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This week’s episode of the “First Opinion Podcast” explores the issue of medical debt, which burdens as many as 40% of U.S. adults. They collectively owe more than a whopping $200 billion.

Private organizations, philanthropies, and even state and federal governments have established various debt relief programs to tackle the problem. Such programs make intuitive sense, and have a “feel good” factor to them. But they may not work and, in some cases, could even harm the mental health of some individuals on the receiving end.

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That’s the surprising takeaway from a study that Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, wrote about in a First Opinion essay and talked about with STAT’s Pat Skerrett on the podcast. They were joined by Allison Sesso, the CEO of Undue Medical Debt, a national nonprofit organization that helped sponsor the study.

“Medical debt is extremely stressful for the people facing it. One of the really awful things about it is that, unlike other kinds of debt, it makes people unwilling to seek other medical care they need.”

“The system is setting up people for failure,” Sesso said. “And I don’t love the idea of trying to go down this road of consumerism, as if you can decide, ‘What might be a better cost of a colonoscopy for me?'”

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