Beyond past-due bills: The varieties of medical debt used to finance healthcare

The high cost of medical care in the United States has led to widespread medical indebtedness in the population. While previous work has highlighted the reciprocal relationship between debt and health, we know less about how families use and experience diverse kinds of debt resulting from medical care. This article draws on in-depth interviews with women in the Midwest having trouble paying for healthcare to understand the ways they use debt to finance care for themselves and their families. I find that in addition to conventional medical debt—past-due bills or payment plans from providers—these women draw on multiple sources of credit in their pursuit of healthcare. Use of credit cards, loans or gifts from family and friends, and other consumer credit was widespread. Current measures of conventional medical debt might be underestimating the prevalence of debt acquired to pay for healthcare, especially among more advantaged households. I argue that researchers must adopt a broader definition of medical debt to encompass all the debt acquired to finance medical care to fully grasp the financial consequences of high medical costs in the US. I also argue that, like other types of debt, medical debt is a double-edged sword—a resource that means more people have access to care, but also a burden in an uncertain future.