How effective are different policies in fighting medical debt? researcher weighs

Wes Yin says it’s impossible to study healthcare these days without facing the problem of medical debt.

“There are a lot of people who are suffering,” he said. yinD., associate professor of economics at the University of California and one of the country’s leading researchers in the field of medical debt.

more than 100 million Americans They have health care debt, according to an investigation by Kaiser Health News and NPR. Another study estimates that Americans have at least $140 billion in medical debt.

Medical debt can destroy people’s credit scores, cost people their homes and force them into bankruptcy. Surveys It has been shown to lead people to avoid care and skip prescriptions, especially among people of color and people with disabilities. some studies Medical debt has been linked to a higher likelihood of developing chronic pain, depression, premature death, and attempted suicide, but there is limited research on whether medical debt directly causes People’s health is deteriorating.

When it comes to solutions, Yin’s own research indicates that medical debt cancellation works in the short term Increases In patients who receive necessary medical care, this expansion of Medicaid leads to Big Sale in medical debt.

In recent years, state, federal, and industry leaders have enacted several policies to try to tackle this pervasive problem, and in an interview, we asked Yin to rank it on a scale of 1 to 10.

Yin said many policies follow different points in what he calls the medical debt pipeline — from the time a patient received care he could not afford, right through to the effects that debt had on his life.

“They are not necessarily alternatives that we should necessarily compare to each other,” Yin said. “They are all likely to be good complements to each other.”

This interview has been lightly edited for length and clarity.

Trade-offs: let’s start with More than 20 countries Which have laws that require hospitals to provide free care to poor patients or limit certain collection methods.

Yin: For this, I think it’s two. Not because of a lack of effort or good intentions. It’s just that a lot of countries aren’t really clear about how much financial assistance is needed. It’s really hard to enforce. So I’ll give it two.

Trade-offs: Now, what about those Two policies from the Biden administration? First, management will take medical debt into account when deciding whether to give someone a loan, such as a small business or home.

Yin: [This] Like a doctor treating an already existing disease. It is not protective. But we know that when people have debt, it affects their credit scores, affects their ability to take out loans, and raises their interest rates. even if [this] It’s well implemented, and that really limits the negative impact of medical debt on people’s ability to get federal loans. So that’s a good thing. I’ll give that six.

Trade-offs: Well, let’s talk about Biden’s second policy: They plan to use data on hospital debt collection practices to determine which facilities get federal grants.

Yin: This is the big card for me. All the demons are in the execution details. If they didn’t really force this to be used for potential grants to those hospitals, they might not have much power there. But at least the federal government gets more data about debt collection practices, and how much debt hospitals hold, likely to make some big changes in the future. So I’ll give that a six as well, but I’ll only give that slight advantage to its potential.

Trade-offs: True, the more information you have, the easier it will be in the end to formulate policies that respond to the problem.

Yin: exactly.

Trade-offs: yes. So let’s move on to Congress, which is Block sudden off-network medical bills By law no surprises.

Yin: I have two minds about this. [Surprise medical bills are] Not a huge source of medical debt, but in fact one of the most worrisome sources of medical debt. Emergency department spending is about one-tenth of hospital spending, and surprise bills handle a small portion of emergency department bills. So this gets rid of that, which I think is great, but it doesn’t solve a larger source of the problem. So let’s give it five overall.

Trade-offs: Well, we have another one for you to arrange, Wes. Starting next year in 2023, the three largest credit reporting agencies say they will Clearing unpaid medical debts of less than $500 From people’s credit reports. This can be As much as 70 percent of medical debts currently in credit reports.

Yin: I’m really optimistic about this too. Having medical debt can affect a person’s credit score, affecting interest rates and ability to borrow. It may even influence hiring and rental decisions. So anything we can do to mitigate the negative effects of medical debt is a good thing. So I’m going to give this one a six.

This story is from the Health Politics podcast Tradeoffspartner Side effects of public media. Dan Gorenstein is the Executive Editor of Tradeoffs, and Ryan Levy is a reporter/producer for the program that ran This story November 3, 2022. Tradeoffs coverage of healthcare costs is supported in part by Arnold Ventures and West Health.

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