In a bombshell piece this week, @sarahkliff & @sangerkatz revealed that Americans owe much more in medical debt than previously thought, as collection agencies held $140 billion in unpaid medical bills in 2020.

Here's the crazy part: the real total is WAY higher. Let me explain.
First, as the piece notes, the $140b doesn’t include anywhere close to all the medical bills Americans owe, just debts that have been sold to collection agencies. Not counted are bills patients put on credit cards & try to pay off. Many of those patients will never pay them off.
Another crucially important fact the @nytimes story does not mention is that much of Americans’ medical debt--maybe more than half of it--is owed not by the uninsured... but by people who have health insurance!
To meet Wall Street’s profit expectations, insurance companies, like the ones I used to work for, keep jacking up the amount Americans have to pay out of their own pockets before their coverage kicks in.
It is not at all uncommon for patients in this country to have to pay thousands of dollars in deductibles, copayments and coinsurance every year. That’s in addition to the premiums they have to pay to get the coverage in the first place.
I'll never get over stories like Sharon Kelly, a breast cancer survivor who stopped going to the doctor--even though she had insurance--for fear of adding to her debt. “It kind of paralyzes you,” she said, while paying ~$7K/yr in premiums alone in 2019.…
Sharon learned from a routine mammogram that she had cancer when she was halfway through the calendar year. She had no choice but to pay her deductible over the remainder of the year. And then January came, and her deductible shot back up to $7K.
Her treatment continued -- and so, of course, did the bills. And because of those bills, Kelly decided not to undergo chemotherapy as her doctors advised. She also has put off going back to the doctor. She's far from alone. This country has a problem.
Fixing this disaster must become a priority of Congress & @joebiden. He is understandably protective of the ACA, but just getting more people enrolled in health plans & increasing premium subsidies is not helpful to the millions of middle-class Americans in high-deductible plans.
Zeke Emanuel, who helped write the ACA, told the @nytimes last year that not anticipating the growth and consequences of ever-rising out-of-pocket requirements was “a huge mistake.”

It is long past time for Congress & the Biden administration to fix that huge mistake.
For more on the huge amount of medical debt that Americans owe, read my latest on @SubstackInc!…

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More from @wendellpotter

17 Jun
Now that the Supreme Court has once again upheld the Affordable Care Act, lawmakers in Washington and the states must get serious about fixing its flaws and addressing what one Obama administration official called “a huge mistake.”
It’s good that the law enabled 21 million people to get health insurance but 30 million are still uninsured.

The other problem is that 40% of people with Obamacare insurance and 30% with coverage through employers can’t use it b/c of impossibly high out-of-pocket requirements.
That’s the huge mistake that Zeke Emanuel, one of the architects of the law, acknowledged last year. Lawmakers should have known better than to trust health insurers and they should not have allowed the out-of-pocket limit to soar through the stratosphere.
Read 5 tweets
10 Jun
IMPORTANT: While many of us fought for major reform to our broken health care system (and President Biden campaigned on a public option), nothing has happened on the federal level.

But! Serious action is happening in the states. Most recently: Nevada. Here's why that matters:
The Nevada Option was just signed by its governor, and will lower premiums & cover 350k uninsured Nevadans. The bad news? The fight wasn’t easy, as the industry poured millions into propaganda to confuse voters.

The good news? We now have a blueprint for how to beat them back.
To counter the industry's lies (that are designed to protect their profits), we at @cforhd testified before the legislature, ran ads, wrote op-eds, wrote to legislators, distributed posters & beat them at their own game. The lesson is clear: We can win this battle elsewhere, too.
Read 6 tweets
19 May
Congrats, America! Two days after Tax Day, you’ve made it to... Deductible Relief Day! 🍾🎉🎊

What's that?

It’s the day where the average person with employer-based health insurance has spent enough on health expenses to finally meet their deductible.
Health insurance deductibles have been rising so rapidly (year after year after year) that the Kaiser Family Foundation (@KFF) decided to track the trend to show how severely Americans are getting ripped off (and sick).

And it’s bad:…
As you might guess, the Deductible Relief Day is being pushed further each year. In 2005, you had to wait until Feb 28. By 2009, you wouldn’t be popping champagne until March 18. In 2019, you had to wait even two months more than that.
Read 9 tweets
29 Apr
In last night's speech by @POTUS, something stood out to me that was overlooked by many pundits: the president spoke of the NEED to fix sky-high health insurance deductibles immediately. It's not the sexiest topic, but here's why it matters:
Many think that the only ones suffering in this health care system are those without insurance. They're struggling big time, but know who else is? People with BAD insurance. The fact is, millions of Americans can’t use their coverage because their deductibles are so damn high.
These millions of Americans with bad plans don't go to the doctor or get the care they need, like cancer treatments that could save their lives. Why? Because they don’t have enough money to cover their deductible: the amount you have to pay out of pocket before coverage kicks in.
Read 7 tweets
19 Apr
Get this, my former health insurance industry colleagues are trying to intimidate lawmakers again - this time in Connecticut - because the state government has the gall to consider a public health plan that could compromise some of the industry’s massive profits. It's despicable.
If I were still in my old job as head of comms at Cigna, I bet I would have had to write a self-serving letter to Connecticut’s governor – signed by the country’s biggest insurer CEOs – implying that they'd consider taking jobs out of the state if they don’t get their way.
And that’s just what happened. The PR chiefs of those companies wrote to CT’s governor & tried to intimidate him. This is the kind of stuff that made me leave the industry & become a whistleblower. I couldn't stomach misleading Americans so a few rich people could get even richer Image
Read 9 tweets
15 Apr
Democrats are not yet on the same page about what health care reform proposals to include in their infrastructure bill. As a former health insurance executive, I’ve got a suggestion: lower deductibles and co-pays. And do it fast.
Some Democrats seem to be turning a blind eye to the fact millions of Americans WITH INSURANCE can’t use it anymore.
A favorite campaign talking point last year was that 150 million Americans have private insurance and don’t want to lose it. What most politicians avoided saying is that more and more of those Americans can’t use their insurance.
Read 11 tweets

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