Special Report
Medical Debt Clinic Report: New Orleans But what about when debt is incurred unavoidably, just to stay alive?
If debt were just a matter of numbers, of X owes Y Z, it would be simpler to think about. But it isn't. It's a concept laden and confused with the deepest emotional and religious values of the West.
From day one, we're made to feel there's something shameful about borrowing money. In German, for example, the word schuld means both guilt and debt, related to English “should.” We have “owe” and “ought,” not to mention “redemption;” as if debt were sin, and salvation the final pay-off; as if our soul were a coupon to be redeemed. As Psalm 37 says: The wicked borrow and do not repay.
By extension, that puts the creditor in the position of a powerful god, free to dispense the grace of credit and demand retribution for faithlessness. It's only logical that the sinner atone for her debt with the penance of interest, motivated by guilt and the desire to be relieved. And for the unrepentant to be damned.
That might seem ridiculous, but it isn't far from the truth. People do feel guilty about their debts, apart from any considerations of justice or proportion in the sums involved. Embarrassed to seek help and powerless to do anything but continue to pay. And maybe, if they only got into debt through irresponsible hedonism, squandering other people's money on their own sordid pleasures and luxuries, this moralizing scheme would make more sense. But what about when debt is incurred unavoidably, just to stay alive, for things like food or health care emergencies, or for education? Are these luxuries?
What does it mean when people working multiple jobs more than full time cannot get by? And have to charge their groceries, or shoes for their children? When there's no money, but plenty of credit? What happens when you can't afford the price of your own life? Is that a moral failing?
At issue, I guess, are conflicting views of state and citizen. In one view, the state should serve and safeguard its citizens. This would mean security, healthcare and child care, decent wages and education, as rights which the government should subsidize or provide. European social democracy style. The other view - put charitably - is that government should get out of the way and do as little as possible, both to and for the citizen. Leave him alone. Supposedly thus, freedom is maximized, which is a different way of serving and safeguarding the citizen. American, free-individual style. A boy and his dog.
Perhaps in an ideal world.
But in practice this simply exposes people to neglect and corporate predation. Mass shootings and incarceration, substandard or no education or health care, NAFTA, the withering of unions, obesity and diabetes. And perhaps the battle is already lost, the necessary result of granting personhood to corporations and making their political donations legally protected free speech.
If corporations are persons, and their freedoms are deregulation and bribery, then what are people, and what will happen to them? The answer is obvious. They'll be compelled deeper and deeper into debt for basic necessities, at higher and higher interest rates.
“Predatory lending.” Consider the ugliness behind that commonplace phrase. The abuses of the credit industry: sudden rate increases, a ballooning mortgage, wages and tax returns garnished and taken, foreclosure and repossession; the whole gamut. It's debt bondage basically, we are slaves to Pharoah and Citibank in South Dakota. Where is the Moses or Jesus to deliver and save?
Okay. Well let's not get too grandiose.
I was in New Orleans at an event with the Democratic Socialists of America, billed as a health fair. The idea was to help people sign up for Medicare, entice them in with free blood pressure tests and free snacks; gatorade, granola bars, fruit, pizza. The Debt Collective had a table set up to help contest medical debt. It was a hot Sunday afternoon in the parking lot behind an eccentric second-hand cookbook and culinary antique emporium, across the street from an immense church under renovation.
Grass crept up through cracks in the concrete. Lightning Hopkins was playing on the radio. We sat there waiting for people to show up, but not much seemed to be happening. The radio continued its blues show. After a while, a haggard, prematurely old-looking man hobbled in, his forehead beaded and dripping with sweat. A thrift-store brown tweed jacket hung from his protruding shoulder bones like a blanket. A perky volunteer directed him to the snack table and handed him a banana. He hobbled back out, muttering distractedly. We continued to wait.
After a while, a few more people trickled in, got their pressure checked, asked some questions, some about medical bills and collection agencies harassing them. An elderly couple sat down and the woman pulled a few envelopes out of her purse, bills from an area hospital. Her husband looks at me and says, “I heard about this on the radio and I said, babe, we got to go check this out, cause we got too many doctor bills. They just keep piling up and we need all the help we can get.” His wife, Etta, shows the bills to Laura. $50 here, $137 there, another $200, for tests and procedures she was told were covered by medicare, but they're still getting bills in the mail, with threats of action if they don't pay. They're intimidated. There must be a misunderstanding. This is the way their treated in their declining years? “I'm surprised y'all don't have lines around the block with all the medical bills people got around here,” says Arthur. These people worked and paid their taxes for fifty years.
A man brings in his brother who had a debilitating stroke last year but is being discharged from a nursing home after six months, even though he's alone and can't take care of himself. There's no more money. He's unshaven and disoriented, using a rickety folding stool as a walker to follow behind his brother. They don't know what to do. It makes me ashamed. How can it be normal for people to be in a position like this? Why does America treat its people so badly? This situation would be unthinkable in any of the other wealthy democracies of the world. And these are just a couple of examples, from a parking lot in the back of New Orleans. Not even the horrendous ones of tens and hundreds of thousands of people and dollars that abound across the country.
But there's no place for personal emotion, no place for anyone to say this is wrong or illegitimate, because it isn't, it's perfectly legal, for the big to abuse the small, to fix the game and buy the cops, and the judges and lawyers, and the goons on capitol hill, because that's what makes it legal, fees for this and fees for that, and one late payment, even a minute late, and your interest ca double or triples and you're in debt for years. I guess you didn't read the fine print, where it said, for example, "Any benefit, reward, service or feature offered in connection with your card account may change or be discontinued at any time for any reason, except as otherwise expressly indicated." It's like a kind of classical language, Latin polysyllabic for fuck you, plebeian, we make the rules, but go ahead and charge that x-ray.
A former Facebook friend, who unfortunately has turned into a leering redneck, posted this the other day: Refusing to pay for your healthcare is not the same as denying you healthcare. Which is a mystifying perspective: I mean, who's supposed to be paying what for whom? Who is the “you” in this comment. You can almost hear the buried slur, “you shiftless, lazy welfare queen,” and the sleazy connotations of the word “entitlement.” What about taxes? Don't we pay taxes? Are they just supposed to be for bombs and corporate bail-outs? It's true that income tax was invented to pay for war – first, temporarily, in 1861 for the Civil War; then permanently in 1913 for WWI on the way, but really? What are bail-outs if not a social safety net for shiftless, fraudulent bankers? Is this what it's like to live in a crumbling empire?
But like I said, perhaps there's no place for anything personal, for right or wrong. It's just too small. An ant can't really contest a steam roller. Even if the cause is just, he'll just get crushed as he stands there squeaking inaudibly. A swarm of threatened bees, however; now that's a different story. A swarm of organized, working-class debtors angry enough to apply some real democracy. The Debt Collective aims to amass that hive, one bee at a time. Perhaps it's time for you to be a bee
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