Latest / What the Hal?? 2.0 / WHAT THE HAL? PODCAST 2.0 – EPISODE 23: Undue Medical Debt: Erasing Bills and Restoring Hope

Transcript

WHAT THE HAL? PODCAST 2.0 – EPISODE 23: Undue Medical Debt: Erasing Bills and Restoring Hope · What the Hal?? 2.0

• 0:00
  For millions of Americans, getting sick or injured doesn't just threaten their health, it can threaten their financial future.
• 0:07
  I'm Hal Eisner with Hunter Lowry and Elsa Ramon.
• 0:10
  And this is what the hell.
• 0:13
  Smart, fresh and uplifting.
• 0:20
  We've got the stories that make you want to say what the hell.
• 0:26
  Medical debt has now become one of the leading causes of financial hardship in the United States, forcing families to choose between paying medical bills and meeting basic needs.
• 0:37
  In fact, medical expenses are now the main reason for bankruptcies in the US fully 2/3 of the people declaring bankruptcy, that's just from the burden of getting and staying healthy.
• 0:50
  So one organization is stepping in and trying to help.
• 0:53
  And today we are joined by Marisa Clemente, vice president of philanthropy at Undo Medical Debt, to talk about how this crisis affects everyone, everyday people, and what can be done to make things better.
• 1:08
  And if it hasn't affected you, I see it this way, Marisa.
• 1:11
  If it hasn't affected you now, at some point it might, which is unfortunate.
• 1:17
  But we'll get to that.
• 1:19
  First of all, welcome to the show.
• 1:20
  Thank you for joining us to talk about this issue because this is something that is bound to affect just about everyone in the United States, whether they get sick or a family member or a child gets sick and
• 1:36
  ends up with some hefty medical bills.
• 1:41
  Let's talk about that for a little bit and some of the things you see with undue medical debt.
• 1:47
  Sure.
• 1:47
  Well, thank you guys so much for having me, and I'm happy to talk bit more about the medical debt landscape and overall, just the urgency of this crisis.
• 1:57
  I think we're in a wonderful position right now because we've had a transformative gift from Evan Spiegel and Miranda Kerr, really lift up what folks are feeling across the country.
• 2:08
  Undue medical Debt is a 501C3.
• 2:10
  We're a national nonprofit and we work across all the countries for all the states, excuse me, to abolish medical debt.
• 2:18
  So we purchase it from hospitals directly to give folks who are in need of this relief some hope and a burden off their shoulders.
• 2:29
  But to your point, Elsa, you know, medical debt is something that everybody is impacted by.
• 2:34
  So whether you are experiencing it yourself or if you know of someone, whether it's a relative, a friend or a neighbor, everyone has their own story.
• 2:44
  We know that in this country there's over $220 billion worth of medical debt and that's impacting over 100 million Americans.
• 2:53
  And that's just the debt that we know of.
• 2:55
  Right.
• 2:55
  It doesn't really Take into consideration when it becomes financial debt because people put it on a credit card or if they borrow from a friend or a loved one.
• 3:03
  And we also realize that because of this debt, you know, folks are forcing themselves to delay care until it's more serious and more expensive.
• 3:13
  And, and about 4 in 10 adults, about 43% say that they or a family member postponed, you know, life saving health care due to the cost.
• 3:22
  And beyond the cost, beyond the financial issue here, it's a mental burden.
• 3:27
  It's a, it takes an emotional toll and it follows people beyond the hospital bill.
• 3:32
  Right.
• 3:32
  It could wreck credit scores.
• 3:35
  When someone's ability to pay their rent or put food on the table or provide for their family is, is removed, that's a problem.
• 3:42
  And it turns a health issue into, you know, a long term financial one.
• 3:46
  And you know, Hal mentioned this beginning, but it's the leading cause of bankruptcy in this country and we hear this every day from the constituents that we impact.
• 3:56
  And it hurts again their ability to buy a car, get a mortgage, rent a home or even, you know, get a job, which is wild when you think about it.
• 4:04
  And then I will just say too, that part of our ethos is the fact that, you know, we want folks return to healthcare and we are to get care.
• 4:12
  We don't want people to, you know, delay that.
• 4:15
  We want to create a world where they're getting the care they need when they need it.
• 4:18
  And with that in mind too, medical debt itself is the only debt that folks don't ask for.
• 4:23
  So when you think about that coupled with, you know, this idea of personal responsibility around debts, you know, even people who do things right, so to speak, are impacted.
• 4:32
  Right.
• 4:32
  And there's really nothing that people can do sometimes to, to prevent from being in situation, whether they step off a curve incorrectly and have to go to the hospital, ambulance, so things like that, you know, we are acknowledging
• 4:46
  our issues.
• 4:47
  And when you think of the medical debt crisis overall, it is a bigger systemic issue that we're trying to make right here.
• 4:55
  I want to jump in for a second and just bring up a little example of something that happened to me the other day that maybe happens to everybody.
• 5:02
  You know, we, we get EOBs like we get, you know, bananas at the grocery.
• 5:08
  It is just like, it's crazy how many things we get from healthcare companies and nobody really wants to go through it and look at it.
• 5:16
  I for one am like blinded, I glaze over.
• 5:20
  You know, it's like not something I want to look at because, you know, because the insurance company and then the provider are trying to figure out what are we supposed to pay on behalf of our client.
• 5:31
  And then the other side is saying, you got to pay us this.
• 5:33
  Then they say, no, we got to pay you that.
• 5:35
  So it's a battle between other people and not me.
• 5:38
  But the other day I got $1000 plus bill from a company claiming that they couldn't process my insurance.
• 5:47
  So that was what I was responsible.
• 5:50
  And upon pressure to the person on the other end of the line, we discovered that they had one number wrong.
• 5:58
  On my health card, it wasn't me that owed a thousand dollars.
• 6:03
  It was them that had to figure out what insurance was going to pay.
• 6:06
  But they were, they, somebody messed up.
• 6:09
  There was human error.
• 6:11
  So, I mean, I think, I think we also, as we have a conversation about what to do about undue death, then we probably need to have a conversation about do we really look at our own EOBs and make
• 6:21
  sure that what they're telling us, we owe them, we owe them?
• 6:25
  Yeah, I think unfortunately, you know, that's, that's not an uncommon occurrence.
• 6:30
  Right.
• 6:30
  And I think even the fact that you had the wherewithal to call someone to ask questions and to review your bill, I think that's wonderful.
• 6:37
  And not everyone knows that they can do that.
• 6:39
  So sometimes when folks get a bill in the mail, they automatically say, I have to, you know, I have to pay it.
• 6:43
  Right.
• 6:43
  But one of the things that we really lean into in talking about, you know, giving folks advice on, on those who are struggling with medical debt is really, you know, asking those questions.
• 6:54
  Get an itemized bill and check it for errors, you know, and on top of that, even asking for financial assistance.
• 6:59
  But I do think your story, Hal, kind of touches upon just the bigger issue here, right?
• 7:05
  Where there are more.
• 7:06
  There are a lot of cooks in the kitchen.
• 7:08
  There are a lot of things that can go into these lofty bills.
• 7:13
  And again, being able to ask the right questions and know when is crucial.
• 7:18
  And I think that's also the beauty of Undo's work in a way where we're able to partner with hospitals in making sure that they are serving their patients in the best way, especially when it comes to financial assistance
• 7:31
  policies and charity care.
• 7:32
  Yeah.
• 7:33
  The problem with that particular example is just simply that the bill was right, the number they had for my insurance card was wrong.
• 7:42
  And how would I know that?
• 7:44
  I mean, I wouldn't necessarily know that because it wouldn't necessarily be displayed on the eobs.
• 7:49
  So sometimes you just gotta, you gotta just fight back.
• 7:53
  You have to raise some questions.
• 7:54
  You have to sort of say, I don't think that's right.
• 7:57
  It doesn't sound right to me.
• 7:59
  Let's talk about it.
• 8:01
  And you know, this guy, this guy was pretty tough on me.
• 8:04
  He was kind of a pressure guy and you gotta pay.
• 8:07
  And I said, wait a minute, I don't know that I do gotta pay.
• 8:10
  So at the end of the call, he kind of limped away and said, oh, well, we've got a wrong number here.
• 8:17
  Anyway, just a thought.
• 8:18
  These things can happen, but when you get to real medical debt, the cost of medical services is pretty much skyrocketed through the roof.
• 8:29
  Yeah, I think it's hard and I think it's definitely become something that is attainable and unmanageable for a lot of folks.
• 8:36
  And particularly thinking about the constituents that we're able to impact directly.
• 8:41
  You know, we focus.
• 8:43
  A lot of the people that we focus on are folks who are underinsured.
• 8:47
  So they're insured, it's about 50% of them.
• 8:49
  However, they can't afford deductibles.
• 8:51
  There was a really powerful story that I read recently.
• 8:55
  A woman by the name of Melanie who was from Oklahoma, she previously was unemployed and she had been healthy for years.
• 9:02
  And then 10, 10 years to the day of which her mother was diagnosed with cancer.
• 9:07
  She was diagnosed with tambo.
• 9:09
  And so it was, you know, obviously very emotional for her and bear its own burden.
• 9:14
  But what came after that were a number of surgeries, a number of doctor's appointments, and a number of bills that she wasn't able to pay because of the deductibles.
• 9:23
  Even having the insurance from being self employed wasn't enough.
• 9:27
  So I think again, it's about understanding that there are other systems and solutions that need to come to play here in order to make our healthcare system across the country something that's equitable and something, something that, you know,
• 9:41
  really values and does right by the patient.
• 9:45
  And I think what's beautiful about undo's work is the fact that, you know, we focus on two pieces of criteria.
• 9:51
  I can dive in a little bit more on our model.
• 9:53
  So if folks fall 400% or below the federal poverty level, which is about $100,000 for a family of three, or if their medical debt is 5% or more of their annual income, then we'll move forward with abolishing those
• 10:08
  debts.
• 10:08
  So for us, we're really making sure that we are taking care of the folks who truly need our assistance and are unable to pay their bills, which I think is very powerful.
• 10:18
  And I also couch that with we know this is a Band Aid solution, but it's something that provides immediate relief to these families, to these individuals while we can.
• 10:31
  And to date we've abolished almost $50 billion worth of medical debt for more than 31 million people across the country.
• 10:40
  So that alone just goes to show that the need for our work is there, but there's a lot of work to do behind the scenes as well just to make the system right.
• 10:51
  Those numbers are mind boggling and the fact that that's only just tackling a tiny tip of the iceberg is even more mind boggling.
• 11:00
  But I know it's not a simple answer, but can you kind of run us through how undo medical debt works?
• 11:08
  I mean what's the, what's the process and how do you, where does the money come from and how does that work?
• 11:13
  Of course.
• 11:14
  So we are as a 501c3 the majority of our funding comes from private donors like Evan Spiegel and Miranda Kerr.
• 11:22
  So folks who see the need for what we're doing and who want to make an impact to truly change the lives of people in their community and across the country.
• 11:30
  So how we do it, you know, it's very nuanced, very unique and really wonderful.
• 11:35
  So let's say we are in the process of we'll approach a hospital and say that we want to purchase their bad debt and we've built a piece of software called Dead Engine which is our proprietary software in house.
• 11:48
  We have a team of engineers that help us to manage that.
• 11:51
  And when we're in these conversations with the hospital, you know, we take the portfolio that we're considering for abolishment and we'll put all the information into the software and it helps to parse out the patients that we can
• 12:04
  move forward with based on the two piece of criteria.
• 12:06
  Charico 4 We also ensure that we have data on their annual income.
• 12:12
  So that way again we're focusing on people who truly need our assistance versus folks who are choosing not to pay their bills.
• 12:19
  And once we are able to get a composite of what those that debt figure looks like and what we're going to move for, we purchase it for pennies on a dollar.
• 12:29
  So the wonderful thing is the fact that, you know, $1 can purchase at least $100 worth of Medicare.
• 12:36
  When you think about it from a donor perspective and you know, truly making an impact on someone's life or family's life for such a small amount, that ROI is incredible.
• 12:47
  Right?
• 12:48
  And I think for our, from our perspective and in thinking about our relationship, the hospitals, you know, what we pay for these debts is not lining pockets, right?
• 12:58
  It's giving the hospital a little bit of compensation where they would not get it elsewhere because these folks do not have the financial means to pay this bill.
• 13:06
  And it's also allowing the hospital to do some good by the people they serve.
• 13:10
  Right?
• 13:10
  So by partnering with a 501C3 that has no stake in the game, they're really showing their commitment to their community.
• 13:19
  I also think that when it comes to making sure that we're covering as many bases as possible, let's say there's about 5 to 10% of that portfolio that we're not going to move forward with.
• 13:34
  We've done the heavy lifting and source the data to provide additional feedback on those folks to the hospital so that way they can revisit their financial assistance policies, their charity care and see if those folks may qualify.
• 13:47
  Because we see that sometimes people fall into the cracks.
• 13:51
  You know, there are bandwidth issues within these hospital systems and we understand that.
• 13:55
  And furthermore, you know, situations can change.
• 13:58
  So if someone goes to the hospital, you know, in, in January and they're, you know, in one financial state, then six months later, if they lost their job or they're homeless, that changes and that should impact what they're
• 14:10
  able to, to pay.
• 14:12
  So that data, I think is so helpful for hospitals because one, it takes that burden off their shoulders because they've already done it and again, it strengthens their ability to do right by their patients.
• 14:23
  So once we.
• 14:24
  Yeah, can I just get something clarified because I'm ignorant about this stuff and you said you can purchase this debt for pennies on the dollar.
• 14:33
  How does, how does that work?
• 14:34
  Is there some special regulation that lets you do that?
• 14:37
  So as a 501C3, we're able to do that.
• 14:41
  So if there was a person that were to go to a hospital and say, I want to file your debt, then that would create tax implications for the patient.
• 14:47
  But through a 501 entity that has, you know, there's a lot of legality involved and you know, checks and balances also, you know, to your point, Al, making sure that the price and of what they're quoting a patient
• 15:00
  is accurate, we're able to cover all that through the, through the way that we work at the hospital and the way that we're able to, you know, the bylaws that we create.
• 15:12
  So we sign baas, which are business associates associate agreements, and just having conversations about data and what this looks like.
• 15:19
  So it can take, you know, sometimes three months to close a hospital portfolio.
• 15:22
  Sometimes it could take longer.
• 15:24
  But as a 501C3, we're able to do this without making a tax worry or burden for the patient.
• 15:33
  So the fact, though, remains that this is a uniquely American problem.
• 15:40
  And the fact remains that people who are in trouble have to rely on the kindness of people like celebrity couples donating money to be able to help people cover, excuse me, their medical debt.
• 15:57
  You know, it takes nonprofits like undue medical debt to help people.
• 16:02
  There's so many moving parts to just bringing people peace of mind as they're trying to heal.
• 16:09
  And their medical debt is piling up.
• 16:13
  The problem still remains that we have this system in this country that is to people who don't live here, who aren't American, seems completely inhumane to have to make a decision to sell your house or things or take
• 16:32
  out loans or whatever it is, is.
• 16:35
  Yeah.
• 16:37
  You know, to have to.
• 16:38
  To go to these extremes to be able to just pay their medical debt and to be able to basically live if you don't have the money to be able to take care of yourself.
• 16:51
  And your medical bills.
• 16:53
  I mean, if we're cutting it down to the simplest explanation, you don't live.
• 16:57
  Yeah.
• 16:58
  No, you're completely.
• 16:59
  You're completely right, Elsa.
• 17:01
  And I think, you know, for us, it is unfathomable the fact that folks in this country even have to choose, right.
• 17:06
  They have to choose between getting the health care they need or putting food on the table or taking care of their families.
• 17:12
  And when you think of things like extraordinary collection actions, which we call ECAs, if they do not pay this medical bill, then their wages can be garnished, the home can be taken away.
• 17:23
  So there are these things that have been institutionalized as allowances to get this debt back or these payments back.
• 17:32
  And I think that is very.
• 17:34
  It's a really hard pill to swallow, you know, and I think that's also why our work is so important.
• 17:39
  And also the beauty of it, again, is the fact that, you know, you don't have to be a celebrity to make a difference.
• 17:45
  Right.
• 17:46
  While Evan and Miranda's gift is truly incredible, and it's helping because it's putting, you know, our work on this huge platform and they're giving us more.
• 17:55
  More visibility and they're adding.
• 17:58
  Shedding some light on the voices of our constituents with our 1 to 100 ratio, anybody can be a philanthropist.
• 18:04
  So if you have $10 in your pocket, you can help someone who has a bill of $1,000.
• 18:09
  And I think that's what's also powerful.
• 18:11
  Where it truly is the only organization where you're able to make a direct impact on someone in your community and feel good about that, as opposed to it going to a larger endowment or a bucket that just sits
• 18:23
  there like, we're buying debt.
• 18:25
  We're doing things.
• 18:26
  And, you know, with us, there is another element of upstream solutions.
• 18:31
  Right.
• 18:31
  While we know the debt relief component is immediate and it's our tried and true work, we're always going to do that.
• 18:38
  It's a band aid, though.
• 18:39
  Right.
• 18:40
  So I think where we really need to focus is how are we helping to influence policy?
• 18:44
  How are we creating partnerships with advocates that help to change the tone of what is causing this medical debt?
• 18:51
  Right.
• 18:52
  And how people are.
• 18:53
  Are really understanding the peril and, and the burden that so many, so many folks of this country are suffering.
• 19:01
  You know, I'm thinking about.
• 19:03
  And actually, I have another question I want to ask about California, but, but, you know, I, I'm thinking about the shut in.
• 19:10
  I'm thinking about the person who lives alone.
• 19:13
  I'm thinking about the person who doesn't have somebody to advocate for them.
• 19:17
  I'm thinking about the person that doesn't know anything about something like this.
• 19:21
  I'm thinking about somebody who's sick.
• 19:24
  Yeah.
• 19:25
  Who needs help.
• 19:26
  Yep.
• 19:26
  And, and, and so is there some way that your organization also reaches out looking for those who otherwise wouldn't know to look for you?
• 19:36
  Yeah.
• 19:36
  So, you know, I think there are a couple of ways that our, our work comes to light.
• 19:40
  So, because it is a, It's a program that folks can apply for.
• 19:46
  And we also don't focus specifically on particular ailments or diagnoses.
• 19:51
  Just knowing that lots of other.
• 19:54
  This debt can come about in myriad ways the way that folks have really been able to know more about us.
• 20:00
  And this is kind of the second part of the work we do, which I didn't get to before, is through our letters.
• 20:05
  So the big push, and I think is my most favorite part of my job here, is really letting folks know this debt is no longer an issue.
• 20:14
  So we send out thousands of letters every day to folks letting them know that this debt is no longer a burden and it's been abolished by, you know, sometimes the donor will include with their name in the letter
• 20:27
  or they'll, you know, have a sweet message just letting them know that someone's thinking of them and understanding this burden overall.
• 20:34
  And so it's through those letters, a lot of folks have gotten to know about us.
• 20:37
  Right.
• 20:38
  And I think what's really helpful, too, is that through some of our government partnerships where we've been able to do abolishments on the same transformative scale as what Miranda and Evan have helped us to accomplish in California, that's
• 20:50
  another way that more folks are able to learn about our work.
• 20:54
  And I think for me, not everyone is in a position to donate.
• 20:58
  If you're able to, that's wonderful.
• 21:00
  But I think just talking about medical debt and it carries a lot of un unearned stigma, and people often feel shame about something that isn't their fault.
• 21:11
  But I think talking openly about it with friends and family, we've learned, has helped to spread the word as well.
• 21:16
  So there are myriad ways they can go on our website.
• 21:20
  There's a lot of information in terms of what they can do if they're suffering from medical debt.
• 21:26
  And then to your question, Hal, about how we source it, we will partner with any hospital provider that's willing to partner with us.
• 21:34
  So if we know that there is a need for our work within a hospital system, whether it's nonprofit, for profit, what have you, we will take that on because we are patient focused and we know that this will
• 21:44
  help to alleviate a lot of the mental, emotional, and financial strain that folks have been going through.
• 21:52
  And so for us, it's a big part of what we do.
• 21:55
  Being able to show up and come to the table and provide relief.
• 22:01
  I can't even think what it must be like to get one of those letters.
• 22:06
  To be sitting there snowed under by medical debt and illness and just not being able to figure out how you're going to get through it and then get a letter.
• 22:18
  It's like.
• 22:19
  It's like fairy dust.
• 22:21
  Do you ever get to hear any of the stories of people you've helped?
• 22:26
  Yeah.
• 22:27
  So I will say that is truly the best part of my job.
• 22:30
  Obviously, working with our incredible supporters is wonderful, but being able to see the impact is so beyond and so fulfilling.
• 22:39
  And we, our constituents, are so amazing because not only do they, you know, show up in the most vulnerable ways and also with the most amount of gratitude, but they're.
• 22:50
  They're unwavering and sharing what this debt has meant to.
• 22:55
  And I think it's those outcomes and those emotions that really help to guide our work.
• 23:01
  And so can you share any specific examples that might come to mind?
• 23:06
  One example, I think we lifted up, actually, when we announced this amazing guest with Amanda.
• 23:12
  Sorry, with Miranda and Evan, but there was a woman by the name of Brooklyn from California.
• 23:17
  And she was in a traumatic car accident.
• 23:20
  And because of that, she was dealing with, you know, the burden of recovery.
• 23:24
  She was dealing with multiple surgeries.
• 23:26
  And this debt, I want to say, was maybe close to $5,000.
• 23:31
  Have been following her around for years, and we hear that often too, from our constituents.
• 23:35
  And so, you know, when she wrote in to tell us about her.
• 23:39
  Her experience, she just was.
• 23:41
  Was so unburdened and relieved that it was something she didn't have to think about anymore.
• 23:47
  And she said that it gave her hope.
• 23:49
  And I think that's what's so amazing, right?
• 23:51
  Where it's this idea again, of having people return to care and know it's okay.
• 23:55
  You know, like you need to get the help that, that you need and there should be nothing stopping you from that human.
• 24:00
  Right.
• 24:02
  And I mentioned earlier there was another person, Melanie from Oklahoma, who was suffering from cancer.
• 24:09
  Right.
• 24:09
  And so the idea that she would not move forward with treatment or she was afraid of, you know, that, that next lab bill or what have you, that's beyond.
• 24:19
  Right.
• 24:19
  I think that, you know, hearing their voices and really being able to center what we do on our constituents is so critical.
• 24:28
  And I will say too, my.
• 24:29
  My background was from larger institutions, you know, higher ed and culturals.
• 24:36
  And I've never worked for an organization where, you know, you see the impact that you're having on folks every day and you really feel it.
• 24:44
  And I think, as I mentioned before, because medical debt is the only debt that folks don't ask for.
• 24:51
  When you are dealing with something traumatic and having to then deal with a medical bill that you can't afford, that increases the trauma for months and months to come.
• 25:00
  And we hear from our constituents that they'll consistently, you know, move or they'll try to avoid collectors or, you know, again, I mentioned the extraordinary collection actions, and that just shows you that they can't live their life.
• 25:12
  Right?
• 25:12
  They can't be joyful and they can't, you know, be present for their friends and family as they want to and who wants to have a life like that.
• 25:20
  So we really just stand on the shoulders of our constituents.
• 25:25
  And it is, you know, this idea that medical debt itself, no matter how old the debt is, is something that's truly debilitating for folks.
• 25:38
  There's so many incredible nightmares.
• 25:39
  I mean, else you remember I told you the story about my, my daughter's friend in New York that was.
• 25:46
  Had a traumatic brain injury and, and it was from a car wreck.
• 25:53
  And the only way it's it's such a grim prognosis, but the only way she's going to live is with a particular surgery that is about a million dollars.
• 26:05
  And, and, and, and she can't afford to do that.
• 26:08
  And there's no GoFundMe that's going to raise a million dollars to be able to help this girl.
• 26:13
  This girl's in her 30s.
• 26:14
  She's a young woman.
• 26:16
  And, and the prognosis is she's not going to live unless she has a surgery she cannot afford.
• 26:23
  And if she took on that surgery, she would have a huge, undue medical death.
• 26:28
  Well, I, and I.
• 26:29
  Can I add to that how with stories like that, you know, we're talking about the generosity of so many people, and I'll bring that up again to help all lift each other up in situations like this.
• 26:43
  But it baffles me that we continue to not really attack the root issue, which is the insane amount of profits that insurance companies regularly, you know, rake in.
• 27:00
  In fact, I believe I, I just read an article and I believe it was UnitedHealthcare that just shattered expectations and raked in billions in profit for their reportable period.
• 27:13
  And it just, it, to me, it's, it, it's just maddening how we all just kind of sit here and take it.
• 27:21
  And, you know, the, the root issue is really what needs to be addressed here, which are the insurance companies, because a lot of people conflate the healthcare industry with the health insurance industry and, you know, the doctors and
• 27:38
  the medical professionals are the ones trying to save lives and help people.
• 27:42
  They have to navigate the health insurance companies, too, and get approvals, and they have to fight the insurance companies and to get approvals to do certain procedures on patients to save them.
• 27:53
  Their main goal is to save lives, and they're wasting their time fighting insurance companies, too, to get permission as doctors who are trained to save lives from people who are not doctors to do these procedures.
• 28:05
  It's just so deeply rooted in, in this country, this problem.
• 28:10
  So how do we, how do we attack it at the root?
• 28:13
  And do you know if anything is being done now on a, you know, legislative level to take care of this?
• 28:20
  Because really, we should be rioting in the streets, honestly, over the atrocities that.
• 28:27
  If we weren't so sick and in debt.
• 28:29
  Right, right.
• 28:29
  If we didn't have so many bills and have to work and.
• 28:31
  You're right, but what do we do?
• 28:34
  What can be done?
• 28:35
  What is being done?
• 28:36
  Yeah, no, I appreciate that, Elsa.
• 28:38
  And I think, you know, your, your thoughts are really spot on in the Fact that overall, you know, the healthcare system is one that, that prioritizes profits over people, right?
• 28:50
  Like that's, that's the number one problem and that's a big reason why we're in a situation, in the situation we are in today.
• 28:56
  I think, you know, again, just to reiterate, like while the debt relief component that we do is essential, you know, it's not a bridge and it's not a finish line and there are upstream solutions and systems that we
• 29:10
  need to put into place to make, to make this better.
• 29:13
  Right?
• 29:13
  To make things right.
• 29:14
  And I think that really requires, you know, health care coverage that actually protects people.
• 29:19
  Right?
• 29:20
  Like coverage simple enough to understand with out of pocket costs that don't wreck a family's finances.
• 29:26
  I also think, you know, requiring, you know, the banning of extraordinary collection actions which I mentioned earlier.
• 29:33
  So like no lawsuits, no wage garnishment, you know, no repossessing, you know, a wheelchair over a medical bill, which we have heard from folks in the past.
• 29:44
  Right.
• 29:45
  And then, you know, I think that another component that's important is just requiring screening for people for financial help early.
• 29:54
  Right?
• 29:54
  That's very simple and it's called presumptive eligibility.
• 29:57
  So before, you know, they meet with that doctor, there is a full understanding of what they're able to pay and what they're not.
• 30:03
  And it's before the debt piles up.
• 30:05
  Right.
• 30:06
  And I think that's a huge component that we can really implement across this country to make some, some true change.
• 30:13
  And I think, you know, we internally at undo say that we want to, you know, put ourselves out of business.
• 30:20
  And we think we know that some of these components will really help to create a healthcare system that, that, that works.
• 30:28
  Right.
• 30:28
  And I will say to your clear question about policy that's being enacted to tackle this, you know, I think that now more than ever, and you know, our connection today is a perfect example of that the medical debt
• 30:42
  crisis is getting more visibility, right.
• 30:45
  People are understanding more about the folks that are suffering from this, what it means, how much is out there, at least what we can quantify.
• 30:52
  Right.
• 30:53
  And I think that some states are taking it upon themselves to make things right.
• 30:57
  So, you know, last year there was a ruling about adding negative credit infractions to a credit report and making that illegal.
• 31:07
  Right?
• 31:08
  Now, while that was pulled back, unfortunately, I know that there are other states that are taking it upon themselves to make that their own policy.
• 31:16
  And so it's that sort of creativity and willingness to come to the table to create some impactful change that I think is really important.
• 31:26
  But you know, there's so much out there I don't have all the policy answers I can share with you that we have an incredible advocacy team that really is boots on the ground.
• 31:38
  Right.
• 31:38
  They're working with our governments, they're working with local community engagement advocates and supporters to really understand, okay, how can we make things better within this area if we know it's also going to take time to spread that.
• 31:52
  But all we need is one, you know, and then from one comes many.
• 31:55
  And I think that's how we operate.
• 31:57
  And for again, having folks be able to stand up and say, this is a problem and this is what I'm dealing with, or this is a problem and this is how I'm helping to contribute to a solution, I
• 32:09
  think is so powerful.
• 32:12
  So Marissa, if someone is inspired and does want to contribute to a solution, even if it's somebody who wants to toss 10 bucks into the pot, what do they do?
• 32:22
  I mean, you take small donations as long as, as well as big ones, right?
• 32:26
  Yes.
• 32:27
  So we certainly take small donations.
• 32:29
  Again, like we pride ourselves on the fact that anybody can be a philanthropist.
• 32:33
  So if you have a dollar in your pocket, that's $100amedical debt.
• 32:36
  If you have 10, that's $1,000.
• 32:38
  And what's beautiful about our work as well is the fact that you can focus on a particular state.
• 32:43
  If I were to say I want to impact all, you know, folks throughout New York, I can do that or even drill down to a particular county.
• 32:50
  So this level of affinity really creates a sense of community bond and help feel as though they're doing something in their backyard.
• 32:57
  And even with some of the faith based entities we partner with, we'll get stories from folks that share.
• 33:03
  Oh, someone in my congregation got a letter or my neighbor got a letter.
• 33:08
  So wonderful.
• 33:09
  So I would say donating is wonderful and we would truly appreciate that.
• 33:14
  Knowing that other folks don't always have the opportunity to do that.
• 33:18
  Just being able to contact your elected officials.
• 33:21
  Right.
• 33:21
  Let them know that medical debt protections matter to you when Things like banning ECAs are something that you want them to tackle, and requiring hospitals to proactively screen patients for financial assistance, folks can ask for that.
• 33:34
  I think that would really make move mountains.
• 33:38
  I would also say just in relation to our amazing work in California thus far, for the folks that are getting letters, they're dropping in mid July, so they're ready, out the door and paid.
• 33:48
  But those folks just, you know, we would love to hear from you.
• 33:50
  You know, again, we stand on the voices of our amazing constituents and it's through them that we're able to lift up the work of undo.
• 33:59
  And of course, you know, if you're social media savvy, I am not in full transparency but being able to follow us and you know, visit our website from time to time.
• 34:07
  We have incredible research that we're always pushing out.
• 34:10
  We did do some incredible work that focuses on how medical debt impacts first responders and impacts doctors, people, health clinicians, people on the front lines who are asked about, you know, how much the shock going to cost me
• 34:23
  before someone declines life saving care.
• 34:26
  So those are some ways that we'd love to have folks be involved and really lift up our I know you.
• 34:32
  Have another place to be we kind of a time but we could talk to you for another hour or two I think.
• 34:37
  I think there's so much information out there.
• 34:40
  Look, give everybody the website you want them to have in order to check out more.
• 34:44
  Or they can go to undo medical debt.org to learn more, donate or to find resources if they're personally facing medical debt.
• 34:55
  And what's also a really wonderful thing is for folks who want to make an impact in their community, we do peer to peer fundraising efforts.
• 35:03
  So if they want to start a campaign that helps them to abolish debt in their backyard, they can do that via our website as well.
• 35:11
  Thank you so much.
• 35:12
  It's really good to talk with you and all the best to you and your organization.
• 35:17
  Likewise, thank you all for having me.
• 35:18
  This was great and we truly appreciate you lifting up our our unique work here in such a meaningful way.
• 35:24
  Thank you.
• 35:25
  And that's what the how 2.0.
• 35:28
  I'm Hal Eisner along with Elsa Ramon and Hunter Lowery.
• 35:31
  This podcast is produced by Hunter.
• 35:34
  Jamie Knapp is our Technical director Editor and he handles all of the post production.
• 35:39
  Our original theme music is composed by Stuart Pearson.
• 35:43
  Earlier versions of the podcast were produced at the studios of Fox 11 in Los Angeles and are available through the link in our Show Notes.
• 35:52
  This version of the podcast is available on YouTube and wherever you listen to podcasts and what the How 2.0 is produced in Los Angeles, California.