Cutting Debt and Restoring Dignity in Health Care

During a global pandemic, health systems are being tried, burdened, and judged, although very few are actually able to pass the test. The need for health care reform has been clear for decades, highlighted by medical detainment and medical debt, the focus of the webinar, “Debt, Dignity, and Health Care: Guaranteeing Health Rights and Universal Health Coverage.” This event was led by GHELI’s Senior Scholar in Residence Alicia Ely Yamin and hosted by the Global Health and Rights Partnership—a collaboration between the Global Health Education and Learning Incubator and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. 

In some parts of the world, thousands of patients have faced detainment in hospitals for being unable to pay their hospital bills. The pressure to pay the bills result in horrendous stories: nurses offering single mothers money in exchange for their babies, or hospital staff pressuring patients into sex in exchange for cash to help pay for bills. Tightly strapped for money, vulnerable patients succumb to these clear violations of human rights, having no other foreseeable option to leave the hospital. Highlighting examples from several sub-Saharan African countries, Robert Yates—Director of the Global Health Programme and Executive Director of the Centre for Universal Health at Chatham House—illustrated how publicly financed universal health coverage (UHC) should be a cornerstone in mitigating these human rights violations. UHC would help ensure that hospitals can become sustainable without needing to charge patients outrageous fees, which disproportionately burden the poor and vulnerable.

While U.S. cases of medical detention are not prevalent, medical debt is still a critical issue that cripples millions of Americans. Wendi C. Thomas, Editor of MLK50: Justice Through Journalism and a leading reporter of Profiting from the Poor: Inside Memphis’ Debt Machine, highlighted an investigative initiative that she led, unveiling hospitals in Memphis, TN, which targeted vulnerable, poor patients of color and even sued staff members who were unable to pay egregious medical bills. Jay Hancock, Senior Correspondent of Kaiser Health News and contributor to its investigation of the University of Virginia’s aggressive billing practices, put into context why these bills are so alarming: a sore throat can end in a bill of almost $7,000 for patients. It is no wonder that people in vulnerable communities lose trust in the health care system, leading to a vicious, spinning cycle—people are fearful to go to their health care providers and poor health outcomes persist. 

Examining our health systems through the lens of human rights highlights the structural fissures in the way health care is provided; investigative journalism, in turn, uncovers the stories that characterize these gaps every day. Having panelists in both fields gave the audience a closer look at varied perspectives and experiences in health care. The discussion about the best long-term solutions provoked questions from the audience which can be explored through a link to the conversation’s Twitter hashtag, #debtdignityhealth. While the conversation still continues onwards, one thing is certain: slashing medical debt is an essential cornerstone to restoring dignity and equality in a fraught health care system. 

In addition to watching the fully-captioned videos of the sessions, explore GHELI’s resource pack on universal health coverage and resource pack on country cases of health reform to learn more about universal health coverage and health equity.