It has become an all-too-familiar sight—websites, posters, collection jars with photos of children, mothers, young people who need medical care they can’t afford. Some will not receive life-saving treatment without this help. All too often, the bills will saddle the family with a debt burden that will follow them for years—sometimes for life.
Getting sick, having a baby, or being injured can result in tens of thousands or even hundreds of thousands of dollars in bills, even for those with insurance. The debt is routinely sold to collection agencies for pennies on the dollar. There, it is packaged and sold, over and over. Interest accumulates on the original debt, so the amount owed by the patient increases although the amount a debt collection agency pays for the debt is small.
Jerry Ashton is working to change that. Ashton was a debt collector and consultant working in New York City when the Occupy movement erupted. He started showing up at Zuccotti Park, and when the discussion among the occupiers turned to debt, he spoke up, explaining the inside story of how debt and debt collection work. When Rolling Jubilee launched, he joined in.
Rolling Jubilee raised money to retire debt that is especially a burden on poor and working-class families, many of them people of color. Since debt could be purchased for pennies on the dollar, the $700,000 raised made it possible for this Occupy spin-off to retire nearly $32 million in debt by the end of 2013, according to the organization’s website.
What was it like to be in the business of forgiving debt instead of collecting it?
“It was a great pleasure,” Ashton told me when I interviewed him in late February. “First of all, the cause was right. It was just.”
In 2014, Ashton joined up with Craig Antico, who also worked in debt collections, to form RIP Medical Debt, a nonprofit organization, which focuses on buying and forgiving medical debt.
Their effort went slowly at first. “The first couple of years our wives were wondering why we were going into debt to get other people out of debt,” he said. “We were struggling.”
“If it had not been for John,” he said, “we would be standing on a street corner with a paper cup.”
Ashton is referring to John Oliver, who, on a June 2016 episode of HBO’s Last Week Tonight, did a scathing report on credit collection practices and the people targeted with repeated phone calls, calls to employers, garnishing wages, court cases, and so on. It’s all too common an experience: About a third of Americans with credit were contacted by a debt collector or creditor within a year of a recent survey by the Consumer Finance Protection Bureau. Of those, more than half of people who were contacted about a past-due bill were contacted about a medical bill.
Oliver, after excoriating the medical debt system and the politicians who enable it, made an announcement. He had formed a collection agency of his own (which, he said, proves that a complete idiot can create a collections agency), and—with no credentials apart from a minimalist website—purchased nearly $15 million worth of debt for just under $60,000, less than half a cent on the dollar. This purchase entitled him to the names, current addresses, and social security numbers of those who owed the debt, even if the debt was so old it was called zombie debt. And with this information, he acquired the right to try to collect debt.
Debt packs a moral punch in our culture. Most people believe it should be paid, and many families struggle to pay off their debt. According to a 2017 Kaiser Permanente study, 73 percent of families struggling with medical bills cut spending on other household basics, 61 percent use up all or most of their savings, and 58 percent take on an additional job or work additional hours. Still, the size of the debt for some families dwarfs their ability to pay.
Oliver announced on the air that he would not attempt to collect on the debt he’d acquired. Instead, with great fanfare, he forgave it (and congratulated himself for an even bigger giveaway than Oprah’s famous in-studio car giveaway). He worked with RIP Medical Debt to make it happen.
Soon others, inspired by Oliver, contacted RIP Medical Debt. Some donated anonymously—some very publicly.
Last June, the Minnesota Nurses Association announced they had purchased the medical debt of 1,800 Minnesotan families worth $2.6 million via RIP Medical Debt, paying just $28,000 to collection brokers.
“We’d had many discussions about how to repay the community for what they gave nurses during the strike [in 2016 against Allina Health],” Mary Turner, the association president, said in a statement announcing the debt buy-out. “The John Oliver show inspired us, and we decided to see if we could do the same thing.”
There are others, too. Two Pensacola, Florida, high school juniors, Samir Boussarhane and Falen McClellan, formed the Pensacola Debt Sharks in September 2016 as a community service project, with the goal of retiring medical debt in northwest Florida. So far, according to their website, they have raised $28,000, enough to retire more than $2 million of debt.
Recently, network television stations have gotten involved. Just this month, KIRO-7 in Seattle spent $12,000 of station money to pay down $1 million in medical debt, mainly in the Puget Sound area, also via RIP Medical Debt. When they invited viewers to donate on the station’s website, supporters paid off another million in debt.
NBC-owned TV stations are buying up debt, too. This month, affiliate stations—including NBC 4 in Los Angeles and NBC 5 in Dallas-Forth Worth, Texas, are donating $150,000 to retire $15 million of medical debt. And they are encouraging viewers to join them in making donations for debt retirement.
Others are donating anonymously, Ashton said, and he expects the numbers to keep growing.
Apart from donating to organizations that buy and retire debt, there are things we can do in our own communities. Ashton believes many hospitals are falling short on the charity care they should be offering to low-income patients. We can query nonprofit hospitals in our area. We can call out medical practitioners who fail to offer charity care or make payment arrangements. We can work to make our homes, lives, and communities healthier.
And we can work to change a medical system that spends way more per capita than other high-income countries yet has worse outcomes, according to 2013 data from the Organization for Economic Cooperation and Development. California lawmakers are debating a single-payer system. The Bernie Sanders movement, Our Revolution, supports “Medicare for All,” as do 121 cosponsors of such a bill in the House and 16 in the Senate. And just in the last few days, the progressive think tank Center for American Progress moved closer to the Sanders position when it released a modified plan for Medicare for All.
Increasing numbers of insured Americans are finding it difficult to afford health care; the number increased substantially just from 2015 and 2017, according to a Kaiser Family Foundation survey. Our health care system should not be structured so people have to beg for money from family, friends, and strangers to get treatment. Medical debt should not exist. The path from Occupy to NBC-TV affiliates retiring medical debt shows that the impetus for change is spreading.