Dr. Somava Saha, Founder and CEO of We in the World, opened this session with the scale of a crisis: over the last ten years, healthcare has gone from causing half of all U.S. bankruptcies to two-thirds of them. Thirty-eight percent of people are now delaying care — including cancer patients, 95% of whom are insured, who are still delaying treatment out of fear of the bill. “No one can afford this anymore,” she said. Her frame for the day was three pillars for becoming a better ancestor in healthcare — care, civic life, and community — and she brought in three people building each one, in real places, right now.
The care pillar came from Jasmine Hutchinson, Director of Community Benefits at Loma Linda University Health in California. She described what her team found when they started mapping their own hospital’s billing data, warning that “hospital billing practices can harm patients, exacerbate poverty, and fuel homelessness.” The numbers backed her up: Loma Linda had sent nearly seven times more to debt collection than it gave out in charity care, with five zip codes — most among the poorest in California — accounting for nearly 20% of that debt. Her read on it was direct: “Most people in this zip code do not pay medical debt. Most people in this zip code should qualify for Medicaid or charity care. And the bottom line is, we aren’t getting money as well, and we’re causing great harm.” In response, Loma Linda built a cross-functional Charity Care Task Force and added presumptive eligibility tools — and last year cut nearly $300 million from patient accounts, with little to no negative financial impact on the health system.
From there, the conversation moved from one hospital’s numbers to a whole county’s. Melina Boudov, from the Healthcare Consumer Protection Unit at LA County’s Department of Public Health, put the civic life pillar plainly: “Medical debt is a structural failure, and it is a policy choice.” Her department built the Los Angeles Medical Debt Coalition, a partnership of over 45 organizations, and passed a reporting ordinance now covering almost two-thirds of the county’s 100 acute care hospitals. The result so far: “more than $400 million in medical debt has been relieved for over 200,000 households in LA County in the last year and a half.”
That same civic-life work scales up nationally through Eva Stahl, Vice President of Policy Engagement and Research at Undue Medical Debt. Her organization has abolished over $40 billion in medical debt for more than 27 million households by purchasing debt in bulk for pennies on the dollar. Her challenge to hospitals cut right to the point: “why do you income verify people twice?” — patients already verified for Medicaid or SNAP, she argued, shouldn’t have to prove their need all over again just to get help with a bill.
The session closed on the community pillar, with Andrew Martin describing Hope Village, a permanent supportive housing project he’s building in Champaign-Urbana, Illinois. His opening image made the stakes concrete: “Imagine that you are discharged from a hospital today… But now imagine you have nowhere to sleep tonight.” Hope Village pairs 24 trauma-informed homes — designed with the University of Illinois’s civil engineering department and built on their own power grid so residents relying on oxygen or other life-saving equipment never lose power — with six more single-family homes built in partnership with Habitat for Humanity, housing 30 families in total. Getting there required working through real resistance in the community itself, something Martin described with unusual honesty: “We can be our own worst enemy. We can be our own gatekeeper.” He closed with the line that tied the whole session together: “Health equity isn’t achieved only inside the hospitals or in clinics. Sometimes it begins with something much more simple. It’s a key. It’s a safe home… when healthcare, housing, and the community come together, hope truly becomes home.”
