{"title":"Beyond past-due bills: The varieties of medical debt used to finance healthcare","authors":"Elizabeth C. Martin","doi":"10.1016/j.socscimed.2025.118592","DOIUrl":null,"url":null,"abstract":"<div><div>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 <em>all</em> 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.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"386 ","pages":"Article 118592"},"PeriodicalIF":5.0000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Science & Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0277953625009232","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
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.
期刊介绍:
Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.