Your Money or Your Life: Debt Collection in American Medicine

by Luke Messac

Overview

A riveting exposé of medical debt collection in America — and the profound financial and physical costs eroding patient trust in medicine

For the crime of falling sick without wealth, Americans today face lawsuits, wage garnishment, home foreclosure, and even jail time.

Yet who really profits from aggressive medical debt collection? And how does this predatory system affect patients and doctors responsible for their care?

Your Money or Your Life reveals how medical debt collection became a multibillion-dollar industry and how everyday Americans are made to pay the price. Emergency physician and historian Luke Messac weaves patient stories into a history of law, finance, and medicine to show how debt and debt collection are destroying the foundational trust between doctors and patients at the heart of American healthcare. The fight to stop aggressive collection tactics has brought together people from all corners of the political spectrum. But if we want to better protect the sick from financial ruin, we have to understand how we got here.

With wit and clarity, Your Money or Your Life asks us all to rethink the purpose of our modern healthcare system and consider whom it truly serves.

Product Details

ISBN-13:	9780197676639
Publisher:	Oxford University Press
Publication date:	11/01/2023
Pages:	200
Product dimensions:	6.46(w) x 9.35(h) x 0.82(d)

About the Author

Luke Messac is an emergency physician and historian at Brigham and Women's Hospital and an instructor at Harvard Medical School. His research focuses on the history and political economy of health care. His work has been covered by The New York Times and published in The New England Journal of Medicine, and his first book, No More to Spend, was published by Oxford University Press in 2020.

Table of Contents

Acknowledgments

Introduction

Chapter 1: Before the Debt Machine

Chapter 2: No Mercy

Chapter 3: Trading in Misery

Chapter 4: Shame

Chapter 5: My Day in Court

Chapter 6: An Incomplete Answer

Chapter 7: From Here

Conclusion

Editorial Reviews

"The German word for debt is the same word for guilt. But you don't have to be German to be a guilty debtor in the United States, where the sin of being ill and poor is discharged by indentured labor and the harassment of the debt collector. Luke Messac takes us on a tour of the underbelly of America's hospitals and their horrific debt practices. If there's one country where you don't want to be both poor and ill, it's the United States." — Mark Blyth, The William R. Rhodes '57 Professor of International Economics, The Watson Institute for International and Public Affairs, Brown University

"A crystal-clear critique of the travesty of profit-driven US medicine by a historian drawing on archives, oral history, public records, and his own ethnographic experience as a doctor delivering emergency care medicine for a typically predatory 'non-profit hospital' that bankrupts its poorest, most vulnerable patients. All medical students should read this book to prevent themselves from inadvertently becoming cogs in a monstrous wheel that indebts their lowest income patients." — Philippe Bourgois, Author of In Search of Respect: Selling Crack in El Barrio and Co-Author of Righteous Dopefiend

"In the wake of the COVID-19 pandemic, the impetus for transforming the American health care system is more urgent than ever. Doctor and historian Luke Messac shows how the system has been warped by growing financialization and profiteering, with disastrous consequences for the millions of people struggling with medical debt. Both infuriating and illuminating, he paints a portrait too compelling to ignore." — Dave A. Chokshi, 43rd Health Commissioner of New York City

"Your Money or Your Life offers a rare, deeply powerful, and impressively original look at the roots of medical greed and how and why health care debt is driving down the health of our nation. This book is a passionate and inspiring expression of the importance of empowering community leaders and their residents to advocate for affordable, accessible, and equitable health care before it's too late. It provides the roadmap, now it's up to all of us to heed the charge." — Daniel E. Dawes, Author of The Political Determinants of Health

"Usually, doctors keep themselves aloof from their patients' financial troubles, but not Luke Messac. Your Money or Your Life shows how medical debt and the fear of debt decimate family finances and prevent sick people from seeking needed care. Dr. Messac, a historian and emergency physician, is one of our most important critics of the US health system. His voice is engaging and compassionate, and we must listen." — Beatrix Hoffman, Professor of History, Northern Illinois University and Author of The Wages of Sickness and Health Care for Some

"In Your Money or Your Life, Luke Messac weaves together the compelling, and true, story of how medical debt collection became so aggressive and its real-world impact. Taking readers on a remarkable - and eminently readable - journey through the history and practice of medical debt collection...this great book demonstrates how these events are not aberrations or one-off errors in judgment, but baked into the design of American health care and the institutions that profit from the sidelines. Dr. Messac's book proves that it will take more than occasional finger wagging or modest reforms around the edges to ensure that patients and doctors are no longer debtors and creditors. Everyone, and I do mean everyone, should read Your Money or Your Life." — Melissa B. Jacoby, Graham Kenan Professor of Law, University of North Carolina at Chapel Hill

"In Your Money or Your Life, Dr. Messac provides a piercing and must-read investigation into how medical debt came to be such a powerful and grim force in American medicine. To create change for the millions of American families beset by the financial toxicity of our health care system, we must learn from this difficult history." — Victor Roy, Physician, Sociologist, and Author of Capitalizing a Cure: How Finance Controls the Price and Value of Medicines

"Messac (Harvard Medical School) makes it clear that the root causes of these issues are health-care system flaws more than immoral or callous insurance companies, hospital CEOs, lawyers, or collection agencies. This great, quick read demonstrates why chastising and removing bad actors will never be a substitute for systemic health financing reform." — Choice

From the Publisher