Vox: The problem of medical debt, and the wonky fight behind Bernie Sanders’s plan to eliminate it, explained
Bernie Sanders has a big new health care promise: eliminating $81 billion in medical debt.
Americans go bankrupt every year because of unpaid medical bills.
Now Sen. Bernie Sanders (I-VT), one of the leading progressives in the 2020 presidential race, says he wants to eliminate all Americans’ medical debt. Sanders teased this plan in a speech over the weekend, but the details have not yet been formally released.
“I am sick and tired of seeing over 500,000 Americans declare bankruptcy each year because they cannot pay off the outrageous cost of a medical emergency or a hospital stay,” Sanders said on Saturday.
But in justifying his plan to alleviate Americans’ medical debt, Sanders cited this 500,000 figure and reignited a longstanding scholarly debate about the actual scale of the medical bankruptcy problem. The Washington Post’s in-house fact-checkers dinged him for saying 500,000 people go bankrupt because of medical debt every year, stirring up an old fight that originated with a 2005 paper co-authored, in a fun twist, by Sanders’s now-rival Elizabeth Warren.
Academics have been debating since that 2005 paper’s publication how many people actually go bankrupt in the United States because of medical bills. It is a debate about causation and study design that frankly won’t matter to most people. It also risks losing sight of the underlying problem.
There is no denying that thousands of Americans go bankrupt entirely or partly because of medical debt. And even if they don’t go bankrupt, millions more people struggle with this type of debt on their personal ledgers, making it harder for them to borrow money and stay financially stable. Millions of Americans still lack health insurance, and they’re fully liable for their medical bills if they get sick or have an accident. But even health insurance does not always provide security against financial stress because poor health takes its toll in other ways, such as lost wages.