Your Money or Your Life

Debt’s Hidden Toll on Patients and the Path to Justice

Joe Dominguez, Vicki Robin

1992

8 Key Insights

About This Book

Discover how America’s hospitals transitioned from charitable refuge to debt-collecting machine and what that means for you. You’ll follow the arc from 19th-century doctor–patient pacts to today’s multibillion-dollar medical debt industry. Along the way, you’ll meet widows forced into indentured servitude in hospital laundries, patients jailed over $2,000 bills, and reformers who dared to challenge the status quo. This is a must-read roadmap for health workers, policymakers, and citizens ready to reclaim medicine’s promise of care, not condemnation.

About the Author

Dr. Luke Messac is an emergency physician and medical historian who has published widely on health policy, patient advocacy, and the history of American medicine. A graduate of Brown University and Harvard Medical School, he’s held faculty appointments at Brown and the University of Nevada, Las Vegas, and has testified before Congress on medical debt. When he’s not in the ER or the archives, he’s coaching his daughter’s soccer team in Providence.

Biggest Takeaway

You’ll gain: 1) A clear understanding of how policy shifts and financial markets weaponized medical debt against patients; 2) Practical strategies for navigating and reforming hospital charity-care and billing systems; 3) Awareness of your power as a health professional or voter to challenge harmful debt-collection tactics; 4) Inspiration from activists who have forced some of the largest hospitals to drop lawsuits and reform practices.

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