ABOLISHING MEDICAL DEBT
Jerry Ashton and Craig Antico spent decades hounding debtors — until an offshoot of Occupy Wall Street inspired them to pay struggling people’s debts themselves
by Araz Hachadourian / Aug 17, 2015
When Paola Gonzalez received a phone call from RIP Medical Debt, she was certain what she heard was a mistake. A prank, maybe. The caller said a $950 hospital bill had been paid for in full: It would not affect her credit and she wouldn’t have to worry about it again. “They wanted to pay a bill for me,” she said. “I was just speechless.” The 24-year-old student from Roselle Park, New Jersey, has lupus, a chronic autoimmune disease that in 2011 put her in and out of hospitals for a year. Even with insurance she faces a barrage of medical bills that often get pushed aside. “I can’t always work,” Gonzalez said. “I’ll be fine today and sick tomorrow. It’s really amazing that people would help out like this.”
Gonzalez is one of many people who have had a debt paid by RIP Medical Debt, a nonprofit founded by two former debt collectors, Jerry Ashton and Craig Antico, that buys debt on the open market and then abolishes it, no strings attached. In the year since RIP Medical Debt started, the group has abolished just under $400,000, according to Antico. On July 4, it launched a year-long campaign to raise $177,600 in donations, which it will use to abolish $17.6 million of other people’s debt. Millions of people are, in Ashton’s words, “sitting at the kitchen table and you have to decide, ‘Do I buy medication today or do I pay the water bill or do I pay the debt collector?’… We decided we should take the debt collector out of the equation.”
It works like this: typical collection agencies will buy debts from private practices, hospitals, and other collection agencies that don’t find it worthwhile to pursue the debt themselves. The buyers often get a steal, buying a debt for pennies on the dollar while charging the debtor the full amount, plus additional fees. According to a 2013 report from the Federal Trade Commission, from 2006-2009 the nine biggest debt collection companies purchased about $143 billion of consumer debt for less than $6.5 billion; 17 percent of it was medical. Antico and Ashton are plugged into the same marketplace. They say that with the money they raise, they buy the debt for around one percent of the amount it’s worth (when debtors settle directly with collection agencies, they pay an average of 60 percent of the loan.) Then, they forgive it. Some debt-sellers find the cash in hand more valuable. Some doctors want the debt forgiven to help maintain a relationship with their patients.
Ashton worked in the debt collections business for more than 30 years. As he learned about its tactics, he was moved to start his own consulting firm with the goal of keeping people out of collections. He said the industry treated debts as “commodities” and sold them for a profit while the debtor struggled to pay off the full amount. “That I find to be unconscionable,” says Ashton. He was inspired to rethink debt by the Occupy Wall Street movement and its offshoot, Strike Debt, which started the Rolling Jubilee, a program that began buying debt and abolishing it in October 2012.
Medical debt contributed to almost 60 percent of the bankruptcies in the United States in 2013. So when Rolling Jubilee shifted its focus to student loans, Ashton and Antico decided to pick up the torch. “You don’t wake up one morning and decide to have a $150,000 mastectomy,” says Ashton. “This is not elective debt.” For people with chronic illness, like Gonzalez, or those who require extended care, the prospect of a growing pile of debts that cannot be paid is simply frightening. For many, it leads to neglect of care they need: an estimated 25 million adults will not take medicine as prescribed because they cannot afford it; others will avoid the doctor altogether.
This is why RIP Medical debt sees the outstanding bills not just as unpaid, but ultimately unpayable. When buying debts, Ashton and Antico seek out patients whose payments create an immense burden—patients who either earn twice below the national poverty level or whose payments would require five percent or more of their income. They work with the hospitals and medical practices when purchasing debt portfolios to identify debtors who need aid the most. Many of the people who need aid are not properly identified when they go through a hospital registration process. According to Antico, typically 5-10 percent of all hospital cases are uncompensated. When those who cannot pay are billed, those bills often turn into unpaid debts. “This is a systemic issue. It’s not their fault they got sick and incurred debt,” says Antico. “You can’t imagine how bad they feel and they shouldn’t have to.”
Crowd-funding for debt relief is becoming an increasingly popular trend.Back in 2002, a church in Virginia got together to eliminate its members credit card debts. Rolling Jubilee has abolished nearly $32 million in loans since it began. A UK man even tried to crowd-fund a bailout for Greece, raising almost €2 million from strangers by pointing out that Greece’s €1.6 billion debt simmers down to €3 from every European. RIP Medical Debt has been criticized by some within the debt abolition movement for structuring itself as a nonprofit organization that pays for work (though Ashton and Antico work as volunteers, they pay outside contractors for things like website maintenance and design); whereas the above efforts and the original Rolling Jubilee focused entirely on grassroots organization and mutual aid. Still, Ashton and Antico see potential for the project as an opportunity people to help their community. “I think everybody giving to everybody is how we should approach this,” Antico says. As for Gonzalez, while she is excited and grateful for the bill that was paid, her ongoing condition means she still has a lot of debt to get through. Right now she’s focused on avoiding bankruptcy and managing the bill from her primary doctor while the others are pushed to the side. “I just hope that eventually I’ll be able to pay it off,” she said. “This is the first time I’ve been healthy for a couple months straight so I hope that it stays that way.”
DON’T OWE, WON’T PAY
If one debt can be nullified, maybe all of them can
by Charles Eisenstein / Aug 20, 2015
The legitimacy of a given social order rests on the legitimacy of its debts. Even in ancient times this was so. In traditional cultures, debt in a broad sense—gifts to be reciprocated, memories of help rendered, obligations not yet fulfilled—was a glue that held society together. Everybody at one time or another owed something to someone else. Repayment of debt was inseparable from the meeting of social obligations; it resonated with the principles of fairness and gratitude.
The moral associations of making good on one’s debts are still with us today, informing the logic of austerity as well as the legal code. A good country, or a good person, is supposed to make every effort to repay debts. Accordingly, if a country like Jamaica or Greece, or a municipality like Baltimore or Detroit, has insufficient revenue to make its debt payments, it is morally compelled to privatize public assets, slash pensions and salaries, liquidate natural resources, and cut public services so it can use the savings to pay creditors. Such a prescription takes for granted the legitimacy of its debts.
Today a burgeoning debt resistance movement draws from the realization that many of these debts are not fair. Most obviously unfair are loans involving illegal or deceptive practices—the kind that were rampant in the lead-up to the 2008 financial crisis. From sneaky balloon interest hikes on mortgages, to loans deliberately made to unqualified borrowers, to incomprehensible financial products peddled to local governments that were kept ignorant about their risks, these practices resulted in billions of dollars of extra costs for citizens and public institutions alike.
A movement is arising to challenge these debts. In Europe, the International Citizen debt Audit Network (ICAN) promotes “citizen debt audits,” in which activists examine the books of municipalities and other public institutions to determine which debts were incurred through fraudulent, unjust, or illegal means. They then try to persuade the government or institution to contest or renegotiate those debts. In 2012, towns in France declared they would refuse to pay part of their debt obligations to the bailed-out bank Dexia, claiming its deceptive practices resulted in interest rate jumps to as high as 13 percent. Meanwhile, in the United States, the city of Baltimore filed a class-action lawsuit to recover losses incurred through the Libor rate-fixing scandal, losses that could amount to billions of dollars.
And Libor is just the tip of the iceberg. In a time of rampant financial lawbreaking, who knows what citizen audits might uncover? Furthermore, at a time when the law itself is so subject to manipulation by financial interests, why should resistance be limited to debts that involved lawbreaking? After all, the 2008 crash resulted from a deep systemic corruption in which “risky” derivative products turned out to be risk-free—not on their own merits, but because of government and Federal Reserve bailouts that amounted to a de facto guarantee. The perpetrators of these “financial instruments of mass destruction” (as Warren Buffett labeled them) were rewarded while homeowners, other borrowers, and taxpayers were left with collapsed asset values and higher debts.
This is part of a context of unjust economic, political, or social conditions that compels the debtor to go into debt. When that injustice is pervasive, aren’t all or most debts illegitimate? In many countries, declining real wages and reduced public services virtually compel citizens to go into debt just to maintain their standard of living. Is debt legitimate when it is systemically foisted on the vast majority of people and nations? If it isn’t, then resistance to illegitimate debt has profound political consequences.
This feeling of pervasive, systemic unfairness is palpable in the so-called developing world and in increasing swathes of the rest. African and Latin American nations, southern and Eastern Europe, communities of color, students, homeowners with mortgages, municipalities, the unemployed … the list of those who strain under enormous debt through no fault of their own is endless. They share the perception that their debts are somehow unfair, illegitimate, even if there is no legal basis for that perception. Hence the slogan that is spreading among debt activists and resisters everywhere: “Don’t owe. Won’t pay.”
Challenges to these debts cannot be based on appeals to the letter of the law alone when the laws are biased in favor of creditors. There is, however, a legal principle for challenging otherwise legal debts: the principle of “odious debt.” Originally signifying debt incurred on behalf of a nation by its leaders that does not actually benefit the nation, the concept can be extended into a powerful tool for systemic change.
Odious debt was a key concept in recent debt audits on the national level, most notably that of Ecuador in 2008 that led to its defaulting on billions of dollars of its foreign debt. Nothing terrible happened to it, setting a dangerous precedent (from the creditors’ point of view). Greece’s Truth Commission on Public Debt is auditing all of that nation’s sovereign debt with the same possibility in mind. Other nations are likely taking notice because their debts, which are obviously unpayable, condemn them to an eternity of austerity, wage cuts, natural resource liquidation, privatization, etc., for the privilege of staying in debt (and remaining part of the global financial system).
In most cases, the debts are never paid off. According to a report by the Jubilee Debt Campaign, since 1970 Jamaica has borrowed $18.5 billion and paid back $19.8 billion, yet still owes $7.8 billion. In the same period, the Philippines borrowed $110 billion, has paid back $125 billion, and owes $45 billion. These are not isolated examples. Essentially what is happening here is that money—in the form of labor power and natural resources—is being extracted from these countries. More goes out than comes in, thanks to the fact that all these loans bear interest.
What debts are “odious”? Some examples are obvious, such as loans to build the infamous Bataan Nuclear Power Plant from which Westinghouse and Marcos cronies profited enormously but which never produced any electricity, or the military expenditures of juntas in El Salvador or Greece. But what about the huge amount of debt that financed large-scale, centralized development projects? Neoliberal ideology says those are to the great benefit of a nation, but now it is becoming apparent that the main beneficiaries were corporations from the same nations that were doing the lending. Moreover, the bulk of this development is geared toward enabling the recipient to generate foreign exchange by opening up its petroleum, minerals, timber, or other resources to exploitation, or by converting subsistence agriculture to commodity agribusiness, or by making its labor force available to global capital. The foreign exchange generated is required to make loan payments, but the people don’t necessarily benefit. Might we not say, then, that most debt owed by the “developing” world is odious, born of colonial and imperial relationships?
The same might be said for municipal, household, and personal debt. Tax laws, financial deregulation, and economic globalization have siphoned money into the hands of corporations and the very rich, forcing everyone else to borrow in order to meet basic needs. Municipalities and regional governments now must borrow to provide the services that tax revenues once funded before industry fled to the places of least regulation and lowest wages in the global “race to the bottom.” Students now must borrow to attend universities that were once heavily subsidized by government.
Stagnant wages force families to borrow just to live. The rising tide of debt cannot be explained by a rising tide of laziness or irresponsibility. The debt is systemic and inescapable. It isn’t fair, and people know it. As the concept of illegitimate debts spreads, the moral compulsion to repay them will wane, and new forms of debt resistance will emerge. Indeed, they already are in places most affected by the economic crisis, such as Spain, where a strong anti-eviction movement challenges the legitimacy of mortgage debt and has just gotten an activist elected mayor of Barcelona.
As the recent drama in Greece has shown us, though, isolated acts of resistance are easily crushed. Standing alone, Greece faced a stark choice: either capitulate to the European institutions and enact austerity measures even more punishing than those its people rejected in the referendum or suffer the sudden destruction of its banks. Since the latter would entail a humanitarian catastrophe, the Syriza government chose to capitulate. Nonetheless, Greece rendered the world an important service by making the fact of debt slavery plain, as well as revealing the power of undemocratic institutions such as the European Central Bank to dictate domestic economic policy.
Besides direct resistance, people are finding ways to live outside the conventional financial system and, in the process, prefigure what might replace it. Complementary currencies, time banks, direct-to-consumer farm cooperatives, legal aid cooperatives, gift economy networks, tool libraries, medical cooperatives, child care cooperatives, and other forms of economic cooperation are proliferating in Greece and Spain, in many cases recalling traditional forms of communalism that still exist in societies that aren’t fully modernized.
Debt is a potent rallying issue because of its ubiquity and its psychological gravity. Unlike climate change, which is easy to relegate to theoretical importance when, after all, the supermarkets are still full of food and the air conditioner is still running, debt affects the lives of growing numbers of people directly and undeniably: a yoke, a burden, a constant constraint on their freedom. Three-quarters of Americans carry some form of debt. Student debt stands at more than $1.3 trillion in the United States and averages more than $33,000 per graduating student. Municipalities around the country are cutting services to the bone, laying off employees, and slashing pensions. Why? To make payments on their debts. The same is true of entire nations, as creditors—and the financial markets that drive them—tighten their death grip on southern Europe, Latin America, Africa, and the rest of the world. Most people need little persuading that debt has become a tyrant over their lives.
What is harder for them to see, though, is that they could ever be free of their debts, which are often described as “inescapable” or “crushing.” That is why even the most modest challenges to debt legitimacy, such as the aforementioned citizen audits, have revolutionary implications. They cast into question the certainty of debt. If one debt can be nullified, maybe all of them can—not only for nations but for municipalities, school districts, hospitals, and people too. That’s why the European authorities made such a humiliating example of Greece—they needed to maintain the principle of inviolability of debt. That’s also why hundreds of billions of dollars were used to bail out the creditors who made bad loans in the run-up to the 2008 financial crisis, but not a penny was spent bailing out the debtors.
Not only does debt have the potential to be a rallying point of near-universal appeal, it also happens to be a unique political pressure point. That’s because the results of mass debt resistance would be catastrophic for the financial system. The Lehman Brothers collapse in 2008 demonstrated that the system is so highly leveraged and so tightly interconnected that even a small disruption can cascade into a massive systemic crisis. Moreover, “won’t pay” is a form of protest easily accessible to the atomized digital citizen who has been sundered from most forms of political association; arguably, it is the only form of digital action that has much real-world impact. No street protests are necessary, no confrontations with riot police, to stop payment on a credit card or student loan. The financial system is vulnerable to a few million mouse clicks. Herein lies a resolution to the dilemma posed by Silvia Federici in the South Atlantic Quarterly: “Instead of work, exploitation, and above all ‘bosses,’ so prominent in the world of smoke stacks, we now have debtors confronting not an employer but a bank and confronting it alone, not as part of a collective body and collective relation, as was the case with wage workers.” So let’s organize and spread awareness. We needn’t confront the banks, the bond markets, or the financial system alone.
What should be the ultimate goal of the debt resistance movement? The systemic nature of the debt problem implies that none of the policy proposals that are realistic or reachable in the present political environment are worth pursuing. Reducing rates on student loans, offering mortgage relief, reining in payday lending, or reducing debt in the Global South might be politically feasible, but by mitigating the worst abuses of the system, they make that system slightly more tolerable and imply that the problem is not the system—we just need to fix these abuses.
Conventional redistributive strategies, such as higher marginal income tax rates, also face limitations, mostly because they don’t address the deep root of the debt crisis: the slowdown of economic growth worldwide, or, as a Marxist would put it, the falling return on capital. More and more economists are joining a distinguished lineage that includes Herman Daly, E.F. Schumacher, and even (though this is little known) John Maynard Keynes to argue that we are nearing the end of growth—primarily, but not only, for ecological reasons. When growth stalls, lending opportunities disappear. Since money is essentially lent into existence, debt levels increase faster than the supply of money required to service them. The result, as Thomas Piketty described so clearly, is rising indebtedness and concentration of wealth.
The aforementioned policy proposals have a further defect as well: They are so moderate they have little potential to inspire a mass popular movement. Reduced interest rates or other incremental reforms are not going to arouse an apathetic and disillusioned citizenry. Recall the Nuclear Freeze movement of the 1980s: Widely decried as naïve and unrealistic by establishment liberals, it generated a vocal and committed movement that contributed to the climate of opinion behind the START agreements of the Reagan era. The economic reform movements need something equally simple, graspable, and appealing. What about the cancellation of all student debt? What about a jubilee, a fresh start for mortgage debtors, student debtors, and debtor nations?
The problem is that canceling the debts means erasing the assets upon which our entire financial system depends. These assets are at the basis of your pension fund, the solvency of your bank, and grandma’s savings account. Indeed, a savings account is nothing other than a debt owed you by your bank. To prevent chaos, some entity has to buy the debts for cash, and then cancel those debts (in full or in part, or perhaps just reduce the interest rate to zero). Fortunately, there are deeper and more elegant alternatives to conventional redistributive strategies. I’ll mention two of the most promising: “positive money” and negative-interest currency.
Both of these entail a fundamental change in the way money is created. Positive money refers to money created directly without debt by the government, which can be given directly to debtors for debt repayment or used to purchase debts from creditors and then cancel them. Negative-interest currency (which I describe in depth in Sacred Economics) entails a liquidity fee on bank reserves, essentially taxing wealth at its source. It enables zero-interest lending, reduces wealth concentration, and allows a financial system to function in the absence of growth.
Radical proposals such as these bear in common a recognition that money, like property and debt, is a sociopolitical construct. It is a social agreement mediated by symbols: numbers on slips of paper, bits in computers. It is not an immutable feature of reality to which we can but adapt. The agreements that we call money and debt can be changed. To do so, however, will require a movement that contests the immutability of the current system and explores alternatives to it.