Two in five Americans have medical debt, nearly half of whom owe at least $2,500. Concerned by this burden, governments and private donors have undertaken large, high-profile efforts to relieve medical debt. We partnered with RIP Medical Debt to conduct two randomized experiments that relieved medical debt with a face value of $169 million for 83,401 people between 2018 and 2020. We track outcomes using credit reports, collections account data, and a multimodal survey. There are three sets of results. First, we find no impact of debt relief on credit access, utilization, and financial distress on average. Second, we estimate that debt relief causes a moderate but statistically significant reduction in payment of existing medical bills. Third, we find no effect of medical debt relief on mental health on average, with detrimental effects for some groups in pre-registered heterogeneity analysis.
Further. From Paying Off People’s Medical Debt Has Little Impact on Their Lives, Study Finds by Sarah Kliff. The subheading is A nonprofit group called R.I.P. Medical Debt has relieved Americans of $11 billion in hospital bills. But that did not improve their mental health or their credit scores, a study found.
But a study published by a group of economists on Monday calls into question the premise of the high-profile charity. After following 213,000 people who were in debt and randomly selecting some to work with the nonprofit group, the researchers found that debt relief did not improve the mental health or the credit scores of debtors, on average. And those whose bills had been paid were just as likely to forgo medical care as those whose bills were left unpaid.
A single study study (large and rigorous though it might be) does not a conclusion make.
On the other hand, it is consistent with findings in virtually all other areas of economics and sociology. People don't get into trouble because of their race or gender or marital status or their access to credit or whatnot. They get into trouble because of bad decisions and poor behaviors. Every single damn time.
Of course there is the separate category of people affected by exogenous events such as earthquakes or fires or war or civil disturbance or pandemics or storms or flooding, etc. Everyone affected is tautologically affected though some more than others (preparation makes a difference) and there are great differences in rates of recovery (back to decisions and behaviors).
$11 billion spent (some of it being directly from taxes and most of it being indirectly from taxes) on helping 83,000 people with no measurable benefits achieved.
Programs that do not demonstrably improve decision making and behaviors (especially behaviors) are unlikely to make a difference. At least none have made a difference in the past fifty years. Simple transfers of resources are always welcome by the recipients but the difficulties in most people lives arise from their own actions, not from limited resources.
And instead of killing the programs which waste money without achieving benefits, they just go on as barnacles on the commonweal, consuming scarce resources to no useful outcome.
Almost a Social Law:
Any social program which does not improve values, behaviors and decision-making is guaranteed to waste money and fail to achieve its stated goals.
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