Good health is not something that all young people can take for granted.  Although catastrophic and chronic illnesses are less common among the 20- and 30-something crowd, Stephanie Crocker’s story is a stark reminder that no one is immune.

Many health care pundits have called uninsured people in their 20s and 30s “young immortals” — people who expect to use few medical services and therefore risk going bare by not buying health insurance. This “blame the victim” mentality is yet another way for older generations to claim that young people are irresponsible. While there might be a few “young immortals” out there, this rhetoric overlooks the vast majority who hold jobs that don’t offer health coverage and go uninsured because the cost of non-group coverage is too expensive. Without the benefit of employer-based insurance, some young adults feel that the only coverage they can buy is not worth the price.  The Crockers’ calculation to not buy insurance is a case in point.

When a person gets sick, the most pressing concerns are diagnosis, treatment, and recovery. Too many young adults delay seeking care or experience financial hardship because of the costs. A 2005 Commonwealth Fund survey of adults ages 19-29 found that more than half of the uninsured reported not filling a prescription, skipping a medical test or treatment, or not seeing a doctor for a medical problem. Delaying care was not limited to the uninsured, however: nearly 1 in 3 young adults who had insurance for the entire year experienced a health access problem, possibly a symptom of inadequate coverage.  The survey also found that more than one third of all young adults had a medical bill problem or outstanding debt.

For the past seven years, my organization, The Access Project, has worked to reveal the prevalence and consequences of medical debt through community-based research.  We have produced reports on numerous topics related to medical debt, including the adequacy of health insurance (“The Illusion of Coverage”), medical debt’s relationship to credit card debt (“Borrowing to Stay Healthy”), how medical debt leads to housing problems (“Home Sick” and “Living in the Red”), and the Massachusetts student insurance mandate (“Not Making the Grade”).

We also look towards innovative solutions, both system-wide policy changes and actions that individuals can do to reduce their own medical debt. I coordinate The Access Project’s Medical Debt Resolution Program, which provides one-on-one coaching for people struggling with medical debt.  I am happy to work with people of any age or income level. Feel free to contact me if you need assistance.

The primary goal of the program is to help individuals avoid the financial and health access consequences of medical debt. A crucial second priority is health system monitoring: personal stories are, to borrow a phrase, the canaries in the coal mine that provide early warning signals about the failures in our health system that lead to medical debt.

This blog posting kicks off a series of entries that will reveal practical steps that individuals can take to deal with unaffordable or unfair medical bills. While there are a number of excellent written guides to dealing with medical debt (such as NEFE’s Managing Medical Bills series), my goal is to provide information that will help young people develop their own medical debt resolution action plans. I will offer explanations of why these concrete steps make sense within America’s fractured health care system.

Please share your stories with us—in future blog postings I will (with permission) use personal stories to outline the strategies that the individuals, and others like them, can use to deal with their medical debts. I look forward to hearing from you!