“Philanthropists and foundations like the one I work for take a lot of calculated risks,” Katherine Hempstead writes over at Stat. “We invest in research, advocacy, strategic communications, technical assistance, and many other activities, hoping they will help us advance our strategic priorities. We evaluate our efforts whenever we can, but many defy measurement — assessing the impact of our work is a persistent challenge. Results from a recent study, currently published as a National Bureau of Economic Research (NBER) working paper, on the important topic of medical debt relief provided an all-too-rare burst of clarity. The amount of medical debt in the U.S. is estimated to exceed $220 billion, and affects 2 in 5 adults. Medical debt most often results from unexpected injuries and illnesses, and disproportionately affects people of color, low-income households, women, and parents. … Hospitals often sell outstanding debt to collection agencies, and medical debt relief works by using donations to negotiate the purchase of large amounts of debt from these agencies at a fraction of the face value. A team of researchers assessed the impact of medical debt relief using a rigorous randomized design that allowed them to compare people who had medical debt relieved with those who did not. Contrary to expectations, they found that relieving medical debt did not improve financial outcomes such as access to credit, health care utilization, or financial distress, and actually reduced the likelihood of repaying existing medical bills. Debt relief was even found to have a small but significant negative effect on the mental health of certain subpopulations in the study. The results have surprised and disappointed observers, and threaten to disrupt a trending charitable activity. … The leading medical debt relief organization, Undue Medical Debt, which participated in the study published by the NBER, reports that nearly $12 billion in debt has been relieved so far as a result of their efforts. (The organization receives funding from my employer, the Robert Wood Johnson Foundation, but had no input into this essay.)” Katherine Hempstead, “When medical debt relief is not enough: A study showing what doesn’t work may help point to better solutions,” Stat.
