High and rising medical costs, plus medical debt, keep many Americans from gaining access to healthcare and also affect their other human rights, including access to food and other essentials, the international watchdog group Human Rights Watch said in a recent report.
“Tens of millions of people who are uninsured or underinsured are exposed to the country’s high and rising costs of medical treatment,” a summary of the report says. “As a result, the US healthcare system has persistent problems with both high out-of-pocket costs for accessing health care and the indebtedness that these costs create. Together, these form sometimes insurmountable barriers to accessing health care and adversely affect people’s enjoyment of other human rights, including the rights to housing, food, and education.”
The report cited a Kaiser Family Foundation study from 2022 saying that 41 percent of American adults had some form of outstanding debt due to medical or dental bills, with hospital services contributing significantly to outstanding debt.
“Nearly 60 percent of the more than 5,000 community hospitals across the US are privately operated nonprofits, which collectively receive public subsidies worth billions each year, largely in the form of tax exemptions, in exchange for providing ‘community benefits’ like free or reduced-price health care,” the report says. “In other countries, such free or subsidized health care is the norm and widely understood as a key way that a government meets its right to health obligations. But in the US, this is tellingly referred to as ‘charity care.'”
The system for charity care is complicated. People have a hard time finding the rules and understanding whether they qualify, and then their applications are often lost or delayed by the hospitals. Jared Walker, founder of DollarFor, a nonprofit that helps people apply for charity care, says that many hospitals do not comply with the regulations mandating charity care for community benefit, and that consequently a lot of people incur medical debt that they should not owe.
DollarFor will help people find charity care policies and apply for free or discounted care depending on income and household size, Walker said in a recent ClearHealthCosts interview.
“This report documents how the US government’s lack of guidance and oversight gives private nonprofit hospitals wide discretion over how much they spend on making health care accessible for people who cannot pay, who qualifies for this assistance, and how far they will go to collect debts from patients who cannot pay their bills,” the report summary says.
The full report is available here.
