The Debt Crisis That Sick Americans Can’t Avoid

Elisabeth Rosenthal

02 de agosto de 2022

President Joe Biden’s campaign promise to cancel student debt for the first $10,000 owed on federal college loans has raised debate about the fairness of such lending programs. While just over half of Americans surveyed in a June poll supported forgiving that much debt incurred for higher education, 82% said that making college more affordable was their preferred approach.

But little public attention has been focused on what is — statistically, at least — a bigger, broader debt crisis in our country: An estimated 100 million people in the U.S., or 41% of all adults, have health care debt, compared with 42 million who have student debt.

The millions under the weight of medical debt deserve help, both because medical debt is a uniquely unfair form of predatory lending and because of its devastating ripple effects on American families.

Unlike college tuition or other kinds of debt, outlays for medical treatments are generally not something we can consider in advance and decide — yes or no — to take on. They are thrust upon us by illness, accident, and bad luck. Medical treatment generally has no predictable upfront price and there is no cap on what we might owe. And, given our health system’s prices, the amount can be more than the value of the family home if incurred for a hospital stay.

When it was time for my kids to choose a college, I knew in advance almost exactly what it would cost. We could decide which of the different tuitions was “worth it.” We made a plan to pay the amount using bank accounts, money saved in college savings plans, some financial aid, a student job, and some money loaned by a grandparent. (Yes, we had enough resources to make a financially considered choice.)

Think about how different educational debts are from those incurred in health care. In one case, profiled by KHN, the parents of twins, who were born at 30 weeks, faced out-of-pocket bills of about $80,000 stemming from charges in neonatal intensive care and other care that insurance didn’t cover. In another case, a couple ended up owing $250,000 when one spouse went to the emergency room with an intestinal obstruction that required multiple surgeries. They had to declare bankruptcy and lost their home. Even smaller bills lead to trashed credit ratings, cashing in retirement accounts, and taking on second jobs; in surveys, half of adults in the U.S. say they don’t have the cash to pay an unexpected $500 medical bill.

In “taking on” medical debt, patients sign only the sort of vague financial agreement that has become ubiquitous in American health care: “I agree to pay for charges my insurance doesn’t cover,” presented on the stack of forms to sign on arrival at an emergency room or a doctor’s office. But no one can fully consider options or say “no” to care while in pain or medical distress or even properly agree to pay an unknown amount.

Student debt causes hardships because it hits people who’ve just started careers, with salaries at the bottom of the pay scale, forcing them to delay life choices, like purchasing a home or starting a family. But medical debt often comes with all that plus medical woes: In a KFF poll, 1 in 7 people with health care debt said they’d been denied care by a provider because of unpaid bills. Sometimes a bill for as little as a few hundred dollars can turn into a collections nightmare.

Already, the federal government is stepping in to assist student loan borrowers. It has paused student debt payments during the pandemic, and the Biden administration has announced that it would forgive student debt for tens of thousands of public sector workers. Late last year, the Department of Education announced that it would no longer contract with outside debt collectors but would instead deal with loan defaults and potential defaults itself to better “support borrowers.”

Medical debt collection has typically been outsourced to aggressive private agents and the for-profit medical debt collection industry; there are few guardrails. Recently, consumer credit reporting agencies have said they will no longer put small medical debts on credit reports and remove medical debts that have been paid. For many people, that will take years. Some 18% of Americans with health care debt said they never expect to be able to pay off their debt.

The irony here is that medical debt is sometimes discharged in bulk by charities, like RIP Medical Debt and church groups, which will pay pennies on the dollar to make patients’ outstanding medical debt disappear. The absurdity of this fix was shown when the comedian John Oliver, in a late-night stunt, cleared $15 million of Americans’ debt after buying it for $60,000.

But medical debt isn’t a joke and now harms a broad swath of Americans. The government could act in the short term to relieve this uniquely American form of suffering by buying the debts for a modest price. And then, it needs to tackle the underlying cause: a health care system that denies millions of people adequate care while still being the most expensive in the world.

This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

“El presente artículo es propiedad de California Healthline

Rosenthal, E. (2022). The Debt Crisis That Sick Americans Can’t Avoid. California Healthline. Recuperado el 01 de septiembre de 2022, de https://californiahealthline.org/news/article/medical-debt-costs-bankruptcy-college-loan-forgiveness/

Housing crisis hits women harder in California, group’s research finds

Anabel Munoz, ABC7

24 de agosto de 2022

LOS ANGELES (KABC) — Woman are much more likely than men to struggle with the cost of housing in California, according to a new report.

“It was stunning how extreme the difference is between women and men,” said Nancy Cohen, president of the Gender Equity Policy Institute, which produced the report on housing and gender in California.

Researchers found that 49% of women are “rent-burdened” compared to 43% of men, meaning they spend 30% or more of their income on rent.

“Black women are facing the most acute crisis of affordability,” Cohen said. “Latinos, single mothers and elderly women, particularly those who are living alone, are really struggling to afford housing in our state.”

In Los Angeles County, some of the greatest gaps impact single mothers of color.

In LA County, about 31% of all households spend more than half of their income on rent. For women-led households, it’s about 41%. And for households led by a Black or Latina single mother, it’s 51%.”

The report was conducted at the request of the California Assembly Committee on Housing and Community Development.

Cohen cautions that the data was gathered prior to the pandemic and the cost of housing has only risen since then, meaning the gap now could be even higher than what was reported in the study.

“El presente artículo es propiedad de ABC7

Munoz, A. (2022). Housing crisis hits women harder in California, group’s research finds. ABC7. Recuperado el 29 de agosto de 2022, de https://abc7.com/affording-housing-womens-issues-cost-of-living-california-gender-equity/12159267/

For Medically Vulnerable Families, Inflation’s Squeeze Is Inescapable

Heidi de Marco, California Healthline

12 de agosto de 2022

ROSAMOND, Calif. — Deborah Lewis rose from bed before dawn and signed in to her phone so she could begin delivering fast food, coffee, and groceries to residents in this western patch of the Mojave Desert where test pilot Chuck Yeager broke the sound barrier generations ago.

Lewis prayed she would earn $75, just enough to fill the tank of her Kia sedan so she could drive her 8-year-old daughter, Annabelle, 80 miles south to Los Angeles to receive her weekly chemotherapy treatment for acute lymphoblastic leukemia. Just a year ago, the same tank of gas would have cost $30 less.

After a full shift as a gig worker, the mother had earned close to what she needed. “It took a lot longer than I thought,” she said.

High inflation is hitting families across the nation. According to the U.S. Bureau of Labor Statistics, consumer prices in July were up 8.5% from a year earlier, one of the biggest increases in recent decades. The Bureau of Economic Analysis found that consumers are spending the most on housing and utilities, food, and medical care.

Overall wages continue to climb, but after adjusting for the rising price of goods and services, workers’ paychecks declined 3.5% over the past year. A recent KFF poll found that 74% of registered voters put inflation, including rising gas prices, at the top of their concerns.

For millions of families living with chronic diseases — such as heart disease, diabetes, and cancer — or other debilitating conditions, inflation is proving a punishing scourge that could be harmful to their health. Unlike dining out less or buying fewer clothes, many patients don’t have a choice when it comes to paying for medicine, medical supplies, and other ancillary costs. Some must drive long distances to see a specialist, and others must adhere to a strict diet.

“Chronic disease patients are usually on the front lines of seeing a lack of supplies or an increase in out-of-pocket costs,” said Paul Conway, chair of policy and global affairs for the American Association of Kidney Patients.

Health care has grown increasingly unaffordable. Half of adults report having difficulty paying their health costs, according to KFF polling. One-third say they or a family member has skipped recommended medical treatment in the past year because of the cost, and one-quarter of adults report rationing pills or leaving prescriptions unfilled.

Inflation has squeezed families further by driving up the price of gas and food, as well as medical products such as needles and bed-wetting pads. Health care costs have risen 5.1% since July 2021, and medical commodities — which include prescription and over-the-counter drugs, medical equipment and supplies — are up 3.7%.

Inflation is particularly detrimental to the health of low-income patients; studies have found a strong link between poverty and health. According to the California Budget & Policy Center, more than half of California households making $50,000 or less struggle to pay for food, housing, and medical costs.

For Deborah Lewis and her husband, Spencer, their concerns about the rising cost of gas have never been about skimping on summer travel or weekend getaways. It’s about making sure they have enough gas to drive Annabelle to Children’s Hospital Los Angeles for chemotherapy and other medications delivered through a port in her chest.

The family relies on Spencer’s disability check, which he receives because he has Ehlers-Danlos syndrome, a hereditary disorder that causes him severe joint pain. He also copes with broken discs in his spine and a cyst pushing against his spinal nerves. In January, he stopped working as a pest control technician, shifting more financial responsibilities to his wife.

The disability check covers rent and utilities, leaving Deborah’s freelance work to cover gas. They also get $500 a month from Miracles for Kids, which helps families with critically ill children.

On a June morning, Deborah packed snacks for the drive ahead as Annabelle, wrapped in her favorite blanket, waited on the couch. Most of her long blond hair has fallen out because of her treatments. The night before, Deborah spent $73.24 to fill up at Costco.

Before they left, Deborah learned the couple carried a negative balance in their checking account. “I have so much on my plate,” she said.

The family has already delayed health care for one family member: Their dog, a Doberman pinscher named Chief, skipped a vet visit for a mass pushing up his intestines.

Politicians are keenly aware of inflation’s leaching effects. In October, most California households will receive “inflation-relief checks” of up to $1,050 to help offset the high cost of gas and other goods under a budget Gov. Gavin Newsom signed in June. The average price of a gallon of gas in California remains above $5, while the national average is about $4.

But health experts worry that even with the one-time aid, affordability could become a life-or-death issue for some Californians. For example, the price of insulin can range from $300 to $400 per vial without insurance.

“We’ve seen a number of patients living with diabetes and on a fixed income greatly impacted by rising inflation,” said Matthew Freeby, an endocrinologist and director of the UCLA Gonda Diabetes Center. “Both Type 1 and Type 2 diabetes typically require multiple prescription medications that may already be costly. Patients have had to choose between day-to-day finances and their lifesaving medications, such as insulin or other treatments.”

Inflation is also a challenge for people who depend on certain foods as part of their health care regimen, especially with food prices up 10.9% in the past year.

Toyan Miller, 60, an integrative nutritional health practitioner from San Dimas, California, has been diagnosed with vasculitis and Hashimoto’s thyroiditis, two autoimmune diseases that cause inflammation. Miller’s medically tailored diet requires gluten-free, organic food. Miller said she’s dipping into her savings to afford the average of $300 she spends each week on groceries. Last year, she spent about $100 less.

“The avocado mayonnaise price freaked me out,” she said. “It used to be $8. Now, it’s $16.99.”

Even those who are healthy may find themselves helping family or friends in need.

In the mountainous Los Angeles neighborhood of Laurel Canyon, Shelley Goldstein, 60, helps her parents, both in their 90s, pay for items, such as incontinence products, not covered by health insurance. Goldstein’s father was recently diagnosed with Alzheimer’s disease and lives in a retirement community with his wife, Doris.

“Those are basic things, but that’s like $70 a month between the two of them,” said Goldstein, who works as a speaking coach. “That’s a lot.”

Goldstein worries about how much more of her parents’ health costs she’ll have to shoulder since they are pensioners on fixed incomes.

“What keeps me up at night right now is what’s to come,” she said. “There’s two of them. My parents’ increased need for pads, meds, and other medical support increases as their health declines.”KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


Subscribe to KHN’s free Morning Briefing.

“El presente artículo es propiedad de California Healthline

de Marco, H. (2022). For Medically Vulnerable Families, Inflation’s Squeeze Is Inescapable. California Healthline. Recuperado el 18 de agosto de 2022, de https://californiahealthline.org/news/article/medically-vulnerable-families-inflation-squeeze/

From LA to Tennessee, unhoused activists and supporters are fighting a wave of anti-homeless legislation

With soaring rents pushing people onto the streets, those struggling just to survive are taking a stand against bills criminalizing homelessness.

This article was originally published on Waging Nonviolence.

Sara Herschander, Waging Nonviolence

12 de agosto de 2022

As soaring rents force many out of their homes, advocates across the country are battling a slew of state and local measures that criminalize homelessness and imperil those living on the street.

Police in riot gear stormed the chambers of a Los Angeles City Council meeting on Tuesday after one protester climbed a bench to confront Council President Nury Martinez over an ordinance banning homeless encampments near schools and daycares.

Martinez briefly recessed the meeting as dozens of activists chanted “Abolish 41.18!” — a reference to the ordinance. Last week, around 70 protesters shut down a council vote over the same measure, carrying signs with messages like “If I die unhoused – forget burial – just drop my body on the steps of L.A. City Hall.”

As inflation reaches 40-year highs, pandemic-related eviction protections expire and longstanding housing shortages reach their breaking point, America’s homelessness crisis has become increasingly dire and difficult to ignore. The number of people living unsheltered — whether in cars, parks or in tents on the sidewalk — accounted for nearly 40 percent of the country’s total homeless population last year, its highest level in a decade.

After police ejected protesters on Tuesday, the council voted 11-3 to massively expand the so-called 41.18 zones, which advocates say will now criminalize homelessness in up to a fifth of the city. 

“We knew that we weren’t going to get anyone to change their vote — but we wanted to take a stand,” said Ground Game LA co-founder and Outreach Director Ashley Bennett, who has been present at the actions against ordinance 41.18. “We’re showing that we’re present, we’re here, and we deserve to be heard.”

Across the country, some cities have implemented even more extreme regulations against living unhoused.

Last month, Tennessee became the first state in the nation to make it a felony to camp in parks and other public property, punishable by up to six years in prison and the loss of voting rights. Meanwhile, Texas passed a similar measure making homelessness a misdemeanor last year.

As Momma V, who lives in a tent in Tennessee, told CNN, “They’re trying to run us out of Nashville. We’re out here homeless. We’re trying to struggle to make it, and they’re just trying to make it worse on all of us by criminalizing it.”

Over the past two years, lawmakers in six states have also introduced bills criminalizing homelessness by making sleeping on public property a misdemeanor — punishable by a fine of up to $5,000 and a month in jail — and installing temporary public tent cities. 

The bills are modeled largely after draft legislation published by the Cicero Institute, a Texas-based think tank founded by the billionaire co-founder of Palantir, whose controversial technology has been used for migrant surveillance systems and predictive policing.

Even in relatively progressive cities like Los Angeles, Bennett criticized policymakers’ persistence on implementing “band-aid” solutions that fail to address the root causes of homelessness — namely, a lack of housing, widespread discrimination against voucher holders, and a flawed and inadequate shelter and services system.

“People have a deep innate desire to have the space to go home and feel safe and secure and protected,” said Bennett, who noted that many unhoused people have had negative experiences in the shelter system. “Instead of calling people service-resistant, we need to ask why these services aren’t working.”

https://wagingnonviolence.matomo.cloud/matomo.php?idsite=1&rec=1&action_name=REPUBLISHED%20From+LA+to+Tennessee%2C+unhoused+activists+and+supporters+are+fighting+a+wave+of+anti-homeless+legislation&bots=1

“El presente artículo es propiedad de Waging Nonviolence

Herschander, S. (2022). From LA to Tennessee, unhoused activists and supporters are fighting a wave of anti-homeless legislation. Waging Nonviolence. Recuperado el 18 de agosto de 2022, de https://wagingnonviolence.org/2022/08/unhoused-activists-supporters-fight-anti-homeless-legislation/

AMLO anuncia una veda a cerveceras en el norte, frente a la crisis hídrica 

El presidente ofreció “todo el apoyo” a la producción cervecera en el sur del país, pero aclaró que no pueden seguirse otorgando concesiones de agua donde están abatidos por completo los mantos freáticos. “No vamos a tener plantas para quitar arsénico al agua, como sucede en la Laguna”

Arturo Contreras, Pie de Página

09 de agosto de 2022

Foto: Omar Martínez / Cuartoscuro

CIUDAD DE MÉXICO.- Ante la escasez de agua en el norte del país, el presidente Andrés Manuel López Obrador anunció una revisión de las concesiones de agua que tienen las empresas cerveceras para establecer «una especie de veda» en esa región, así como incentivos para que puedan instalarse en el sur-sureste, donde hay mucha agua.

Esto les permitiría mantener los niveles de producción, en su mayor parte para exportar.

Durante su conferencia de prensa diaria, el mandatario recordó el caso de la cervecera Constellation Brands en Mexicali, Baja California, donde se revocó el permiso después de que en una consulta pública en la que ganó la no instalación de la planta.

Los pobladores de Mexicali rechazaron la instalación de la cervecera porque comprometía “incluso el agua para uso doméstico”, dijo el presidente.

En otros casos, dijo, “tenemos que hacer algo parecido y buscar no dejar sin permiso a las cerveceras”.

Necesitamos poner orden

El tema surgió como respuesta a una pregunta de Pie de Página, sobre cómo lograr que Conagua sea un órgano que defienda a los consumidores primarios del agua y no a las grandes empresas.

“Vamos a trabajar sobre eso. Estoy convencido, desde hace tiempo, pero por lo que ha estado sucediendo en los últimos tiempos, es importante poner orden en todo lo que son las concesiones de agua y darle la prioridad, como debe de ser, al usuario, al que utiliza el agua para alimentarse, para desarrollarse (…) porque es un derecho humano. Eso lo vamos a garantizar. Es cosa de ver cómo”, comentó el presidente.

Para el caso de las cerveceras, pidió transmitir un video de la base de datos de la ONU, que muestra un histórico gráfico, a partir de 1995, cuando México ocupaba el cuarto lugar mundial en exportaciones, con 320 millones de dólares anuales.

En ese año Países Bajos (Holanda) ocupó el primer lugar con mil 90 millones de dólares, seguido por Alemania, con 714 millones, y Estados Unidos, con 409.

Para 2010, México pasó al primer lugar con mil 972 millones de dólares, seguido por Países Bajos con mil 878 millones. 

A partir de 2019, la gráfica muestra un constante crecimiento de exportaciones de cerveza, que se mantuvo a pesar de la pandemia. En 2021, México llegó a 5 mil 15 millones de dólares de exportaciones, que representan más del doble de los 2 mil 160 millones de dólares de Países Bajos, que se mantiene en segundo lugar.

“Entonces, no es decir: ‘ya no vamos a producir cerveza’. Es decir: ‘no se va a producir cerveza en el norte’. O sea, ya veda”, dijo el presidente.

“¿Quieren seguir produciendo cerveza aumentando la producción? Todo el apoyo para el sur, sureste, ahí está el (río) Grijalva, el Usumacinta, el Papaloapan. Lo mismo en el caso de otros productos, pero ya no se puede dar permiso en donde no hay agua donde están abatidos por completo los mantos freáticos y ya lo que se está sacando es agua con arsénico. No vamos a tener plantas para quitar arsénico al agua, como sucede en la Laguna, eso no se puede”, insistió.

Aclaró que en México también se consume cerveza pero la mayor parte de la producción no es consumo interno, sino para exportación.

Se puede ver la participación a partir del minuto 2’51’’30

Constellation Brands ya tiene permisos en Veracruz

El 22 de abril pasado, en su conferencia de prensa matutina realizada en Veracruz, el presidente López Obrador informó que, tras la cancelación de la construcción de la planta en Mexicali, la cervecera estadounidense movería sus operaciones a ese estado.

El día anterior, el presidente se había reunido con representantes de la cervecera, que presentaron un proyecto por 1.3 mil millones de dólares. 

El canciller Marcelo Ebrard lo anunció como un proyecto que generará dos mil empleos directos y diez mil indirectos. “La inversión más grande en 60 años para la zona”.

Por su parte, el mandatario dijo que la nueva planta de la cervecera ya tenía los permisos para instalarse en la Antigua Hacienda de Santa Fe, en Nevería.

El 4 de agosto pasado, la empresa anunció que obtuvo 14 concesiones de agua para una planta en el estado de Veracruz por alrededor de 3 millones de litros, según explicó el abogado Bernardo Martínez Aguirre, responsable de inversión de la compañía en el sureste mexicano, a la revista Forbes.

El abogado destacó que el agua proviene de una fuente independiente de la ciudad de Veracruz, y que la cervecera se está adaptando a un programa del gobierno federal para mantener su cuidado.

“Encontramos un espacio de terreno que cumple con características que nosotros buscamos en este tipo de exploraciones con las vías del tren cercanas, con acceso ferroviario y carretero al puerto, con acceso directo a una fuente de abastecimiento de agua que el gobierno federal nos ha señalado y que es independiente al de la ciudad”, insistió Martínez.

Bienvenidos al sur

En la conferencia de Veracruz, López Obrador destacó que en el sur de México se encuentra el 70 por ciento del agua que tiene el país, por lo que, desde su perspectiva, proyectos como el de la cervecera son viables en esa región.

Por su parte, en la presentación del proyecto, los directivos de Constellation Brands aseguraron que la planta tendrá la mejor tecnología.

El canciller Marcelo Ebrard destacó que “a los directivos de Constellation Brands la inversión que se pone en marcha les parece increíble y están muy complacidos de ser parte de la comunidad local”. También anunció que al día siguiente tendrían un encuentro con numerosas empresas de Estados Unidos y Canadá interesadas en invertir en el corredor del Interoceánico. 

Luego, difundió un mapa de las rutas de exportación que tendrá Constellation Brands, desde los municipios de Veracruz y Coatzacoalcos, hacia varios puntos de la costa este de Estados Unidos, desde Galveston hasta Nueva York.

“Una ventana de oportunidades se abre para la región”.

“El presente artículo es propiedad de Pie de Página”

Contreras, A. (2022). AMLO anuncia una veda a cerveceras en el norte, frente a la crisis hídrica. Pie de Página. Recuperado el 10 de agosto de 2022, de https://piedepagina.mx/amlo-anuncia-una-veda-a-cerveceras-en-el-norte-frente-a-la-crisis-hidrica/