North Carolina Man’s Medical Debt Illustrates A National Crisis For Black People

According to Dr. Rishi Manchanda, a former board member of the nonprofit organization RIP Medical Debt, 'Debt is no longer just a bug in our system. It is one of the main products.'

Terry Belk, a Black former car salesman who lives in Charlotte, North Carolina, says that his medical debts are like an albatross around his neck, a sentiment many people in America would likely agree with. After his wife died of breast cancer in 2012, Belk was left with a mountain of medical bills, which were further compounded by his prostate cancer diagnosis and treatment.

According to NBC News, Atrium Health, a nonprofit hospital that treated Sandra, Belk’s late wife, aggressively pursued the debts owed by the pair. This resulted in Terry signing a deed of trust, which entitled the hospital to $23,000 when he sold his home, which would settle his debts with the hospital.

However, the hospital did not stop trying to collect money from Belk. In 2022, the hospital sued him for $6,000, which he owed for his prostate cancer treatments. Belk told the outlet that he knew he couldn’t win in a court battle, so he agreed to pay off the debt, which ballooned to $8,000 after interest was accounted for.

Belk told NBC News that he felt trapped. “We weren’t trying to abscond from the bills,” he said. “I wanted to pay, but I couldn’t. I’ve been battling this for over 20 years,” the 68-year-old Belk said. “This has been like an albatross around my neck, like an anvil I’m dragging around every day.”

Belk continued, driving home the point that medical debt is a national crisis. “This is a national problem; people are getting millions and millions of these bills. They are making peoples’ lives hell. I’ll probably be paying this into the afterlife.”

According to Berneta Hayes, senior attorney at the National Consumer Law Center, Medical debt is a “problem that is uniquely American. Even if you have insurance, if you have chronic health conditions that require you to interface more often with the healthcare system, you are putting yourself at greater risk for medical debt every single time you make” appointments.

It is such a uniquely American problem that it has received major attention this election cycle and in other political news.

According to The Hill, Sen. Bernie Sanders and other senators are attempting to hold Steward Health CEO Ralph de la Torre in contempt after he failed to attend a hearing on how he made millions of dollars while the hospital system his company managed failed.

On the campaign trail, Vice President Kamala Harris has proposed the forgiveness of $220 billion in medical debt held by approximately 15 million Americans. According to CNBC, in her economic plan, released by her campaign in August, the vice president wants to do more than relieve Americans of their debt. The campaign wants “to help them avoid accumulating such debt in the future because no one should go bankrupt just because they had the misfortune of becoming sick or hurt,” according to their platform.

According to Dr. Rishi Manchanda, a former board member of the nonprofit organization RIP Medical Debt, “Debt is no longer just a bug in our system. It is one of the main products,” Dr. Manchanda told NPR. “We have a healthcare system almost perfectly designed to create debt.”

Alan Cohen, a co-founder of insurer Centivo and a health benefits worker for more than 30 years, agrees with Dr. Manchanda, saying that there is only one reason people end up in medical debt. The costs of healthcare in America are simply more than they can afford. As NPR reported, the problem of medical debt is also more pronounced among Black and other people of color and in the South, where state governments have failed to expand Medicare and Medicaid.

“The No. 1 reason, and the No. 2, 3, and 4 reasons, that people go into medical debt is they don’t have the money. It’s not complicated,” Cohen said.

The focus of the Harris campaign is also in line with voters’ views, according to a May poll jointly conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research, which surveyed 1,309 adults.

According to the poll’s results, 51% of adults indicated that it was very important to them that the federal government forgive medical debt, while 39% felt the same about student loan forgiveness.

In North Carolina, Gov. Roy Cooper announced that nearly 100 hospitals had signed on to the state’s Medical Debt Relief Incentive Program, which incentivizes hospitals who participate in eliminating $4 billion in medical debt for approximately 2 million low and middle-income North Carolina residents. According to NBC News, Vice President Harris closely coordinated Cooper’s plan and helped announce it.

According to Ciara Zachary, an assistant professor in the Department of Health Policy and Management at the University of North Carolina’s Gillings School of Public Health, the program has the potential to become a national initiative.

“It could be like an expansion, where states can adopt it, or there could be some kind of big, sweeping legislation,” Zachary said. “I think maybe a Harris administration could also just continue to incentivize and promote these efforts.”

Zachary continued, comparing potential pushback of the North Carolina plan to the criticism Barack Obama’s Affordable Care Act received. “There are going to be states that are going be like, ‘This is great, we want to be progressive. And then there might be a couple more traditionally or historically red states that might not be early adopters but recognize that they have hospitals at risk of closing.”