The United States of Debt

Why Americans Are Drowning in Medical Debt

The United States of Debt looks at surprise medical bills, rising health care costs, and why a clean bill of health is so costly.

hospital bills usod 4.
Why is going to the doctor such an expensive proposition for so many people?

Fanatic Studio/Thinkstock

This article supplements the United States of Debt, our third Slate Academy. Please join Slate’s Helaine Olen as she explores the reality of owing money in America. To learn more and to enroll, visit

Your health may be your most valuable asset, but for many Americans, it comes at a huge cost. Medical bills are the No. 1 cause of bankruptcy in the United States.

In the fourth episode of the United States of Debt, a Slate Academy, host Helaine Olen dives into the piles of bills surrounding America’s health care system. Why is going to the doctor such an expensive proposition for so many people? Has the Affordable Care Act changed any of that? And is there a realistic way to avoid surprise medical bills?


Lastly, learn why even health insurance won’t keep you from going into medical bankruptcy.

To join this Slate Academy and hear future episodes, chat in our private Facebook group, and read supplementary materials, visit

  • Leigh, 64, is a computer consultant from New Jersey. Leigh’s survived several heart attacks, a quintuple bypass, and has had to deal with out-of-pocket medical bills of up to $17,000.
  • Mayleen, 46, lives with her husband and two small children in Sacramento, California. Following an emergency surgery for her husband and health complications with her children, Mayleen’s family racked up $10,000 in medical bills.
  • Ester, 34, is a New York–based journalist who wrote about her battle with medical bills during her “Obamacare” pregnancy. Ester, who was worried about her deductible cost, decided to forgo an epidural when she went into labor with her second child—just to avoid higher medical bills.

Our guest experts on Episode 4 include Trudy Lieberman, a consumer affairs reporter and longtime expert on health care and medical insurance, and professor Joseph Cohen from Queens College at the City University of New York.

Read the transcript of Episode 4.