An Army of Normal Folks - How $1 Can Erase $100 of Medical Debt in Your Community

Episode Date: August 18, 2026

1 out of every 3 Americans carries medical debt. It's the #1 cause of bankruptcy in the country - and the single greatest predictor of whether you end up in it isn't your income or your insurance. It's whether or not you get sick. Allison Sesso is a normal person leading an abnormal (and awesome) nonprofit doing something about it. Undue Medical Debt has erased nearly $50 billion in medical debt for over 31 million people!  In this episode, she breaks down exactly what to do if you get a bill you can't afford, why you should never put medical debt on a credit card, how debt collectors acquire debt for pennies on the dollar, how they’ve flipped this very same model on its head to abolish debt, and how you can partner with them to erase a crazy amount of medical debt in your community. ARMY ACTIONS Subscribe to the podcast and rate & review us! Signup to join the Army, visit NormalFolks.org Follow us on social media @ArmyofNormalFolks Join or start an ANF local service club at https://normalfolks.org/service-clubs/ Take The 10 Level Challenge, "the hero's journey for service" at 10LevelChallenge.orgSupport the show: https://www.normalfolks.us/#joinSee omnystudio.com/listener for privacy information.

The problem of medical debt is huge in the United States. It affects one in three people. It's the number one cause of bankruptcy. And it's at least a $220 billion problem. More than 100 million Americans carry medical debt. And the single largest predictor of medical debt, it isn't what you think. Number one predictor of whether or not you end up in medical debt is not your income level. It's not your insurance.

It's whether or not you get sick. And that is part of the burden that people are clearly carrying where we can. hear from individuals. They feel like failures, like they did something wrong when something actually happened to that. Today's guest is Allison Sesso, president and CEO of Undue Medical Debt. She has helped scale a once small nonprofit into an organization that has raised almost $50 billion in medical debt for 31 million Americans. We buy medical debt for pennies on the dollar. And, And we use donated dollars to do that $1, it gets rid of $100 of medical debt, and we erase it. That's insane.

In this episode, you'll learn what to do when a medical bill arrives. How to look for financial assistance. Question the charges. Negotiate what you owe and avoid turning protected medical debt into more expensive credit card debt. Most importantly, do not put it on a credit card. That's the one I wanted you to say loud and proud. Take that again. Do not put it on your credit card.

You'll also learn how ordinary people, you know, normal folks, are partnering with undue medical debt to erase medical debt in their community and how you can do this in your community. We've had over a thousand churches work with us, and collectively they've gotten rid of $10 billion of medical debt. $10 billion. Yes, that's correct. $100,000 could get rid of $10 million in debt. Yes, that's correct. This is Army of Normal Folks, where our mission is to make service easier. for us all, and together, change the country.

Experience with Cameron Wickcombe live at the Ryman. Flights and two nights in Nashville. To see Cameron Whitcomb at the legendary Ryman Auditorium. Plus a thousand dollar spending caps. Just listen to Pure Country for 10 minutes a day on the free IHard radio app and you're in to win. Cameron Wickham. Stream the new single, Kingdom of Fear. Available now.

If your bookshelf and your for-you page are equally important to your personality, welcome home. This is Prose Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsesives, and anyone who thinks pride and prejudice and love island deserve the same level of discourse. I'm Eli Rallo and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. I'm obsessed. From bestselling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters, then that is a Trojan horse.

Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro Society on the Iheart Radio app, Apple Podcasts, or wherever you get your podcasts. See you between the pages. When I was 14 years old, I was kidnapped and held captive for nine months. I survived, and I've spent my life exploring how other people survive what should have destroyed them. I'm Elizabeth Smart, and these are the Survivor Files. I just remember this low, taunting voice next to my ear saying, shut up, don't say anything. Every week, I'm with survivors who live through the unthinker.

I knew if he woke up, without a doubt, he was going to hurt me. I started feeling that there was someone at the end of my bed, and I just started screaming. They are abducted, stalked, controlled, and nearly silenced. But these aren't stories about what's taken from them. There's stories about what it takes to make it out alive. Listen to the Survivor Files with Elizabeth Smart on the IHeart Radio app, Apple Podcast, or wherever you get your podcasts. I'm Hoda Kotbby, host of the podcast, Joy 101 with Hoda Kotbby.

If you know me, you know, I'm always searching for inspiration and useful tools to maximize joy. So this podcast lets us uncover those things together through meaningful conversations with fascinating people. Like when my friend Henry Winkler offered advice to aspiring actors and really anybody hoping to stand out. You're not hired just to fill time and space. You're hired to fill the space with you.

You have something in your guts. You go with it. And Sean Johnson recalled the moment she realized her now husband, Andrew, was the one. He was just so unapologetically himself and knew nothing of Hollywood. He hadn't been on a plane before without his family. It was so pure. Listen to Joy 101 with Hoda Kotby on the IHeartRadio app, Apple Podcast. or wherever you get your podcasts.

All right, everybody. We have super exciting news coming at you. I mean, Alice is excited about it, but I'm not sure how excited I am. The podcast is now live on YouTube, which means now you get to see me in case you prefer watching it there. And we're switching up the audio format of the podcast.

You can now either listen to the full version of the podcast on the same episode, meaning you no longer have to go to part one and part two to hear a whole episode we got going. Or you can listen to a 30-minute version of the podcast that will be labeled as highlights. And we get it. Many listeners who aren't as into long-form podcast or struggle to find the time to listen to the whole thing each week have requested something like this. And so Alex got off his butt and we finally created it.

We're really not perfect. Nobody is, but we really do try to take in all of your feedback and advice. We hope to create a product that makes service easier for you and all of us. So check it out. And keep it coming. You can email us anytime at normalfolks. And we will respond. Now, let's go to the episode.

Allison Sesso from Queens, New York City, New York, but Queens really is where you're from, yeah? Yes, that's right. That's even where our offices are. And just landed. Yep, just landed. I mean, you've seen all the five seconds of Memphis, I guess. That's about right, yep. And we missed you the first time because of weather, and we almost missed you again because of weather.

That's right. But I made it. Here I am. Thanks for being step. fast. Everybody, Allison is the president and CEO of undue medical debt. And I'm just going to say when I read about you, I was really disappointed when you didn't come the first time because I was excited, but now I'm double excited because I think what you're doing is really creative and interesting and scalable and applicable in just about any corner of our country. So I can't wait to

get into it. Great. But I do want to compliment you on the creativity of what you've done to actually make such a big dent in people's lives was so little. Thanks. I appreciate that. Although I will say I do hope for a day where I don't have to exist because medical debt is not something I hope we have to have forever. I've read you've said that. We'll get to it. So how did you come into this? Your passion for it, you didn't, so many people I talked to. So many people I talk to. So many people I talk to. found the 501c3 or the philanthropy, whatever. And so you understand their passion because it was their baby and they've grown it, right?

These other two guys found it, but your passion for it is so apparent. How did you get involved in this? How did, and I guess what I'm asking is, is how did your passion for this develop and kind of intersect at this opportunity? Yeah, so before I, took on this role, I was the head of an association of social service providers. So like 200

nonprofits operating, providing everything from homeless shelters to after school programs, mental health clinics, food pantries, you know, all these different social services that exist that are working deeply in communities to in some ways relieve the burdens of poverty that we've talked about, right, in different ways. So when I heard about this nonprofit that was looking for a new head, because it was started by Jerry. and Craig, but I think the board realized that wanted to scale it and take it to the next level and wanted a nonprofit kind of executive with a little bit more experience and how to fundraise and how to scale things. So when I saw the opportunity, I dug deeper. I did, you know,

some interviews and learned more about this model. And because of my history, I knew that this one was wholly unique, that there was nobody else doing this particular thing. And I knew that it could not only bring attention to, you know, help many, many people at scale, but also that it would tell the story of medical debt and people's lives effectively. There is a story to tell. Yeah, because, like, for me, medical debt is like two broken systems. It's economic system. Like, why don't people have $200? Like, that's not, that's a problem that half of Americans don't have $500 in savings. That's an economic system is broken. People aren't getting

access to enough means to make it. And then you've got the healthcare financing system where the expectation that people have gobs of money to get access to health care is absurd. And so to me, medical debt was telling that story really well. And I sort of had this vision that if I could scale this and get enough people excited and interested in this, that I could not only relieve the debts for lots and lots of people, but tell the story of medical debt and have people's voices heard in this in the way. that I've been saying over and over again that it's not their fault and that we need to do something different. What I'm hoping at the end of all of this is that, you know, we can go out of business

because we've figured out a different way. I don't say pretend to have the answer for what that different way is. That's a political fight that's somebody else's paycheck, right? Not mine. But I do know that we knew, and I think everyone across the United States knows that we need to do something differently here. And I want to push for that change and that conversation to happen in a very real way that puts patients, not hospitals, not insurance companies, but the patient first. One of our listeners, Robin Horton, emailed us that her church just abolished every available dollar of medical debt in their region over the last year. Yes.

How is that possible? Yeah. So I think you're talking about the good. The simple church. The simple church. Yes, the simple church. but they have a name of their project that's called the good. The do good maybe?

The do good, yes, exactly. It's a do good pastor? Yes. So they're incredible. They have raised, I think they've done. Where are they? They're in Louisiana. Okay.

They have raised twice outpaced themselves. So I think the first time they tried to raise, or at least the last time in 2025, they tried to raise $25,000, and they ended up raising over $50,000. And then they tried to raise $50,000 and raised $50,000. and rate like $113,000. And because of that, they've been able to wipe out $13.2 million of medical debt

with those dollars. And I know that sounds outrageous, but that's what our model does. We buy medical debt for pennies on the dollar, and we use donated dollars to do that $1, it gets rid of $100 of medical debt, and we erase it. That's insane.

Just hearing that $130 or 40 or 50, thousand dollars can make 13 or 14 million dollars and burdensome debt go away how that works we're going to get into but but i think it's first i think it's important for our listeners to understand um how bad is the problem of medical debt really it's pretty bad um unfortunately and i will just say that it's 13 you know over 13 million dollars but almost 12 000 people right And that's really the... In the U.S. 12,000.

I'm saying how many people of this particular campaign that we just talked about got rid of, helped 12,000 people. So they helped get rid of $13 million of debt, but for 12,000 people. So it's a lot of people that are impacted

by one of our many, many campaigns. And the problem, yeah. And while $130,000 is a whole lot of money, I've talked to a lot of people who raise a whole lot more money than that and don't affect 12,000 people in a very real way. Yeah, the return on investment is hard to match. It's, it's really insane. But the problem of medical debt is huge in the United States. I mean,

it affects one in three people. One in three people. So it's a lot. It's the number one cause of bankruptcy. And it's at least, and this is probably an undercat, a $220 billion problem. $220 billion. Correct. All right. How many people we got in the U.S.? Alex, $340,000? $340 million? Probably around that, yeah. Not right? It used to be 330, so it's probably higher now.

All right, well, let's say $350 million. Let's say $300 million. Right. If you're saying $1 and 3, that means 100 million people in our country. Yes, that's right. That's about the number. Yes. At medical death, they can't satisfy.

Correct. Yes. So when I ask how big of a problem it is, it's as big as cancer. Yeah, and it's not just a... Oddly. Yes, I know. And cancer is... put you in medical debt and makes you much more susceptible to it. It really does bankrupt people.

And I would say the problem is beyond the numbers, right? It's living in people's psyche. They're not going to get the care that they need. They're avoiding going to the hospitals. They're ignoring problems with their bodies. And once they have a medical debt, they're, you know, not only dealing with trying to get better and, you know, heal from whatever ailment that, that originally they needed to go get help with, but they're also sitting with this like sense of failure. They feel like they've failed themselves and their families because they got cancer or because, you know, they were in a car accident. And now they're putting their families and this financial ruin estate. And that's the part that I think is the biggest problem and the most motivating for me and my team.

Well, explain how the for profit marketplace for medical debt in the U.S. kind of works. Yeah. So unfortunately, with medical debt in particular, there's a real misalignment between what people actually owe or what the expectation is that you pay at. a pocket and what you actually have, which is different than I think other kinds of debt. It's also a weird marketplace in general because how many times when you go to the doctor do you actually price out? Well, if I'm buying a call. Yes.

I'm going to go to five different people and ask what the price is. As a patient, we almost never ask or even know what the hell it is we're paying for something. But even if you did, how you tell me, anyone in this room know how much a colonoscopy is supposed to run you? Yeah. Right? Like, how would you even know what the basic cost of that is? You know what a basic cost of a car would be? And if you're getting, you know, taking advantage of, you don't know that for health care. But there is a for-profit market for medical debt and for other kinds of debt as well. But the thing is the people who owe those debts can't really pay for them, right? Because there's this mismatch, which I just described. And so being able to make money off of buying those debts is really hard. And so for-profit debt buyers, is they have to buy those debts for pennies on the dollar to make the math work for them. And so we as a nonprofit take advantage of that existing market.

And instead of trying to collect on anybody, we just get rid of those debts for all those people using donated dollars. And now a few messages from our generous sponsors. But first, there's Army members looking to start one of our ANF local service clubs in Oklahoma, San Antonio, Texas, Lincoln, Nebraska, Huntsville, Alabama, Bozeman, Montana, and Sumner County, Kansas. If you happen to live in one of those areas and would be interested in being a part of the potential club, shoot Alex an email at Alex at NormalFolks.org, and he'd love to connect with you and the person looking to start the club. And if you'd be interested in starting one of these clubs yourself, shoot Alex an email, too, you can also learn more about them at normalfokes.org

backslash service clubs. We'll be right back. You're in with Cameron Wickham. Live at the Ryman. Lights and two nights in Nashville. To see Cameron Wickcombe at the legendary Ryman Auditorium. Plus a thousand dollar spending caps. Just listen to Pure Country for 10 minutes a day on the free IHart radio app and you're in to win.

Stream the new single, Kingdom of Fear. Available now. If your bookshelf and your for-you page are equally important to your personality, welcome home. This is Prose Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives, and anyone who thinks Pride and Prejudice and Love Island deserve the same level of discourse. I'm Eli Rallo, and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. From bestselling authors and your favorite book talk creators

to the latest pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters, then that is a Trojan horse. Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much,

you're in the right place. Listen to pro society on the Iheart radio app Apple Podcasts or wherever you get your podcasts. See you between the pages. When I was 14 years old, I was kidnapped and held captive for nine months. I survived and I've spent my life exploring how other people survive what should have destroyed them. I'm Elizabeth Smart and these are the Survivor Files. I just remember this low, taunting voice next to my ear saying, shut up, don't say anything.

Every week I'm with survivors who live through the unthinkable. I knew if he woke up, without a doubt, he was going to hurt me. I started feeling that there was someone at the end of my bed, and I just started screaming. They are abducted, stalked, controlled, and nearly silenced. But these aren't stories about what's taken from them. There's stories about what it takes to make it out alive. Listen to the Survivor Files with Elizabeth Smart on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. I'm Hoda Kotbby, host of the podcast, Joy 101 with Hoda Kotby.

If you know me, you know, I'm always searching for inspiration and useful tools to maximize joy. So this podcast lets us uncover those things together through meaningful conversations with fascinating people. Like when my friend Henry Winkler offered advice to aspiring actors and really anybody hoping to stand out. You're not hired just to fill time and space. You're hired to fill the space with you. You have something in your guts. You go with it. And Sean Johnson recalled the moment she realized her now husband, Andrew, was the one.

He was just so unapologetically himself and knew nothing of Hollywood. He hadn't been on a plane before without his family. It was so pure. Listen to Joy 101 with Hoda Kotby on the I Heart Radio app, Apple Podcasts, or wherever you get your podcasts. All right, let's say Methodist Hospital here in Memphis. It's a great hospital. They do good work. And profits are a necessary measure of any organization's success.

So they have to pay their doctors and the nurses and their insurance and stuff. So I get it costs, okay. But written into their process. profit loss statement is a reserve for bad debt because they know they are not going to collect all the dust because there are simply people that come in that can't afford it. They have been inadequate or no insurance. Right. All right. So they get at the end of this year this $10 million in unpaid bills. And they really don't think they're going to collect them because of what the world is, right? So this for-profit model, how much do these, I guess they're,

medical debt collectors that buy the debt from the hospital? Yeah, and I will say not all hospitals sell their debts. So don't assume that all of them do that. They don't. Some of them just write it off to bad debt and then it just sits on their books. Now, they will have tried to collect it at some point from those individuals. So those individuals still think that they owe those debts, even if the hospital is an actively trying to collect all those debts.

They may have already written it off and they're still trying to get it back on their balance sheet. In fact, a lot of the debts we buy have already been written off technically. But the patient doesn't have that information, right? So they're still avoiding going to get the care that they need. And then they can give it to a collection agencies to either work the debt. So even if they don't sell it, the debt collector, an outsource debt collector can try to work that debt and try to make some returns from that. And they can do that for as long as they'd like. Or the hospital, you know, writes it off at some point, just puts it down to zero.

And, again, the patient doesn't know. So that's how it often works. But if that hospital does sell their debt, they would sell it to a for-profit debt buyer, and they would sell it for pennies on the dollar because then that for-profit debt buyer would go and call those people that are in that portfolio and try to cut them deals. So say you owed $1,000, they might call you and say, hey, and they bought that $1,000 for $10. That was my question. Yes, they buy it for $10. They buy it for $10.

So a hospital that maybe has $10 million in debt, they may pay. Yeah, take two zeros off the end. That's basically the math. You're kidding. No. All right. And their goal is if I can get anything over 1%, right, whatever I've paid. But the thing is, listen, the majority of those people in that portfolio are not going to be able to pay anything. So that's the thing. They're taking a risk. So that, you know, that's, that's really where we end up. Yeah, exactly. That's the business model.

But if I'm a blue-collar working person and I've got, you know, I'm making $22 an hour driving a for Home Depot, and I have a $3,000 medical debt out there. Right. That there's just no way. There's no way you're ever paying that. Right. But somebody calls me up and says, if you'll give me $100, we'll call this good and it'll be taken off your deal. Yes. I don't, that could happen. Yes. I would, I'm not sure if they would take $100. $100, like if they would cut a deal that deep.

But, you know, maybe they'll put you on a payment plan and say, pay me over the next, pay me $100 a month for the next X number of years, right? And then they'll be like, okay, I'll take care of that, you know? Then I'll take that deal. But the deal is for these guys, these companies that buy the medical debt, if they're paying 1%, if they can get 10% of a debt, they're making money. Yeah, right. But again, many of those debts in that portfolio, they will get zero on.

Right. So they've got to wait it. Yeah, exactly. All right. So that's not what you do, obviously. But that's this business. I didn't know what existed that way. And I bet the vast majority of our listeners didn't even know there's this industry out there that buys bad medical debt and makes a profit ignoring the people that they can't get any money from, but then just getting more than they put into the debt from collections.

Yes. there is a for-profit and market that does that, absolutely. And you're right, most people don't know that. And often people say, like, can I just buy my debt directly from a hospital in that way? And it doesn't actually work that way. You have to have, they're not just going to let you buy one debt at a time in that way from the hospital if you owe it. So, but we take advantage of that model and flip it on a tent. Exactly. That's what I said at the top. It's so creative. So you guys know that exists out there. And so you're like, if we can raise money. Yep. And help folks get their debt cleared. Now they feel okay going back to the doctor. Now they don't have this burden waiting them down every day. They don't have debt collectors calling them at work and at home and texting them and emailing. They don't have it on their credit report. They don't have it on their credit report. So now they can finance a car or maybe apartment or a house. Yep. That's incredible. Yeah. That's what we do. Who came up with this idea? So we were founded by two former debt collectors who understood that this industry. Are you kidding? No.

So we had two former debt buyers, Jerry and Craig, knew that this existed. And they were like, okay, if we can, you know, get donated dollars, we can buy these debts. And so they started out doing this. Only in 2014, we've only been around for a relatively short period of time as an organization. And then I was brought in to scale it. And that's what we've done. We've gotten rid of almost $50 billion of medical debt using this model. for 31 million people.

I can't wait to get to that. But what I found interesting is most of the medical debt your race is relatively small. It's $200 to $2,000 is what I read. Yeah, that's the average. And that's, I think, the average medical debt that somebody has from a single occurrence. Yep. Well, so how does eliminating that little bit make that big a difference? So remember that, or maybe no,

that half of Americans don't have $500 in savings. So if you apply that to this to a $2,000 or a $200 bill, it does make a difference. It takes a weight off the people's shoulders. They also feel like somebody's out there where they didn't have to do anything. There's no application for this. You just get a letter in the mail that tells you, we bought your debt. It's free and clear. You don't have to even ever tell us or call us or do anything to take advantage of this. And so I think it creates an opportunity for people to feel like they believe again in humanity. But actually, I think it's tangible for people as well. We'll hear from, we call them constituents or individuals or patients that call us and let us know what it's been like to get rid of this debt. They talk about the fact

that they feel comfortable going back to the doctor, that they can go now and get their child that dance lesson that they had canceled because they were trying to make ends meet, et cetera. All right. So on paper, you're actually a debt collector because you are on paper a debt collector, but and your founders were deck collectors. They were, but we're not debt collectors because we never collect a single penny from anybody. Right. I get it, but what I'm saying is when these...

The mechanics. That's it. Yes, the mechanics are like a debt collector. The mechanics are like a debt collector. But unlike, instead of being motivated by profit, we're motivated by mission. When these founders that you told me were deck collectors decided they could do this, let's be honest. When you think about a deck collector, you think about the nasty, mean, calling you at night people. And I want to tell you, I know a deck collector, Big Al, right?

Huh? Big Al. Oh, yeah. He's a duck collector. Big Al Holdren. I forgot about that. Big Al Holdren's a guy we interviewed about, I don't know, 18 months, two years ago. So he does amazing things for his community at Christmas and all this other stuff.

But Big Al is a debt collector. And when you sit across from this jovial, gregarious, outgoing guy, he does not match the thing you think of as a debt collector, some seedy guy sitting on a phone just making your life miserable until you pay your bills. Have you seen Talladega nights? What's that? Have you seen Talladega nights? Yeah. You know, it reminds me that scene where he's like, I just want to be like a first. friendly drug dealer.

Yeah. A friendly debt call. Right. Right. Right. Exactly. Right. Right.

Yeah. Oh, that's funny. So what, what happened with these two guys? Well, I don't know. I think Big Al, I think that's like, you know, that's, this is, it's an occupation for people, right? They're trying to make money and there's a market for medical debt and people, you know, there's an ability to make money off of this. I don't know that they're all not also made equal, right?

Like, we actually do buy medical. debt from some of the for-profit debt buyers as well. Like, we get that off their hands. So, you know, I don't know that they're all inherently evil. I think what they do and their tactics can be really problematic. I think that this industry exists as points itself to a larger problem. But as individuals, I'm not sure that that's always the case. Jerry and Craig, I think that they actually were worn down by trying to call people

and felt kind of bad about it, that they realized that this is not. a problem of failure, of personal failure, and I don't want to pay. This is a, there's a misalignment between what I's expected of me and what I actually have. And so what am I supposed to do about that? You can call me all you want, but you can't get blood from a stone, you know, what am I supposed to do? And so when they realized they could flip it on its head, I think they thought that was an attractive option, you know, to really take their knowledge of this industry, try to raise donated dollars, and apply it to as many people as they possibly could. It's just, I have employees that I know have struggled with medical debt before.

And I have given them, I've given no interest loans to help them through it and everything else. And it's a real thing. Yep. And it crushes people. Yes. And it kicks them while they're down, right? Because you just got some kind of life event happened to you. And then on top of that, it's like, here's the financial kick in the butt behind it, right?

It's like really painful for people emotionally as well as physically. I mean, and then they know that I might not do the follow-up care. There's a lot of elements and layers to this problem. Okay. So, and you said, and we're going to get to it in a minute because I can't imagine this letter that shows up. I put myself in the letter getters shoes. Yeah. Like, nah.

So, but we'll get to that a minute. But before we even get to the letter going to somebody, I've read that there's like $220 billion in unpaid medical debt out there. How in goodness name do you guys figure out who you're going to help? Because even as great as you're doing, there seems like there's more need than you're able to satisfy. So how do you – and if nobody's applying, how do you know how do you find them? What do you do? Yeah, great question. So first of all, I have no illusions that I'm solving this problem fundamentally.

I'm solving it for individuals and a scale for a lot of individuals. But I'm not this, like, I cannot sit in a seat where I'm like, yes, we should just keep relieving the debt. Like, we need to get at the root causes of this and fix the way we finance health care fundamentally. But at the same time, I do what I can from where I sit. And that's what we're doing. I love that. Yeah.

You do what you can from where you see. Yeah. And that's exactly what we're doing. and we're centering the stories of these people whose debts were relieving and telling those stories really, really effectively so that we can push for that greater change at the same time as removing these debts for people. Sorry, what was your actual question? How do you find them?

Oh, how do we find them? How do we pick them? Right. How do we pick them? Okay. So we don't really pick them. Who's the lottery winner of the debt? No, it's, I mean, look, if we have dollars and we have debt, we put those two things

together, right? And we qualify everyone that is 400% of poverty or below, which is roughly a little over 100,000. Say that again, 400% of poverty or below. That's the threshold. So if you qualify, which is usually like 90% of a hospital's files qualifies. If you're at 400% of poverty or below, you will automatically qualify. We actually created this debt engine. How do you get to 400% of poverty? How did we pick that number? Yeah. Well, yeah. So basically it's an income threshold, right? So a lot of like, is it roughly if you're a family of three, it's making a little over $100,000 a year. We used to be, our threshold was at 200% of poverty, but we raised it to 400 because inflation's been killing families. And this is really like an almost anti-poverty. Like this one medical bill could be the thing that brings you down. And we didn't want to leave people hanging, right? So we thought, let's raise it up to 400, especially when we're working with hospitals and we're getting us access to. to the debt and this close. Also, those people aren't clearly not able to pay their bills, which is why they're still there. And their debts are still in those files. That's interesting.

400% of poverty levels higher than what I would have expected. Yeah. But because in, for a family of three, I mean, yeah, I hear you. But in Memphis, the poverty level is in Memphis, the poverty level is anyone making less than, I think it's $23,000. Yeah. But it's, this is, that's old, but I remember hearing that about a year. So multiple that times four, that's 80 and 12. That's $92,000 a year. In Memphis, if you're making. But that would be for one person.

That's, you were talking times three people when I say $100,000. Yeah, this is in New York. But yeah. No, I know. Yeah, but I'm serious. Somebody, a family of three making $90,000 year in Memphis is they're able to live a life. not great, not killing it, but they're able to live a lot. But can they pay a $2,000 unexpected bill?

Like, that's the thing. That's what I'm getting to. But if you think about it, a $2,000 or $3,000 unexpected bill, those are probably the families that are paying their bills and are getting by week to week, but don't have the $500 in the same account and can't. I'm encouraged that it's that high as what I'm saying. Yes. All right.

So it's actually a bill. It's very common. Even the Obamacare subsidies might be at that level. Like a lot of nonprofits and other things used for. Focus on that. Yes. Because there's actually, at the lower levels,

there's more government programs to support your insurance levels. And at the higher levels, it gets decreasing, right? So it's almost like this point. There's a middle group that has, doesn't have government help, that doesn't make enough. Okay.

Well, also get rid of your debt. If you're above that threshold and the debt is five percent or more of your income, so if it's large relative to your income, we'll also get rid of it. We'll flag it. And then we just send, we just, the entire file, if we have the money, we buy the, we buy all of the debts that qualify. So it's not like a lottery exactly.

I mean, it kind of feels like you won the lottery and didn't buy a ticket when you get a letter, but it's not really a lottery. It's just an algorithm that we apply. Yeah, you said you had a formula that you guys invented. This is it. We'll be right back. in Nashville to see Cameron Wickham at the legendary Ryman Auditorium. Plus a thousand dollar spending cash. Just listen to Pure Country for 10 minutes a day on the free IHart Radio app and you're

in to win. Cameron Whitcomb. Stream the new single Kingdom of Fear. Available now. If your bookshelf and your for you page are equally important to your personality, welcome home. This is Pros Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives, and anyone who thinks

pride and prejudice and love island deserve the same level of discourse. I'm Eli Rallo and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. So I'm obsessed. From bestselling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters, then that is a Trojan horse. Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro Society on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. See you between the pages.

When I was 14 years old, I was kidnapped and held captive for nine months. months. I survived, and I've spent my life exploring how other people survive what should have destroyed them. I'm Elizabeth Smart, and these are the survivor files. I just remember this low, taunting voice next to my ear saying, shut up, don't say anything. Every week, I'm with survivors who live through the unthinkable. I knew if he woke up, without a doubt, he was going to hurt me. I started feeling that there was someone at the end of my bed, and I just started screaming. They are abducted, stalked, controlled, and nearly silenced. But these aren't stories about what's taken from them.

There's stories about what it takes to make it out alive. Listen to the Survivor Files with Elizabeth Smart on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. I'm Hoda Kotby, host of the podcast. Joy 101 with Hoda Cottonby. If you know me, you know, I'm always searching for inspiration and useful tools to maximize joy. So this podcast lets us uncover those things together through meaningful conversations with fascinating

people. Like when my friend Henry Winkler offered advice to aspiring actors and really anybody hoping to stand out. You're not hired just to fill time into space. You're hired to fill the space with you. You have something in your guts. You go with it. And Sean Johnson recalled the moment she realized her now husband, Andrew, was the one.

He was just so unapologetically himself and knew nothing of Hollywood. He hadn't been on a plane before without his family. It was so pure. Listen to Joy 101 with Hoda Kotby on the IHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Well, so, okay, you got the formula, but how do you found? The debtors? Yeah, so they're in the file. So we go to the hospital.

So we buy the debt directly from the hospital. This is all source-based. We go directly to the hospital or another health care kind of provider. It could be a large physician group or an ambulance group. It could be a debt collector that already bought it from a hospital. And we put it through our debt engine that we created. And then we get the file. I thought you waited into one of these poor-profit people bought it from the hospital,

and then you went and negotiated with them. We do both. You're usurping them, though. Correct. You're going to buy it from the hospital. Yes. And now you know how much the debt is. Yes.

And you're able to, oh, that's cool. Yes. And then we buy income data to pair it with that. And then we just let everybody know, we get updated address information and let them all know that their debt's been released. I got to chase the squirrel to tree. How do you decide what hospitals to go to? Yeah.

So that has a lot to do with where there's two ways. A hospital can come to us, and if we have funds, we apply them. The hospitals will come to you and say, hey. Sometimes, yeah, because they know, look, for hospitals, this problem falls in their lap as well in some ways. And they, you know, they provide financial assistance. You talked before about, you know, there's a percentage of people they know that they're not going to provide care for. They're not going to get paid for. I'm sorry, they're going to provide care for, but they're not going to get paid for.

That's called uncompensated care. And they do actually apply financial assistance, which is free care to some of those folks, but people still fall through the cracks. Not all of those financial assistance policies go up as high as 400%. But they also know that if they don't provide free or discounted care to people, those people, they have a medical bill. They're not going to come back and get the care they need. And they're going to oftentimes show up in their emergency room with a worse off condition,

which is more expensive for them as well. Then that kills the bottom line for the hospital. Right. So there's both a mission driven and a profit-driven reason, I think, for hospitals to do this. And they get a little something from us, obviously. in terms of this bad debt portfolio, you know, in exchange for it. Plus, they get it off their books. Right.

They get it off their books. But I think with the hospitals we talk to do it because they know that it's patient-centered and it's really they want people to come back to get the care they need. All right. So the first way is they find you. What's the second way you found hospitals? Yeah. So if we have a, we approach hospitals.

We pitch them. We tell them who we are. You know, we say, hi. Like, we're this nonprofit that buys medical debt. And we do it based on, you know, interest if we have donors in a particular. region that are motivated to raise money, we'll be looking at those hospitals to see. So it really has to do with donors being interested in having the money. So, Alex, if an army of normal folks service club, correct.

Through their giving circle, correct. Were to weighs $100,000. Or so the minimum actually, I was exploring this on your website is $10,000. How much? 10,000, which is very... Ken? That's it? minimum. So, so yes.

Yeah, but okay, let's just say 50, because 50 starts to make it a little worthwhile. Yes. All right. So if an Army and Normal Folks Service Club, just follow me here, right? If an Army and Normal Folks Service Club, through their grieving circle, were to raise $50,000, some of which we have matched if they've hit in certain par levels, they could choose to then call Allison and say, we want you to call this hospital. In our city, we're going to give you $50,000 and you go remove all the possible debt you can from people in our community at this hospital. That could work. Kind of. So I'll just say there are some caveats.

Well, then take me through it. Okay. So you should call us and see whether or not we have access and we already have an existing relationship with that hospital and or. And we don't always, the debts that we relieve can be a mixture of different debts from different hospitals. so we won't necessarily say like, it's 100% from this hospital. Like, we'll tell you we have this much debt and it could be from a range of people. $50,000 is probably not enough money for us to open up a new relationship with a new hospital. How much is?

It depends on the size of the hospital, but probably more like closer to like 500,000. I know, it's a lot. But it doesn't mean that we don't already have debt. We have a lot of existing relationship. We've worked with over 300 hospitals. And so we have existing relationships that might already be there. We'll be able to tell you. I believe we do have dead in Memphis.

Yes. All right. There's a club. Do you have any in? I'm sure, Wichita. Do you have any in Wichita? Probably. I know she's got one.

What about Atlanta? Yes, definitely. What about them up in New York? I'm guessing they actually have Oxford too because I was on the site and somebody had created a campaign. Oh, if there's a campaign there, we have that there. We have access. Yeah.

For Calabushia County. Yep. Which probably means they have Baptist Hospital. hospital. And what about the one in New York? I don't know whether. So we have a club in Duchess County, New York. Oh, yes, Dutchess County. Yes. I know exactly where that is. Every one of our club potentially could use their giving circle to come up with $50,000 provided you had access to the debt. Then they could absolutely remove debt for people in their specific community. Correct. That's exactly that. That is awesome. Well, it's actually really, I mean, yes, on the giving

circle. Obviously, other Army members could consider this, whether you're part of a service club or not, people listening to us. I really like how Robin approached it with her church. That's a great way to do it. And they did, like, videos and talked about the problem, which I thought was really super cool, too. So, Bill, what they did is, they did around Easter weekend. I remember reading that. Yeah, like, how much can we raise, or they raise, like, all this. I think even just engaging a lot of your local churches, hey, here's the size of the, I mean, you tell me if you think this makes sense of. Here's the size of the problem in our community that we can see. solve. Absolutely. That's exactly how it works. We've had over a thousand churches work with us,

and collectively they've gotten rid of $10 billion of medical debt. Ten billion? Yes, that's correct. Over our lent. Oh, in the last five years, I think. For how much money probably? What was raised to get $10 billion off of people's backs? Yes, let me. But that would be a hundred million on average. Maybe $10 million was raised? Yeah. $10 million got rid of $10 billion. I believe so, yes. That is insane. Mm-hmm. Thousand churches. More importantly, a hundred thousand, which is a, that's a number of people can fathom.

Yes. That you could raise. Yep. A hundred thousand could get rid of $10 million in debt. Yes, that's correct. 10 million. And if you think about these debts are often $200, $2,000, $3,000 and $5,000, think how many people that affects in your community. Yep.

And obviously you don't have to be a member of a church either. I'm just using that as an example of a convening body, right? We can engage a lot of people at once, and there's other types of convening bodies. Yeah, right here in Tennessee, we actually had a group of students that were medical students with Vanderbilt. And they raised $10,000 to get rid of $1.00, almost $7 million of medical debt because they realized as medical students that people were avoiding going to get the care that they needed in the first place. So, okay. Quarter school student projects. Right.

So that's how you find hospitals. Yes. Through the hospitals and getting the death, that's how you find your benefactors is a good word. Yeah, patience. I mean, yeah. Okay. Your patience, fine. I get where the money comes from.

So now I got it. I get what you do. I'm Billy Bob, bankhead Courtney sitting in Memphis, Tennessee. I'm at 400. a percent, I'm at 300 percent above poverty level. My wife and I have two children. We're paying our car note. We're paying our rent.

We keep our light bill paid. We probably are able to take a small weekend vacation once a year, maybe twice. We will go out to eat when Charlie's offers free chicken fingers to the kids. Gas is killing us, but we're getting back. And then somebody has something. Now I got this $5,000 debt. And I can't get rid of it. Right.

And we're both working. We're doing what the rules say we should do. Yep. And it's not working. Right. And then I get a letter in the mail and it says, hey, your desk gone. I'm probably throwing that in the garbage because it's not much difference than Steve Harvey is going to show up to your house with $10 million dollars in balloons and publishers clearing the house. It's not much different than, you know what I mean?

Yeah. In this day and age, I'm curious. if people believe us? Yes. I would think you get a lot of people like, nah. Yeah, look, I'm sure there's some people that don't believe it, you know, for sure. I will say we really work hard to try to pair the relief moments with some media moments so that people know it's coming and we do some social media work. So we're very intentional about trying to get people to understand that. We're also, you know, going on shows like this, like trying to make sure people know that we are real so that they can expect this to be a thing.

Right. Right, exactly. So thank you for having me for that reason alone. But yeah, people, look, they come back to us. There's actually a QR code on every letter that we say, please tell us your story. Please help us because we're trying to break the stigma of this as well, right? It's not a personal failure. And that's how people feel. They feel like they have failed. Right. And that their failures. And honestly, the number one predictor, this is the part that kills me. The number one predictor of whether or not you end up in medical debt is not your income level. It's not your insurance. Whether or not you're insured. It's whether or not you get sick. What? Yeah. So we're all potentially going to be hurt by this. We're all potential victims. Yeah, because everybody can get sick. Exactly. We're human beings, right? So that to me, you know, is the story I want to tell is that the system really is rigged against you actually here. You're like in a very real way. And like people need to pay attention to the fact that they should not feel that personal failure, although I understand it. It's not their fault. And I want people to know that and believe that.

And so when they find out about this letter and the work that we're doing, I feel like it really should matter to them that that someone that was stranger, that didn't even know, they didn't pick them, just wanted to do something kind for the world. And through us, was able to raise money, do what they can from where they sit and get rid of this person's medical debt. And they don't have this $5,000 bill that you mentioned anymore because of that and can feel like they can sleep better at night. Are you ready to watch them, grimmis? I'm going off scrubbed.

Okay. All right. I have other questions I need to ask that we've decided are important. Go ahead. And one of them touches on what you just said, which is 60% of medical debt is owned by people with insurance, which drives me insane. But we're going to get to that in a minute. Yes.

I have a curiosity question. Sure. Yeah. One of the biggest problems with my hometown, and it is the same in St. Louis and Birmingham and New Orleans, and all these flyover state, Midwestern southern cities that are struggling with tax base and people leaving the city is crime and poor education. Well, crime and poor education is predicated by poverty. It is predicated by people that are nomadic because they can never stay in one place long enough to get a kid in a school and learning because they can't pay the round or the light bills go off. It is a massive, big old problem. Yes.

But debt is one of them. One of the precursors to putting people on poverty and medical debt is a huge one. I'm just curious, have any municipalities. said, you know what, if we could get rid of a lot of this medical debt off the most underserved of our population or the hardest work in our population that don't have anything extra, they would be able to start investing in our communities and our tax base and make our city better places. Have any municipalities ever reached out to you and said, we want to pay you to get rid of our citizens' medical debt? 28 of them. No kidding. Is that in the prop somewhere?

Yeah. Oh, I'm sorry. I must have skipped ahead. Yes. Really? Yeah, we've done work. You mentioned New Orleans. That was one of the early ones.

Did they use taxpayer money to do it? They did use taxpayer dollars. Yep. I love that. Well, what's good about, well, you know, I think it's somewhat controversial depending on the, you know, what people believe tax dollars should be, you know, which is a healthy debate. What I like about it is that we can scale with those dollars and do all the wonderful things you said. The other thing is it's a one-time investment.

Unlike other programs that governments kind of invest in, you can really invest in this and then we get rid of the medical debt. Now, yes, there will be continuation of relationships with the hospitals that we can keep going, but we can do that with private and public dollars. You know, we can kind of mix it together. What I love about our model is that it really does mix private and public dollars together because municipalities are investing. And at the same time, so are droves and droves of individuals and people.

That is really interesting. I've missed it in the prop, if that's later on in the prop. Sorry, Alex, but... I'm glad I had a good answer, though. Well, it was just, as we're thinking about who was doing it, it just popped in my head that that just makes a ton of sense. It does. I think, I mean, it's a return on investment.

It's huge. We'll be right back. With Cameron Wickcomb. Live at the Riemann. Ask me out. It's in two nights in Nashville. To see Cameron Wickome at the legendary Riemann Auditorium. Plus a thousand.

thousand dollar spending caps just listen to pure country for 10 minutes a day on the free iHeart radio app and you're in to win cameron will come stream the new single kingdom of fear available now if your bookshelf and your for you page are equally important to your personality welcome home this is prose society the weekly podcast that's part book club part group chat for thought daughters pop culture obsessives, and anyone who thinks pride and prejudice and love island deserve the same level of discourse. I'm Eli Rallo, and every week we're connecting the dots between books, the internet, and the conversations everyone can't stop having. I'm going to have to look up this story. I'm obsessed. I'm obsessed. From bestselling authors and your favorite book talk creators to the latest

pop culture moments, nothing is off the table. It's like if you can hide some real messages inside compelling characters, and that is a Trojan horse. Whether you're looking for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place. Listen to Pro Society on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

See you between the pages. When I was 14 years old, I was kidnapped and held captive for nine months. I survived, and I've spent my life, exploring how other people survive what should have destroyed them. I'm Elizabeth Smart, and these are the Survivor Files. I just remember this low, taunting voice next to my ear saying, shut up, don't say anything. Every week, I'm with survivors who lived through the unthinkable. I knew if he woke up, without a doubt, he was going to hurt me.

I started feeling that there was someone at the end of my bed, and I just started screaming. They are abducted, stalked, controlled, and nearly silenced. But these aren't stories about what's taken from them. There's stories about what it takes to make it out alive. Listen to the Survivor Files with Elizabeth Smart on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. I'm Hoda Kotbby, host of the podcast, Joy 101 with Hoda Kotby.

If you know me, you know, I'm always surprised. searching for inspiration and useful tools to maximize joy. So this podcast lets us uncover those things together through meaningful conversations with fascinating people. Like when my friend Henry Winkler offered advice to aspiring actors and really anybody hoping to stand out. You're not hired just to fill time and space. You're hired to fill the space with you.

You have something in your guts. You go with it. And Sean Johnson recalled the moment she realized her now husband, Andrew, was the one. He was just so unapologetically himself and knew nothing of Hollywood. He hadn't been on a plane before without his family. It was so pure. Listen to Joy 101 with Hoda Kotby on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. 60% of medical debt is owed by insured patients.

Yes. I don't understand how people that are working. hard and paying their insurance premiums. Every insurance policy I've ever seen has a max out of pocket for annual situations. How are people with insurance paying for their insurance, even if you're employed and you have an employee insurance plan, you're paying something. Yes. Very few companies just pay your insurance. Right. You should have to pay a lot out of your paycheck. How are they ending up with medical debt. How does that work? Because increasingly, the insurance is thinner and thinner, if you will, in terms of what it covers. And the

deductibles, there's a lot of high deductible plans. So in order to lower the premium, what the insurance companies do is they put the burden on the individual and they won't pay a cent until you pay a certain amount out of pocket. And so the higher, the deductible, the lower the premium and vice versa. If you want a no premium plan or sorry, no deductible plan, you have to pay out of the nose for premiums. And then what ends up happening, is the people who are chronically sick and know they're going to use the health insurance,

they're going to use their health insurance, end up paying for the plans that have low deductibles and pay through the nose in terms of the premium, but they're in the pool. But then that makes the people who are well take the plans that are more, are thinner. Right. And then that's how insurance works, right? It's like pooling risk. And so you're skewing the pooling of the risk. You know, I think that's interesting because I'm thinking about my company's plan.

And I know that my business, we pay close to 70% of the premiums for our employees. And like a family plan for us is $1,700 a month. Yep. And so I pay a thousand. No, I pay probably 12. The company pays 12 or 1300. What does it go up every year? How many percent?

12, 15 percent. You're like, are you serious? Right. Every time. Or 20 or 25. Right. In fact, I just switched from one insurer to another to keep the premiums down. But the point is the max out of pocket on that family thing is still $7,800.

And I work that down as far as I could. And the deductible was down as far as I could to get the best point I could for my employees. The whole point is my guy making $25 an hour with two kids in school and his wife is also working somewhere. if they have to get the max out of pocket, even though they're covered from catastrophic, they still can't pay that $7,000. That's right. And so they end up with that debt. That makes sense.

And I think the other thing that we lose sight of is that if you didn't have to pay that, you probably could increase the wages. I mean, that's the part that I don't think we realize collectively that. If you didn't have to pay that. If you as an employer didn't have to pay as much towards the, you would be able to increase. increase the wages. Absolutely would. But you can't.

And I don't think that, I mean, even unions now, what are they fighting for? They're fighting to hold on to that good health insurance. But what are they sacrificing, the fight for the wages? It is true. It's funny that you say that because I'm always, as a business owner, I'm always faced with, here comes the new year, everybody's going to want a little bit of a raise. And at the same time, here comes my insurance policy, is up 25%. Here comes my all of the, and you do have to balance it.

And I don't expect employees to fully understand. They're thinking about themselves and what they got to do, and that's just the way it is. But the truth is, there's only so much to go around. And when I have to pay more for insurance, I can't keep giving races. And it's in particular, the healthier people at your company are the ones that don't get it, right? Because they're not using it. And so they don't see the value of it. But the people who either have family members or themselves have kind of chronic illness or on their medication that they need to keep them alive or well, they will understand and appreciate the investment you're making.

But what happens is they're the ones that end up going to the max out of pocket at $0,000, $7,000 and can never get out of that. Right. That's fair. And here comes you. Yep. What do you say to the person who did work hard and did pull extra shifts and did have this burden and fault? and scrumped and didn't go out to eat and told their kid no on the new pair of fleets and did pay their medical bills who are in the same 400% of poverty levels of people that you're battling out. What do you say to those people? Because they figured it out when others can't.

Yeah, and I think that that's a fair frustration, right? I think that that's fair. But, you know, I, and the truth is life isn't fair. And I'm not, that's not a great answer. But like, Actually, I think it's a wonderful answer because it's true. Like, you know, what am I supposed to not help the people I can because there's somebody that might have figured it out? Like, that doesn't really sit well with me. Life is complicated. The world is complicated. And I'm going to help whoever I can.

And I would hope that those individuals realize that not everybody's, you know, a situation is the same. And I don't know that that other family that I helped, like, was able to buy cleats and all these other things too. I mean that they just made different decisions. And they were like, screw it. you know, I'm not going to pay it. They might have had other situations on their backs. Yeah, and the world is complicated. So I'm, you know, we're trying to do the best we can to help as many people as we can. And I sort of, if you will, don't have time for that kind of argument because it's it's just not serving us collectively well. Do you worry about the incentive this creates for

hospitals in terms of them and potentially provide less upfront patient assistance? or even charged more for procedures because they know there will be people who pay for it, and those that can't will have their debt forgiven? I don't worry about that because we're not giving hospitals that much money, right? At the end of the day, like this is not paying what the debt is valued at, right? It really is. It's really pennies on the dollar, right? And actually, I think it incentivizes the hospitals and gives them actually new information

about their financial assistance policies because we're showing them all the people that they either should have had or that were just above the threshold. So we have this conversation in the process of working with hospitals in which we're like, hey, take a fresh look at the way you're approaching and your financial and also known as charity care. And maybe you want to increase the threshold or you want to make it so that there's not an application that's so burdensome because there's people that are falling through the cracks, et cetera. One of the things we know is that a lot of people don't even know about financial assistance policies. And so hospitals, we try to encourage them through this process to do better. So I don't worry too much about those incentives for hospitals

that I'm messing with their incentives, if you will. That makes sense. One of the things I think is an important distinction is that you say you don't forgive debt. Yes. Explain that distinction. So words matter. And I think if we say we're forgiving debt, then we're laying blame at the feet of the individuals. And to me... If you say you're forgiving debt. Right. If I'm forgiving your debt, like if you've done something to me, I say I'm asking for forgiveness, right? But you haven't done anything.

You're actually, that indicates redemption for something they don't need to be redeemed for. Exactly. And I'm trying to break the stigma, right? So I get it like why it's a comfortable word and people use it. But I really am trying to move away from that and say, you know, we're not forgiving debts. We're relieving them. We're erasing them.

We're even abolishing them. But we do not say that we. we try not to say we're forgiving them because it's not your fault. It's really a system's problem. We're eradicating the death. Yes, eradicating. We use that word sometimes too. I like that one. Yes, I love that word. Yes. And the reason you don't want to use forgive is it is a little bit of semantics, but your whole point is we believe the system worked against you and you don't need to be forgiven because you've done nothing wrong. Exactly. And that is part of the burden that people are clearly carrying when we hear.

from individuals. They feel like failures, like they did something wrong when something actually happened to them. You know, you've said that three or four times since we've started talking. That's a big part of it for you, isn't it? Very much so. Yes. It's the personal thing that you don't want these folks to feel guilty for getting sick. Right. Because I think the world is already stacked against working folks so much. Like, I really think that people are struggling. As you mentioned before, gas prices, food prices. You know, every time you turn around, there's something else laughing you in the face. And then what we hear from individuals is that, you know, they had an accident.

They got cancer, you know, they or even sometimes it could be, I had a stomach pain. I didn't know what it was. And it turned out it was okay, but I needed that, you know, release to know that, right? To be, my family needed me to know to know that I was okay. And in fact, I tried to avoid going to get that test, but my family insisted. And now I ended up in this debt and I feel like I failed them. And to me, that's just untenable. We have to do better.

I might have assumed that this was really about a financial arrangement where you eliminated debt for people so that they didn't have the financial debt. But it's really as much about their psyche and their approach to life and their ability to go attack the day than it is their chat vote. It is both. Yes, absolutely for us. And that is what we hear from the constituents that we help. You know, we have this one woman that we, you mentioned some of the debts are small. This one woman, we actually got rid of $45,000 of her debt. So sometimes we do get rid of pretty big debts. $45,000. Correct. But she. got in she was driving along and she um on a major highway a truck hit her she ended up needing skin grafts and her her bones were broken and they told her she wasn't going to be able to walk for two years and she was young um she ended up getting at it and walking within a year um you know but what

amazingly and i love this part about her story is that the letter of debt relief came just before one of the anniversaries of her accident like where she really spends time self-reflecting on her life and what it could have been and, you know, all of that, well, what it meant for her. And, and, you know, she talks about how she felt just a renewed faith in humanity because of that, that letter coming for her. And she actually is going to work, going to school to become a social worker, really inspired her to, like, give back herself in terms of her own life and career. And so I just love that story because it's so full circle. And it has a lot to do with the fact that we showed up for her. do you do you have any sense of what it what it costs to get rid of that 45,000

do you remember uh probably cost under five thousand dollars so for five thousand dollars you legitimately changed the trajectory in the show that's one percent it would be 450 yeah oh sorry 450 he's better at math we're bad at math yeah you think it was more like screwed it up this whole episode so do you think it was more like five hundred dollars yes that's right that is right Sorry, yes. $500 probably. Yes, that is the right math, yes.

Wow. Mm-hmm. Her life is completely, you know. Completely changed. Completely changed. It went from the most terrific thing to ever happen to her to being reversed. Yeah, I mean, it doesn't take away the, you know, that her life is, right? But at the same time, like, we move this, this pain from her, this financial burden and this meant, and the mental burden is what she talked about.

You know, how she, I know, who knows if she would. I don't know that she said this, but, you know, would she had decided to go take on the probably student loans of going to school to go to get to become a social worker? I don't, you know, maybe that was part of her calculation. That's crazy. All right. Here's one that's really interesting. You hired an anthropologist whose entire job is to talk to people whose debt you've erased. First of all, hiring an anthropologist. You love that. That was one of my early moves. Yeah. Actually, I was hustling when I read this the first time. And I'm like, well, I was like, what a dinosaurs have to do with this?

Yeah. That's hilarious. Yeah. Well, I mean, anthropology is, it's storytelling, right? I mean, and then you've nailed it. Like, we want to tell the stories of these individuals. We want to capture what this means for people in really deep ways and see if there's like patterns and themes, which we are finding. So yeah, her whole job is to just talk to the individuals, understand what it meant to have medical debt.

And that's how I know that these feelings of failure are so real and prominent for people and that they're not going back to get the care that they need. And that when they get a letter from us, it feels like not just a sense of financial relief, but again, the sense that humanity is a real thing, that they have faith in it, right? that there's like actually a way forward for them. It's interesting. I've been reading a lot lately about the K economy. Mm-hmm. And you're helping the very people we're talking about, which are the people on the down backslash.

Right. My concern is a lot of people think that people on, a lot of people assume that people on the down black slash are the folks not working. And it's just almost completely. They're working so hard. Exactly. They're working much harder than a lot of other people, to be honest. Like they're working multiple jobs.

They're trying to make it. That's what we hear from people. And that's actually why they're sick and need health care. Well, that was my, that was why the reason I always said that was getting back to this dinosaur person is what are they hearing about that? Do they get into those questions? They do sometimes. I mean, I think we're careful not to dig, you know, not to let people tell their stories and to listen and prompt, but not dig deeper where people are uncomfortable. But I think people naturally like sharing their stories and how they've been struggling. But yeah, people are working really hard. They're, they feel very overwhelmed. It, you know, it hits, your physical and your mental health are very much connected. And again, they feel like, the system is rigged against them. And that there's, you know, they're doing everything they can, right.

They even, like you said, it's almost 60% of the people have insurance. Those are like, I had insurance. Why isn't it? Why am I still in this debt? And they, and I think that it's not only them, but it's like their, their friends, their family, like one and three Americans. We're talking about a lot of people that are burdened by this. And they're not going to the doctor. I mean, that's the other thing is they're looking towards home remit.

is what she hears, right, that they're not getting cancer screening tests. And we know, like, if you catch things early, you're more likely to do well and survive. And if you wait and ignore that pain in your stomach for too long, you know, you may end up to the point of no return. And that's really hurting families. And people feel like they're failing their families. Or they're, oh, sorry, some of the worst stories are, you know, the most heartbreaking are the ones where it's parents, you know, we buy death from children's hospitals. I mean, those are the stories where, like, parents are like, I am trying, but how do I make decisions about my kids' care? I mean, parents will sacrifice, as you know, everything they have to take care of their kids. And is that

okay? Like, that they're, you know, putting their houses up to pay for medical care because their kid ended up with not even cancer, like a broken leg or something like that. For the person listening right now who just got a bill they can't pay, what do they actually have the power to do? So I get asked this question a lot. And I, you know, unfortunately, there's now perfect answers. I would say importantly, make sure you go and find out whether or not there is a financial assistance policy that you qualify for at the hospital or other health care provider. Mostly hospitals, especially nonprofit hospitals, which the vast majority are required to have some kind of financial assistance or charity care policy. So, and we also know from polling that people are not aware of that. There's also this sense sometimes that people, people kind of to your point, don't feel like they deserve it or that they're too proud. Or sometimes they're too proud, even if they do qualify. And like, don't be too proud.

Like it is, again, the system is rigged against you. Just take the financial assistance. There's lots of people that take it for good reason. And it's there for a good reason. So I would say, number one, look at financial assistance. You can ask for an itemized bill. Sometimes that's helpful. Make sure you don't go back and forth. with your insurance company and find out why it wasn't covered or what the issue is. Most importantly, do not put it on a credit card because then it all of a sudden is not medical debt. And medical debt often has other protections in place. That's the one I wanted you to say loud and proud. Say that again. Do not put it on your credit card. Do not medical debt on your credit card ever.

Right. Do not put it on your credit card. And they're all too happy to take your credit card. Yes, they are all too happy to take your credit card. Exactly. Do not do that. And don't avoid that. Because that brings another creditor into the mix. Well, and it's not medical debt, now it's credit card debt, which has much higher percentage. Like, there's, you know, just so. And they're not going to forgive it. Right. And be careful of what kind of payment plan you sign up for.

You know, sometimes there's these like credit cards at hospitals and other health care providers, especially dentists are notorious for this, like high percentage. Somehow teeth aren't part of the body, so you have to have a separate dental insurance. I don't know why that is. It's crazy. Eyes are also. Yep, exactly. I don't know. But so that, so that ends up.

being people are really thinly insured on the dental side of things. And so there's a lot of high percentage dental credit cards. We're not currently buying much dental debt, but we're actually looking into that for this reason. So be careful of what kind of payment plans you sign up for. And most importantly, don't avoid the care that you need. Like, I know that's, it's easier said than done because you're like, well, what happens when I end up in this debt? But you have to get, take care of yourself. You're not to be able to work. You're not going to, you know, you have to take care of yourself and that means go. Even if you do have medical debt. Yes, go. A hospital. They will take you. They can't not take it. Yes, that's right. That's exactly.

So don't let the debt keep you from getting well. Exactly. So would you say the number one mistake people make when they get a bill that can't afford us, they try to put it on a credit card to take care of it? And you know, I don't know what the number one mistake is. I guess that's probably common is that they put it on a credit card or sign up for a payment plan that they really can't afford and they end up going, you know, not paying it anyway. But also just taking it as it is, I think, is you can call and negotiate and you should. That's, I think, another piece of advice. Absolutely. And if you're not physically well enough, have a family member or somebody that you trust call and do that negotiation for you. You can negotiate these bills. And I don't think people feel empowered to do that.

what do you want my listeners to hear about this, about what you do and about what they can do to engage? Well, so if you want to help your community and, you know, that's, we're a vessel, I feel like, for people wanting to help their community and doing what they can from where they sit. So, you know, go to our website on domedicaldette.org and try to start a campaign or contribute to one that already exists. But also talk about the issue within your communities. Talk about the fact, you know, share this podcast around so people can hear more about this issue, right? That's right. Right? See? Share it around. Talk about it. Good book for you. Yeah.

You know, and also like, engage in the issue. Like, let's talk, let's have a conversation as a country about what else we can do. You know, whether or not you have the solution doesn't mean that you shouldn't have a discussion about what's going on now is not right and not sustainable. And so I think we do need to have a push for change. You don't have to be on the left. You don't have to be on the right to know. And actually, this issue is very bipartisan. in terms of knowing that we need change and we need to do something differently. A lot of the churches we work with say that, like, a lot of the issues that they work with in their church are divisive.

But this is one that, like, is everyone runs with and really brings people together. So I think we do need to have a larger conversation about what we can do differently about how we finance health care and what we, what it does for working people in particular and how this monkey is on their backs. That's interesting that houses of worship say that there's all kinds of issues that divide them, but this is one that is almost universally uniting. Yep. And what wouldn't it be? Right. And there's a financial side to it that I think makes everybody go awesome.

Everybody likes a good deal. That's right. And if you can get rid of mountains of crap of people's back for pennies on the dollar, why wouldn't you do it? Why wouldn't you do it? Yep. And it just feels like a really good deal. It's a win-win.

It is a win-win. What else, Alex? All right, a couple of things. Also, you can make a general gift to undo medical debt, even if you don't do it in your community, right? People can make a general gift to you guys and you use it as best as you see fit. Is there other types of debt that people should consider doing this with? Like, are there other nonprofits?

I wondered about, or actually being created that don't, you know, exist right now. I wondered about credit card debt or even. student debt. Yeah. So I don't, so I'm not an expert on other kinds of debt. I mean, I've become an expert through this role on medical debt. I do think that medical debt is likely different than other kinds of debt. I think it would, you probably wouldn't get the same return on investment because there is this disconnect with medical debt with what people have and what they're expected to pay. You don't have the same kind of disconnect with like mortgages, for example, we used to. Well, it's also, it's also in large part. Getting.

It's not a decision you made. Yes, that's right. Going to school is a decision. Or buying an extra TV or getting a TV on your credit is a decision you made. Getting sick is, right. One, we're all going to do it. And two, it's not a decision you made. So you find yourself in a position that you didn't ask for or do anything to deserve.

That's right. I mean, look, I've heard arguments like, well, that person decided to be overweight or smoke or, but honestly, that's such a minority of what we're talking about. We're human beings. We're going to get sick. We're going to get an accident. Things are going to happen. And we deserve to get care.

And what you said really did hit home with me is the children. I mean, and you're right. If your kid's sick. You're doing anything you have to. What are you going to do? Yep. Say no. No.

Can't afford it. Take everything I have to get my said. Yep. My stomach's been hurting for two weeks. You're going to say tough it out. Right. No, you're not. You're not.

Right. But that very thing may get you right into this position. Yep. One more thing. Yes. Brag about your largest deal to date. Oh, yes. Okay. We actually bought a for-profit debt buyer out of business and bought $30 billion of medical debt in one sitting. Slow down. There's a for-profit medical debt people. Yes.

And you bought their company? We bought all their debt and they went out of business. Yes. Okay. How much you pay for it? I don't think we're allowed to say how much we paid for it. Yeah. But I will say it was better than our business. normal. We negotiated down. It was really pennies on the dollar. And we had them donate all the debts that were in that portfolio that were seven years and older. So that was all, so a lot of it was donated. Plus, we've got even deeper discounts on the stuff that was seven years and younger.

All right. But with that, you got rid of. 30 billion dollars of medical debt was what we bought. 30 billion. And that's spread across the country. Exactly. But, you know, it's concentrated in in certain places, Florida was one of them, Oklahoma, Georgia, a lot of the southern states, unfortunately, because they didn't expand Medicaid, and that ended up being that they have more medical debt. That makes sense. Yeah. But that's why we're there to pick up those pieces and that we have that $30 billion of medical debt that we were able to buy and eradicate.

Yeah, that was a really sort of big moment for our organization because it was a risk for us. Like we were like, okay, can we come up with this money? Can we? Because we sort of had to like, we actually went on a payment plan, if you will, with them to. Like, well, they went out of business and we bought it on paper, but we agreed to pay them over time. And we knew we had to like fundraise behind that after putting ourselves on the hook for it. But we felt really like this was an opportunity we had to take. And, you know, we talked to our board. We did as much math as we could in projecting. And we took the risk. And yeah, we've been doing great. When did you buy? About a year ago, yeah. And have you, had you already retired in a year of the $30 billion? No, we're still working on some of it, but we've retired a lot of it, yes. That's unbelievable. Yeah, yeah, it's very exciting.

And you're still raising, I guess, to continue to pay for it. Yes, we're still raising for some of it, yes. And obviously we're an army of normal folks. We mostly talk about normal folk stuff, but things like this, if you're a large philanthropist, like McKenzie Scott. Yes. I did partner with you guys. I mean, that's like a $100 million. I don't know how much you gave,

but I'm just using that as an example. For large donors out there, it is a great way to deploy $100 million to do tens of billions of dollars worth of good. I mean, your money scales immediately. Yep. No, we do. We have both,

what I love about our work and our model is it brings together, you talked about governments before. It brings together churches. It brings together, you know, medical students who want to put together campaign. And it brings together people who have a lot more, you know, on the other side of that K economy,

that actually want to do something good with their dollars. So we've been able to leverage all of that towards this problem. I genuinely think this is a thing that our service clubs ought to consider taken up. I mean, it could be directly in your community, and you don't have to do anything except raise the money and call. And any listener who just feels motivated to do this in their community, too, service club or not. I do want to ask one more thing before you close off. Sure.

What's next? Just keep scaling? It's a good question. We're just actually finishing up a strategic plan. So we haven't announced what our goals are going to be exactly in that. But it's a lot to do with scaling, but also trying to leverage the stories and the work that we're doing to push for larger changes. Like states can do a lot to protect people from medical debt. We've seen an uptick in some of the policies, things like making sure you can't put it on someone's credit. making sure you can't take someone's home. And again, these issues are bipartisan.

They're across the country. You've seen bipartisan bills get passed in places like Ohio. Texas has some great laws in place, along with places like New York, we're very different. So we're really trying to see if we can get more and more things in place to protect people from medical debts through the storytelling that we're doing and the scaling. Love it. Allison, thanks for coming to Memphis.

Thanks for telling your story. most importantly, thanks for the incredible work that you do with undue medical debt. And we're going to keep an eye on you. And I hope that an army of normal folks is more than just a podcast for you, that some of our people get involved with you. Because I think this is a very actionable thing. So maybe it's a beginning of a fruitful relationship. Yeah. Thank you, Robin, for bringing us to your attention.

Yeah. Right? Great. You're awesome. Do you know, Robin? No, no, no. I mean, my team told me about her, yeah. But I do know about their campaign, and it's great. Yeah, thanks, Robin, for emailing us about your church. She also gets free merch, and she got a guest on the podcast.

Yeah, and Alex is going to send you some free merch, so send us an email and tell us your sizes, and Alex, it'll get you some stuff. Cool. All right, Allison, thank you so much. Thank you so much. And thank you for joining us this week. If Allison Sesso has inspired you in general or better yet to take action by sharing this episode to raise awareness about the problem of medical debt and her nonprofit's awesome solution donating to undo medical debt or starting a campaign with them to erase medical debt in your community, let me know. I'd love to hear about it. You can write me anytime at bill at normalfolks.org. and I promise I will respond.

If you enjoyed this episode, share with friends and on social, subscribe to the podcast, wherever you're watching or listening to it. Rate it, review it. Join the army at normalfokes.us. Join or start one of our local service clubs. Take the 10-level challenge and buy our merch. All of these things that will help us grow, an army of normal folks. I'm Bill Courtney.

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