By Mahlon Meyer
Northwest Asian Weekly
With the pandemic as one of the top health concerns worldwide, the unvaccinated are more likely to face higher medical bills.
Their likelihood of being hospitalized, while varying from state to state, remained significantly higher than those vaccinated.
In Washington state, unvaccinated people between the ages of 35-64 were seven times more likely to be hospitalized with Covid-19 compared to those vaccinated, according to a Feb. 9 Department of Health report. For older adults, the likelihood was eight times higher.
“State data suggests that across age groups, unvaccinated individuals are more likely to get Covid-19 and be hospitalized because of it, compared to vaccinated individuals. Beyond health outcomes, this could create greater financial burden on unvaccinated individuals, increasing medical bills and risk of medical debt at a time when some may also be grappling with unemployment and insurance coverage,” said Dr. Josh Liao, associate professor of medicine and associate chair for Health Systems in the UW Department of Medicine.
In Los Angeles County, the contrast was even starker.
There, unvaccinated people were 23 times more likely to be hospitalized, according to a CDC report, released early on Feb. 4 and obtained by Northwest Asian Weekly.
As a result of such disparities, the vaccinated may have a greater chance of avoiding medical debt.
“We know those that are vaccinated are less likely to be hospitalized and tend to need less expensive interventions which naturally decreases their medical debt risk exposure,” said Allison Sesso, executive director of RIP Medical Debt.
For the unvaccinated, however, even if this translates into only slightly higher rates of medical debt, the effects may still be staggering. Among cases reviewed by Northwest Asian Weekly, credit ratings damaged by medical debt resulted in people failing to be able to rent apartments, get credit cards, or even qualify for government health care.
Asian Americans, who by far have been the largest segment of new Medicare enrollees in recent years, might feel themselves safe from horror stories emerging in the media of surprise medical debts due to Covid-19—and resulting ruination of credit.
But Bob Mitchell, a former marine trainer for special operations, now an attorney, has defended many Asian American and Pacific Islander (AAPI) clients. They are on the contrary more vulnerable to fraud and misrepresentation, he said.
For cultural reasons, AAPI clients may have the propensity just to pay any medical debt that comes their way, rather than challenge it, said Mitchell.
Now that many more medical debts will be coming due as the pandemic wanes, fraudulent medical charges appear also to be increasing. This will make it doubly hard on AAPI patients to respond.
“The smallest population I represent would be Asian Americans. It’s a cultural thing. They don’t like being accused of things. They would rather just pay it than get an attorney. As a different cultural group, they are more prone to just pay it, even if they didn’t owe anything,” he said.
But simply paying a surprise or fraudulent medical debt can be the beginning of trouble.
One of Mitchell’s clients, a Pacific Islander, initially agreed to go on record, but later asked for anonymity.
Despite paying three medical bills accrued during the pandemic, all the charges ended up in collections. The debt collector willfully changed the amount owed, so that even when the man paid them off, he was still technically in debt, ruining his credit record, according to a lawsuit reviewed by Northwest Asian Weekly.
Some people, unvaccinated or not, turn to alternate sources of funding to attempt to pay off steep medical debt, such as crowdfunding—setting up a site online to ask for donations.
But scholars say this approach actually entrenches ethnic and class hierarchies, and often does not solve the problem.
“Crowdfunding as an unfortunate consequence of a broken U.S. health system, the hierarchies at its core are the same as those embedded in privatized health care solutions. Indeed, it is the notion that communities and corporations should choose who gets care that is the central basis of the most marketized, neoliberal health care alternatives and a cornerstone of opposition to universal health care,” wrote Nora Kenworthy, an associate professor in the University of Washington (UW) School of Nursing and Health Studies, in a 2021 paper in Medical Anthropology Quarterly, “Like a Grinding Stone: How Crowdfunding Platforms Create, Perpetuate, and Value Health Inequities.”
In her studies, Kenworthy found that the app, GoFundMe, employs algorithms that lead viewers towards monetarily successful sites and away from less successful ones. This gives the appearance of greater success for marginalized groups than is the reality. This would also impact the unvaccinated, since the largest population of unvaccinated are the unemployed, said Kenworthy.
Between February and May 2020, 5.4 million people lost their jobs and health coverage, said Sesso, a ripple effect that is still working its way through the health care system.
When using crowdfunding apps, such as GoFundMe, those with the most affluent social networks were the ones that fared well, while those campaigns undertaken by poor and marginalized people had fewer resources to call upon—and often garnered nothing despite desperate appeals for help.
In addition, campaigns that emphasized easy and sure cures tended to receive more attention, complicating the fate of those who have such maladies as diabetes, which are more prevalent among some marginalized groups. That could also include people who are suffering as a result of being unvaccinated.
“The stories that GoFundMe had curated and put into public view reinforced a rhetoric of deservingness centered on individual, unexpected, solvable tragedy,” she wrote in another paper she co-authored last year in Social Science and Medicine, “Crowdfunding as a response to COVID-19: Increasing inequities at a time of crisis.”
Even such apparently novel approaches to tackling medical debt, such as crowdfunding, can make things worse and ingrain in marginalized groups the belief they don’t deserve care, said Kenworthy.
Mahlon can be contacted at email@example.com.
This health series is made possible by funding from the Washington State Department of Health, which has no editorial input or oversight of this content.