LOS ANGELES — Every Tuesday, Naman Shah sees tuberculosis patients at a small public clinic in Los Angeles' San Fernando Valley. Shah, a physician and epidemiologist at the Los Angeles County Department of Public Health, pores over images of battered lungs, listens to labored breathing and checks medications. For stories on the science of healthy living, subscribe to NPR's Health newsletter.
It's part of an initiative dating to the early 20th century to control infections so tuberculosis doesn't spread. "We like doing things upstream," Shah said, "meaning before they happen, not after the damage is done." Today, Shah and his colleagues are applying the same principle to medical debt. A key part of that effort is a new system to allow every hospital in LA County to easily screen patients for financial aid.
The goal: to stop low-income families from getting a bill that buries them in debt. Shah estimates this system could prevent several hundred million dollars of medical debt every year. In the U.S., an estimated 100 million adults have some form of healthcare debt.
In LA County, the nation's most populous, public health officials calculate that about 800,000 residents have medical bills they can't pay. "The impacts of medical debt were staggering," said Shah, who used to staff a rural health clinic in India and, since 2023, has led a county initiative in LA to tackle the debt problem. "People end up with credit card debt and then a vicious cycle of high interest rates and poverty," he said.
"People forgo their prescriptions. People forgo appointments. And then you get into worse health." Hospitals typically offer financial aid to patients with low incomes.
But information about assistance is often hard for patients to get. Applying can be cumbersome. And many eligible patients never seek aid, research shows.
Extract — continue reading at the source.
