Personal medical debt is the leading cause of bankruptcy in the United States


March 21, 2019

Only one book, END MEDICAL DEBT, written by three industry insiders, clearly explains the actual causes and proposed cures for our nation's medical debt crisis. The authors founded RIP Medical Debt, the national charity that since 2014 has forgiven $500 million in medical debt for 250,000 Americans -- so far. END MEDICAL DEBT shares practical insights needed for our urgent public debate about outrageous healthcare costs

This is the definitive and new book by Jerry Ashton, Robert Goff and Craig Antico, founders of the national charity, RIP Medical Debt to End Medical Debt..* RIP (rest in peace) first came to America’s attention in 2016 when HBO’s “Last Week Tonight with John Oliver” used the charity to abolish $15 million in medical debt. * By the end of 2018, RIP will have abolished a half billion dollars in medical debt for 250,000 people in communities nationwide. Associated Press calls RIP End Medical Debt the “Secret Santas”.

In our fervent public debates about the broken U.S. healthcare system, we have overlooked the devastating impacts of America’s urgent medical debt crisis. Everybody knows somebody or themselves who struggles with medical debt. The time has come to bring medical debt into the center of our national conversation about healthcare. You can’t have affordable insurance for an unaffordable product

End Medical Debt, written by three industry insiders, is the first book to bypass political posturing to look clearly and realistically at the actual causes and possible cures for more than $1 trillion in unpayable medical debt in America, accumulating over the past ten years and growing. Medical debt causes hardships for individuals, families, communities, and the country.

The authors lay bare the inner workings of our healthcare system. They show how it produces medical bills that people cannot ever pay, including insured middle-class people who think they are covered. They tell how the early hospitals that focused on patient health evolved into today’s healthcare conglomerates focused on patient revenue. They dissect the Affordable Care Act (“Obamacare”) to show where theory and reality do not match. They expose how veterans get laden with medical debt that effectively tells them, “No thank you for your service."

A glimpse into the big picture:

Medical debt destroys financial stability among large segments of America’s most vulnerable communities: The sick, the elderly, the poor, and veterans. It mostly targets the middle class, driving into poverty too many families already barely getting along, who cannot afford any unplanned illness or injury. An unexpected $500 out-of-pocket medical bill can cause hardship. One in five U.S. adults have medical debt on their credit reports, some with tens or hundreds of thousands in bills Medical debt on a credit reports prevents one from buying or renting a home and vehicle, or even getting a job to pay those medical bills. Millennials at age 27, who often carry little or no insurance, carry more medical debt on their credit cards than any other age group. Patients with medical debt tend to avoid adding more debt by ignoring health problems, which worsens their health and increases their costs for care. The doctor of last resort becomes the expensive emergency room, which just compounds medical debt.

Flip to the other side of the picture. For health care providers, "uncompensated care" or bad debt drives doctors away from private practice. Almost half of all U.S. physician are now employed by hospital-owned practices, where business margins often overrule health missions. Unpaid and uncollectible medical bills threaten the fiscal viability of community hospitals, chiefly those providing charity care. A local hospital with massive medical debt may be saved by a community bailout, but taxpayers foot the bill. Higher local taxes make any community less desirable to businesses. Less local affluence attracts fewer talented care givers. Medical debt contributes to both urban and rural communities turning into “healthcare deserts” without affordable care.

Medical debt permeates American society,. Now it’s become a crisis. We cannot ignore it. We need to talk about medical debt. Voicing decades of experience in debt collections, debt buying and healthcare management, the authors of End Medical Debt bring deep expertise to the problem of medical debt.

- Jerry Ashton has more than 40 years of experience in the credit and collections industry.

- Robert Goff recently retired from 40 years in healthcare administration management.

- Craig Antico has 30 years in collections, debt buying, outsourcing, and consulting.


1. The United States spends more per capita (per person) on health care than any other nation on earth.

2. The USA is the only industrialized country reliant on commercial insurance instead of universal healthcare.

3. At least 20 percent of all working-age Americans with health insurance have trouble paying medical bills.

4. An unexpected $500 out-of-pocket medical bill is too much for many people to pay or pay in a timely way.

5. More than 60 percent of all insured Americans will deplete most or all of their savings to pay medical bills.

6. About 10 percent of adults delay or skip medical care due to costs; worsening health costs more to treat.

7. At least 43 million Americans have about $75 billion in past-due medical bills on their credit reports.

8. Medical debt on a credit report generally prevents people from buying or renting homes and cars.

9 Medical debt on a credit report can keep people from getting a job to pay off their medical bills.

10. Only ten percent of all unpaid medical bills appear on credit reports; at least $1 trillion exists.

11. Medical debt drives middle class and lower-income families into poverty or homelessness.

12. Medical debt is the number one cause of personal bankruptcy in the USA.


Cloth Hardcover: ISBN: 978-0-9892241-0-9 (December 2018)

Trade Softcover: ISBN: 978-0-9892241-2-3 (November 2018)

eBook Editions: ISBN 978-0-9892241-1-6 (December 2018)

Print book: 6 x 9 inches, 196 pages.


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