 and $4.5 billion worth of exempt commercial real estate in the county, representing up to $241 million in local property tax revenues, likely much higher today. Yet cash-strapped city governments are now spending public money to pay for debts incurred in these already heavily subsidized hospitals.<\/p>\n Speaking from personal experience, it\u2019s hard to imagine a more gratifying reporting outcome than seeing a powerful hospital corporation forgive suffering patients\u2019 debts, or announce changes in policies toward all patients who can\u2019t afford care. In 2019, Virginia Gov. Ralph Northam and the president of the University of Virginia publicly committed to changing UVA Health\u2019s policies, the day after KHN<\/b>\u2019s expose (9\/10\/19<\/a>) on the hospital system\u2019s lawsuits and collections tactics.<\/p>\n However, by ignoring the history of failed, narrowly targeted reforms; covering gimmicky strategies and pouring effort into the kind of consumer self-help that NGOs have been publishing how-to guides about for decades (e.g., Hospital Debt Justice Project<\/b>, 2003);<\/a> and indulging in ritual defenses of the Affordable Care Act, news organizations leave their audiences with distorted impressions of the policy landscape, undermining the power of their own high-impact reporting.<\/p>\n Jennifer Bosco, staff attorney at the National Consumer Law Center, told NPR<\/b> (4\/14\/22<\/a>):<\/p>\n Ultimately, I think the problem of medical debt isn’t going to go away unless at some point in our country’s future, we adopt some sort of single payer or Medicare-for-All system. But I think that’s very much a blue-sky idea at this point.<\/p><\/blockquote>\n Apparently it\u2019s a popular blue sky idea. In its story on RIP Medical Debt, the Times <\/b>(12\/29\/22<\/a>) noted that polling<\/a> by Tulchin Research, the American Association of Political Consultants\u2019 2022 Democratic Pollster of the Year<\/a>, found that \u201c65% supported \u2018Medicare for all\u2019 and 68% supported expanding Medicaid.\u201d<\/p>\n It will remain a blue-sky idea as long as media keep giving politicians cover with the idea that urgently addressing the incremental Next Bad Thing will make a difference. Three years ago, the bad thing du jour was \u201csurprise billing.\u201d Surprise bills happen when an empowered consumer carefully studies the rules of their health plan and goes to a hospital in their insurance network, but unknowingly gets treated by a doctor that isn\u2019t in their network, then gets socked with a huge bill that their insurer doesn\u2019t want to pay.<\/p>\nCompelling and consistent<\/b><\/h3>\n
![\"NYT:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NYT-Medical-Bills-350x332.png\")
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\n“Since then, the nonprofit hospital system affiliated with the United Methodist Church has doggedly pursued her, adding interest to the debt seven times and garnishing money from her paycheck on 15 occasions.”Barrett, 63, now owes about $33,000<\/a>, more than twice what she earned last year.\u201d (Guardian<\/b>, 6\/27\/19<\/a>)<\/li>\n\n
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An evergreen problem<\/b><\/h3>\n
![\"WSJ:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/WSJ-Medical-Debt-350x204.png\")
![\"MLK50:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/MLK50-Medical-Debt-350x344.png\")
Community outrage<\/b><\/h3>\n
![\"Quinton](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/Quinton-White.jpg\")
Historical amnesia<\/b><\/h3>\n
![\"NYT:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NYT-Higher-Bills-350x465.png\")
History of failure<\/b><\/h3>\n
![\"NPR:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NPR-Medical-Debt-350x346.png\")
Burdened despite ‘breakthrough’<\/b><\/h3>\n
![\"Record](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/Murphy-Listening-350x225.png\")
![\"Post-ACA](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/Post-ACA-Progress-600x338.png\")
<\/p>\nHow to cope with the Kafkaesque<\/b><\/h3>\n
![\"Fox](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/Fox-Business-Medical-Debt-350x417.png\")
The limits of consumer empowerment<\/b><\/h3>\n
![\"NPR:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NPR-Medical-Debt-Avoid-350x594.png\")
Limiting future torture<\/b><\/h3>\n
![\"NYT:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NYT-Medical-Debt-Erased-350x426.png\")
Distorted landscape<\/h3>\n
![\"NYT:](\"https:\/\/fair.org\/wp-content\/uploads\/2023\/05\/NYT-Nonprofit-Hospitals-350x521.png\")
Giving politicians cover<\/b><\/h3>\n