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Health Advocacy reviews Ashton and Goff book: The Patient, The Doctor and The Bill Collector.

Houston Health Advocacy

Bonnie Sheeren,
Independent Patient Advocate.

HOUSTON — As an independent patient advocate, I field phone calls and emails from upset, frustrated people who don’t understand their high medical bills that include incomprehensible explanations for the care they received. I deal mainly with people here in the Houston area and I network with my patient advocate colleagues around the country—and all of us have been grappling with a dysfunctional system that doesn’t seem to work very well for patients or doctors.

We needed something to connect these dots into a bigger picture—and this book is it. In their book “The Patient, the Doctor and the Bill Collector”, Robert Goff and Jerry Ashton use the metaphor of the Scarecrow and the Tin Man—the struggle between head and heart.

The head part? Our health care system has to be financially sustainable. If hospitals or ERs close due to money problems or doctors leave the profession due to the same reason—the very people and facilities that we expect will be there to save the lives of our loved ones might be gone. And if these are gone—the “Golden Hour” when the most critical medical care needs have to be delivered to save lives might come and go with no one to help us.

The heart part? It seems like not a day goes by that I don’t see a “Go Fund Me” page posted for medical costs with sad stories about people losing their homes and unable to afford basic necessities—it’s heartbreaking, but it’s also not sustainable. We can’t have people depending on the kindness of strangers instead of being able to have the dignity of finding some way to pay their own medical bills.

This books calls for our country, our society to have a long, hard conversation about our health care “system” (and as Robert Goff writes in one of his chapters—it’s a stretch to call it a coherent system).

No one likes to think about getting sick or having a terrible accident—but if we don’t think about this and have this discussion, we stand to lose our health care facilities on which we depend on for our care or being incapacitated by debt for the rest of our lives. For a productive society to go forward, this is no way to proceed.

Buy this book. Read it carefully. Then, take action.

Republished with gratitude to
Houston Health Advocacy
(July 28, 2016)

By | 2017-04-10T08:26:09+00:00 July 29th, 2016|Comments Off on Health Advocacy reviews Ashton and Goff book: The Patient, The Doctor and The Bill Collector.

The Miracle of Medical Debt Forgiveness on HBO’s Last Week Tonight with John Oliver

Click to see 4-minute clip featuring RIP, posted with permission from Last Week Tonight.


HBO 20-minute “Debt Buyers” segment on Last Week Tonight, originating June 5, 2016. 

by Robert Goff,
RIP Board of Directors.

Medical debt pursuit, or more precisely, the endless harassment of patients unable to pay their bills (as opposed to unwilling), has gained increasing prominence as a major social issue.

Among the more egregious practices in the collections industry is the sale of old medical debt – for pennies on the dollar – to bill collectors who will then aggressively pursue this debt at full face value for an additional two to 10 more destructive years. This happens regardless of the personal circumstances of people who clearly are still struggling with the economic consequences of illness and accidents.

Jerry Ashton and I explore this practice in our book, The Patient, The Doctor, and the Bill Collector. In one chapter, we discuss how our RIP Medical Debt charity, inspired by the debt abolishment work pioneered by the “Rolling Jubilee” of Occupy Wall Street, was created to focus specifically on locating medical debt portfolios, buying them, and then forgiving every last penny.

We know that we are not alone in our concern for those needing medical care but unable to pay the resultant bill. Many people are left with financial stress that endures longer than the physical harm done by an illness or accident. We also know it’s been difficult to raise national awareness of the medical debt crisis.

Thanks to a June 5 airing of the HBO comedy series, Last Week Tonight Show with John Oliver, far more of us now are privy to this collection industry practice, and the debt treadmill it creates. In a painfully hilarious piece at the end of the show, John Oliver triumphantly out-Oprah’s Oprah in giving away valuable gifts.

Oprah Winfrey in 2004 set a record for any TV show by giving away about $7 million worth of GM cars to everybody in her audience. John Oliver in 2016 gave away forgiveness of nearly $15 million worth of medical debt for about 9,000 people — a new record.

Oliver and his LWT staff investigated the debt buying industry, and then registered a debt-buying company in Mississippi for $50, calling it Central Asset Recovery Professionals (CARP, like the bottom-feeding fish). They located and bought for about $60,000 a medical debt portfolio worth $14.9 million, which  they donated to the RIP Medical Debt charity. John Oliver then had the debt forgiven by RIP with great fanfare before his live studio audience with millions of viewers. Almost $15 million in medical debt. Abolished. Poof!

Craig Antico, Jerry Ashton and I deeply appreciate the issue of medical debt gaining national attention. We are grateful for an opportunity to be involved with a comedian who wanted to give 9,000 people the last laugh.

Gratifying, and so very funny.

By | 2017-04-10T08:26:09+00:00 June 5th, 2016|86 Comments

Memorial Day Needs to be Every Day

by Jerry Ashton,
RP Cofounder and EVP.

Memorial Day Needs to be Every Day Where Veteran Medical Debt is Concerned.

This blog post appears on that usual, anticipated and important point on the calendar where Americans are expected to pause, reflect on our liberties and show gratitude to the service men and women who made the ultimate sacrifice to ensure our freedoms.

I would like to say that Memorial Day should take place every day, but it does not.

Memorial Day was officially set aside by Congress in 1968 as the last Monday in May. There is even a specific hour, 3 o’clock local time, where Americans are asked to participate in a national moment of remembrance.

Once a year. One particular hour. And then life goes on. and the flags are put away.

When we launched RIP Medical Debt over a year ago, it was – and still is – our intention to turn the nation’s focus to veterans’ debt. The veterans alive today did not pay that ultimate one-time price, but they live with visible and invisible wounds. They carry a burden that should not be theirs to carry –the burden of unpaid and unpayable personal medical debt.

We know it comes as a surprise to many people that veteran medical debt even exists. We have been led to believe, or improperly assumed, that all of the medical costs of our armed forces and their families, both during and after enlistment, are covered by the general government in return for their unselfish service to our country. That’s not the reality.

I won’t go into all the details here (search the web for “veterans medical debt”). What I can do here is offer two useful links:

I am compelled to draw your attention to the emotional and economic pain inflicted by the unpaid and unpayable medical bills. They pile up alongside other unpaid and unopened dunning notes on the kitchen table of way too many veterans and their families. We conjecture that financial stress is likely one more factor contributing to the scourge of veteran suicides.

We all know the horror stories of long waits for veterans to get medical help. The 2015 Clay Hunt Suicide Prevention for American Veterans Act was passed by Congress – unanimously – in response to securing mental health care and suicide prevention programs.

A good thing but it doesn’t cover the unexpected illness or accident that vexes us in life. What about the vets who do not live near VA hospitals, who must seek help from local hospitals and physicians with only a promise they will be reimbursed? Do you know how often that promise is kept, and under what onerous conditions?

Do you know how many veterans suffer from unpaid and unpayable medical debt? In our view, one is too many; the actual numbers aren’t to be found on government websites.

However, we know these people. hey contact us at RIP. We receive emails from them. They are referred to us by their friends and family and other concerned veterans. They are a major reason why RIP Medical Debt exists, and why in particular our military program directs contributions to them.

Contributions to abolish ventral medical debt need to come from you.

So, this memorial Day and every day, c0onsider showing your appreciation to our military members in a different fashion. Remember and honor the dead, certainly, yet also attend to the living, especially those with a burden we can remove.

It’s amazing what pennies and dollars can do. For every $1,400 RIP receives, we can purchase as much as $100,000 in unpaid veteran medical debt and abolish it. Futher, $14,500 will help us buy – and forgive – one million dollars in such debt. That abolished debt that will never reach the desk of a bill collector, or appear on another credit report.

That’s what you help us do: Abolish medical debt. For good.

By | 2017-04-10T08:26:09+00:00 May 29th, 2016|1 Comment

The “Robin Hoods” of the Collections Industry?

Credit Professionals Recruiter.

Interview with Jerry Ashton

Jerry Ashton (left) and Youri Pinard.

How the collection industry finishes off the poor American citizen who survived his hospital stay but is crumbling under debt. How can you liberate this same citizen of thousands of dollars of debt with a $100 donation to the RIP Medical Debt charity.

July 7, 2015. During an interview with Jerry Ashton in a small cafe in Union Square, Manhattan, I ask him about his underlying motives. Why he, a veteran of the collection industry, has jumped over the fence? “How about doing Good?”, he says with a grin.The game of the ones he call the bottom feeders (debt buyers) greatly upsets him and he knows how to shake things up.

Jerry Ashton is also a blogger for Huffington Post. He found his inspiration while covering the Occupy Wall Street movement. A citizen’s initiative named the Rolling Jubilee wanted to attract the attention to the inequity of a system that pushes people towards over-indebtedness in order to receive health care.

The Jubilee’s intention was to collect $50,000 during a social fundraiser to buy 1 million$ of debts and then abolish them without any obligation to the debtors: a message to send to the world of finance and to the politicians.

In this context, they were submerged with contributions, collecting 14 times the goal they were hoping to get, allowing them to abolish 20 millions$ in medical debts. Since then, The Rolling Jubilee has turned its focus towards students debts.

But Jerry Ashton and his partner, Craig Antico, wanted to get back on the horse and create a permanent movement with the ambitious goal of collecting 14.4 millions$ that would allow to abolish 1 billion$ in medical debts, eliminating these debts for 300,000 families.

The mission of RIP Medical Debt is simple, but makes you think. I see it as a form of civil disobedience in an era where the powers against which we have to stand our ground are not really the States, who aren’t the rulers of the world anymore, but the world of finance and its tenets.

In order to understand its scope, we have to put the medical debts in their American socio-economic context where health care costs are prohibitive. It is also useful to put yourself successively in the shoes of the creditors and the debtor. Only through this way can we understand how an opportunistic industry transformed a flaw in our society in a golden business opportunity at the expense of a significant part of the population.

Losing it all because of your health: “How many people do you know in Quebec have lost all their savings and their house because they survived an illness?” Ashton asks me. None.

Another universe that looks like Middle Ages or a third world country: in the United States, the risk of chronic over-indebtedness after an unexpected medical issue threatens an important part of the population. Even people that have an expensive insurance policy sometimes end up unable to pay for their care after a serious illness.

According to Jerry Ashton, one in three families is facing astronomical medical debts, 60{b012322ca4ba671ae115bddef22028f597002cf42e357db3776b36dcfab84db9} of bankruptcies are linked to health care related debts, a type of debt that represents 50{b012322ca4ba671ae115bddef22028f597002cf42e357db3776b36dcfab84db9} of the portfolio of collection agencies.

Creditors that don’t forgive anymore
Credit professionals will tell you that the provider of goods or services is responsible to enquire the buyer’s ability to pay before giving him credit. If the creditor advances credit to insolvent people, he has to prepare for writing off parts of his accounts receivable and generally considers this the cost of making business, and that doesn’t prevent him from making profits.

After some collection effort entrusted, without success, to some professionals, they will forget the debt and life will go on. This is what any reasonable person would do, right?

No. Because by selling their accounts receivables to the collection industry for almost nothing, they renounce to their right to forgive. They pass on the Damocles sword to an industry whose mission is to exclude forgiveness, and to bet on the fact that if the debt is worth nothing for the creditor, it is worth gold for the person who is willing to enforce payment from the debtor.

The collection industry has inserted itself between the physician and the patient by taking away the write off and the forgiveness.

A social issue pushed back to the private sector.

Too confident in its tenets, the American society wasn’t able to provide access to health services to its citizens, letting the market take control of what other nations have decided to oversee.

A Canadian credit and collections professional, Youri Pinard wrote this blog about Jerry Ashton, cofounder and EVP of RIP Medical Debt This social problem was presented as a private problem: What to do with the people who can’t afford to pay? Help us with your compassion. Read Youri’s full piece at: http://bit.ly/1HQHyDc


By | 2017-04-10T08:26:09+00:00 December 15th, 2015|1 Comment

No Vet Medical Debt – Period!

by Jerry Ashton,
RIP Cofounder and EVP.


Our Veterans, who’ve served our nation and are serving it now, should be freed from the burden of their unpaid – and unpayable – medical debt. Here on Veteran’s Day, we urgently need a national campaign to abolish veterans’ medical debt.

May people are surprised to learn that veteran medical debt even exists. We have been led to believe, or perhaps improperly assumed, that all of the medical costs for our armed forces and their families, both during and after enlistment, are paid by the government in return for veterans’ unselfish service to our country.

Not exactly.

Quite frankly, the military has a difficult enough time taking care of those on active duty, much less those who’e been honorably discharged. What’s missing is a nationwide awareness about the state of veterans affairs in America. If we cannot understand the problem, we can hardly come up with solutions. We intend at RIP to create and expand that needed dialogue. Where you come in?

According to Military.com, Congress passed the Veteran’s Health Care Eligibility Reform Act of 1996 to enable the creation of a Medical Benefits Package to be provided to an “enrolled veteran.” Here is a sampling of what is promised:

  1. Outpatient medical.
  2. Inpatient hospital.
  3. Prescription drugs.
  4. Emergency care in VA facilities.
  5. Care provided by hospital emergency care or department will be covered.
  6. The veteran is covered “who has no other contractual or legal recourse against a third party that will pay all or part of the bill.”

These and other benefit are provided only IF: “You are enrolled in the VA health care system or been provided care by a VA health care provider within the last 24 months.”

We do not presume the expertise  at RIP to offer an educated opinion on whether what’s delivered is as good as what’s promised. We do feel it’s our responsibility to invite our readers to report on any shortfalls, and to help come up with answers. In collaboration, there is a greater likelihood that clarity will be achieved and viable solutions will be formulated.

Complaints and Questions

They abound. In my research, I found the following postings by two veterans:

Vet One: “It’s most disturbing that as Vets, we aren’t entitled to full coverage; for Dental, Eye, and especially Mental Health. We gave up plenty to serve, and the suits in D.C. don’t seem to get it.”

Vet Two: “I was in the USMC, active duty, from 1970 to 1974. I received my honorable discharge on Jan 19, 1976. My question is, is there a program to help veterans with their medical costs? I no longer work and am on disability due to heart failure and diabetic neuropathy in my legs, feet and hands. I am going broke due to medicine expenses, hospital bills and doctor bills…. I was just asking if there is any veteran benefits that could help me with my medical expenses.”

The VA Medical Care Hardship Program

The VA does offer the Medical Care Hardship Program, focused on helping people to pay off their medical bills and healthcare expenses. However, the hoops that need to be jumped through – proving a deteriorating financial situation, losing a job, etc. – are intrusive and time-consuming.

Those enrolled in the program (and I could use an explanation of the exact qualifications for enrollment) are given a “repayment plan” option, if they are having trouble meeting a co-pay on an account. A repayment plan is helpful and welcome, I’m sure. For those unable to repay anything, this VA program merely adds yet another monthly bill onto a stack of others. Shouldn’t we be making that pile smaller?

In some cases, the VA offers debt relief in the form of compromises, so the medical debt can be settled for less than the amount owed. The VA also can decide to waive or eliminate a veteran’s existing health-care debt – if that vet has experienced a job loss, if a salary or income has decreased, or if other expenses have increased.

Debt relief from the VA may be no relief at all, however because the forgiven debt may be counted as taxable income by the Internal Revenue Service, pushing the veteran into a significantly higher income tax bracket – and for money that never actually existed in the veteran’s pocket. The supposed debt relief instead produces just one more bill to be paid!

Is this VA hardship program the best America can do as a nation? Is this the best way for American keep its promise to our warriors?

We think not. RIP Medical Debt is showing what’s possible for veterans any one one with unpaid or unable medical debt. Because RIP is a tax-deductible 501(c)(3) charity, those whose medical debts we can forgive are off the hook. That debt are abolished. Gone for good.


By | 2017-04-10T08:26:09+00:00 November 11th, 2015|Comments Off on No Vet Medical Debt – Period!

Publishing Announcement

The Patient, The Doctor
and The Bill Collector

NEW YORK — RIP Co-Founder Jerry Ashton and Board member Robert Goff have co-authored a medical debt survival guide, a timely critique that only “insiders with an edge” could have put together.

Is the book needed? Almost 43 million Americans have unpaid debt today. Medical debt is cited in more than 60 percent of all personal bankruptcies. One in 10 of the 12.5 million non-elderly veterans report having neither health insurance nor Veterans Affairs’ health care.

The Patient, The Doctor and the Bill Collector. A Medical Debt Survival Guide (PDBC) cuts cleanly through the Gordian Knot of industry rules and shortcomings, laying bare the insidious influence of special interests that do not have the patients’ economics in mind. The big picture is not pretty, but it needs to be known, so we can make better decisions — individually and as a nation.

To learn more about the book, click here.

By | 2017-04-10T08:26:09+00:00 November 9th, 2015|1 Comment

Former Debt Collectors Decided to Ditch the Industry, Buy Up Medical Debt, and Forgive It

CBS New York

Seen At 11: A Phone Call From Collectors That Can Actually Get You OUT Of Debt. As CBS2 Found Out, What RIP Medical Debt Offers Is Too Good And Very True.

Jerry Ashton and Craig Antico spent decades hounding debtors to pay their bills—until an offshoot of Occupy Wall Street inspired them to find a way to pay struggling people’s debts. 

Jerry Ashton and Craig Antico

When Paola Gonzalez received a phone call from RIP Medical Debt, she was certain what she heard was a mistake. A prank, maybe. The caller said a $950 hospital bill had been paid for in full: It would not affect her credit and she wouldn’t have to worry about it again. “They wanted to pay a bill for me,” she said. “I was just speechless.”

The 24-year-old student from Roselle Park, New Jersey, has lupus, a chronic autoimmune disease that in 2011 put her in and out of hospitals for a year. Even with insurance she faces a barrage of medical bills that often get pushed aside. “I can’t always work,” Gonzalez said. “I’ll be fine today and sick tomorrow. It’s really amazing that people would help out like this.”

CBS New York 
“Seen at II”
July 17, 2016

By | 2017-04-10T08:26:09+00:00 September 21st, 2015|Comments Off on Former Debt Collectors Decided to Ditch the Industry, Buy Up Medical Debt, and Forgive It

How to Look at the Numbers When Donating to a Worthy Cause for The Greatest Good

by Jerry Ashton,
Cofounder and EVP,
RIP Medical Debt.

The Atlantic in June 2015 published a terrific article by Derek Thompson, “The Greatest Good.” He posed an intriguing question. When you donate, can you do so effectively and not just emotionally? Can it be “munificence matched with math?”

RIP Medical Debt Greatest Good

When faced with multiple and conflicting requests for a contribution to a cause, you might pose the same question as the article’s author, Derek Thompson: “What is the best charitable cause in the world, and was it crazy to think I could find it?”

Thompson’s answer for the optimum choice? “One can make an astonishing difference in the world with a pinch of logic and dash of math.”

What didn’t meet that test for Thompson was donating money to Yale or Harvard. They already have endowments in the billions. Derek felt the wisest question is not “What is the greatest good?” but rather “What is the greatest good where the next dollar could have the greatest impact?

What did meet that rigorous test, for him, are monies directed to the Against Malaria Foundation that help them stop malaria – the biggest killer of children and pregnant women in the world. Every penny given is returned hundreds-fold in saved lives and people returning to productive work.

Why are we telling you this?

We want you to consider the math when you consider how to get the biggest “bang” for your donated buck.

On a worldwide basis, for Derek Thompson, the clear choice is the Against Malaria Foundation. What about the in the USA?

We face no urgent medical scourge here like malaria, at least, not in the immediately life-threatening sense. The urgent unmet need we find here is the very real and for many desperate peril of unpaid – and unpayable – medical debt.

Are you aware that one in five families struggles to pay medical bills? Are you aware that $100 billion annually is accounted as lost revenue by U.S. hospitals and doctors, that uncollected debt jeopardizes those ventures’s viability? Are you aware that medical bills are involved in 60 percent of all bankruptcies, even those with health insurance? Are you aware that fully 50 percent of all collection agency activity is devoted to medical debt?

For those who want to keep their donations within our borders and still reap the benefit of multiplied effectiveness, the best bang for the buck is abolishing medical debt.

Founded in 2014 as a 501(c)(3) non-profit, RIP Medical Debt promises a gratifying “multiple factor” in answering the problem of taking unpaid and unpayable medical debt off the kitchen tables of our fellow citizens, friends and neighbors.

The “ROI” is impressive – a return on investment of almost 99 to 1.

That’s right. A $50 donation can help RIP Medical Debt buy – and abolish – some $5,000 in a family’s unpaid doctor bills. A campaign war chest of $14.4 million could actually see this non-profit extinguish of One Billion Dollars in medical debt.

In the spirit of Independence Day, it’s time to declare America’s independence from unpaid medical debt. A good starting goal will be to raise 177.6 thousand dollars and abolish $17.76 million of this debt.

That’s our goal in the July 4th campaign. It’s a worthy goal, both symbolically and realistically, for $17.76 million in debt relief will remove the financial suffering of some 6,000 individuals and families.

Derek Thompson did his best to find the best way to do the greatest good on this globe, and he succeeded. Might the same be true for you when it comes to making a difference here in the 50 states and territories?

Please donate to RIP Medical Debt by giving what you can, for the satisfaction of seeing the positive impact of a penny on the dollar to benefit the families that this campaign will unburden. The value of relieving someone of the financial and emotional pain is not just quantifiable, it’s immeasurable.

It’s not just looking at the numbers; it’s looking into the soul.

By | 2017-04-10T08:26:09+00:00 July 1st, 2015|1 Comment