The Scale of the Problem, and How to Fix It 

The longest government shutdown in US history came to an end this week, with no deal in place to restore enhanced Affordable Care Act (ACA) marketplace plan subsidies. As the Roosevelt Rundown detailed last month, skyrocketing insurance premium costs will result in more people dropping coverage, forcing insurance companies to raise premiums further for everyone else and leaving uninsured people no choice but to take on medical debt if they get sick.

“Because the hospitals aren’t going to leave people to die in the streets. They’re not allowed to, legally,” Roosevelt’s Stephen Nuñez told CBS News this week. “So the question is who’s going to bear that cost? And the answer is, one way or another, society is going to pay for it.”

The medical debt crisis is the result of a wholly broken health-care system that burdens patients, employers, and health-care providers alike for the benefit of a handful of insurance corporations, pharmaceutical companies, and pharmacy benefit managers.

As Roosevelt Reimagine America Fellow Mara Heneghan explains in a new blog post, “The myth that our health-care system is a functioning market that can and will course-correct any problems on its own also leaves us looking for solutions from the very stakeholders who benefit from the structure as it is currently.”

That illogic is a pervasive theme. Heneghan, who ran a medical debt cancellation program in Illinois, notes how aggressive medical debt collection practices cause unnecessary suffering for people already drowning—and they don’t even generate meaningful revenue for hospitals. “If someone doesn’t pay their medical debt, it’s usually because they simply don’t have the money,” Roosevelt’s Brad Lipton told CNBC last week. “The government and the system can torture them all they want, but you’re just not going to get much money out of it. It’s water from a stone.”

Heneghan’s follow-up blog post dives into possible solutions beyond just canceling this debt: from price controls and public provisioning to a fully overhauled single-payer health-care system.

Read the posts: 

• “What Medical Debt Cancellation Teaches Us About Our Failing Health-Care System” 
• “How to Start Fixing a Health-Care System That Creates Medical Debt”

What We're Reading

• On labor solidarity: Roosevelt Senior Fellow Darrick Hamilton and Community Change Copresident Dorian Warren explained organized labor’s essential role in restoring democracy for Nonprofit Quarterly. “Appeals to relative status are the calling card of authoritarianism—they fracture the solidarity necessary to challenge elite power. They turn the working class against itself, ensuring that organized money faces only fragmented resistance from organized people,” they write. “The antidote is solidarity—real, practiced, institutionally expressed solidarity—instead of sentiment alone.” 
• On consumer protection: Roosevelt’s Brad Lipton spoke with Bloomberg Law about the Consumer Financial Protection Bureau’s current efforts to weaken fair lending laws, pointing out that the proposal would make private lending discrimination lawsuits and even cases from state attorneys general potentially more difficult.