0:00

This Marketplace podcast is supported by

0:02

Disney. On April 3rd, Disney

0:04

will be hosting its annual meeting of

0:06

shareholders. Learn more about how to vote

0:08

along with a list of all Disney

0:10

nominees at votedisney.com. Buying

0:13

too many flat screens or sneakers

0:16

is not the cause of personal

0:18

bankruptcy in America, the leading cause.

0:21

It's needing medical treatment. I'm

0:24

David Brancaccio, first a day after

0:26

a disabled container ship hit and

0:28

destroyed the Francis Scott Key Bridge

0:30

in Baltimore. Supply chains are already

0:32

under stress. Companies are scrambling to

0:34

reroute goods, and other ports on

0:36

the East Coast could benefit. Here's

0:38

Marketplace's Henry Epp. Thousands of

0:41

cars, trucks and large farm and construction

0:43

equipment roll on and off ships in

0:45

the Port of Baltimore each year, more

0:47

than any other port in the country.

0:49

So closing down that facility will have

0:52

serious ripple effects, as Secretary of Transportation

0:54

Pete Buttigieg noted at a press conference

0:56

yesterday. You also have container traffic, you

0:58

have bulk traffic. There is no question

1:00

that this will be a major and

1:03

protracted impact to supply chains. That impact

1:05

could be an economic positive for some

1:07

other East Coast ports, like in Brunswick,

1:09

Georgia, home to the second busiest port

1:11

for vehicle imports and exports. Officials

1:14

there have been investing in the port's

1:16

infrastructure with the intention of overtaking Baltimore's

1:18

top ranking. Other East Coast

1:20

ports that can handle vehicle shipments include Savannah,

1:23

Georgia, Jacksonville, Florida and the Port of New

1:25

York and New Jersey, all of which could

1:27

also see more container ships. But

1:30

rerouting huge ships and the supply chains to

1:32

offload their cargo will take time and money.

1:35

That could have an impact on the cost of moving

1:37

freight. And shipping rates have risen a

1:39

bit in the last few months, due in part

1:41

to attacks on commercial ships in the Red

1:43

Sea and drought in the Panama Canal. Still,

1:45

they're significantly lower than in 2021 and 2022,

1:48

when widespread supply chain snarls

1:51

helped fuel inflation. I'm

1:53

Henry Abb for Marketplace. spike

2:00

upward hitting an all-time high yesterday over

2:02

ten thousand dollars a ton. Cocoa farmers

2:04

in West Africa have been dealing with

2:07

poor weather and crop disease and those

2:09

costs are expected to hit retail prices

2:11

hard in the months to come. Hey

2:30

there, I'm Bridget, co-host of Million

2:32

Bazillion, Marketplace's podcast for kids about

2:34

money. I want to tell you

2:36

about our email newsletter, Million Bazillion Academy.

2:39

In this new and improved course, we'll

2:41

help your kids learn about crypto, credit

2:44

cards, and inflation in just six weeks.

2:47

Each lesson comes with a podcast episode, a

2:49

fun cartoon, discussion questions, and an activity that

2:51

lets kids apply with their learning in the

2:53

real world. You can start at any time

2:55

and work at your own pace. Sign up

2:58

today at marketplace.org-academy. The

3:02

leading cause of personal bankruptcies in

3:04

America? Debt to payback medical bills.

3:06

Experts say three million people have

3:08

more than ten thousand dollars in

3:10

medical debt and a hundred million

3:12

have some. I'm just

3:15

back from a panel and audience

3:17

discussion in St. Paul, Minnesota exploring

3:19

medical debt among panelists. Alison Sesso

3:21

with a national nonprofit called RIP

3:23

Medical Debt, which takes donations to

3:26

cancel debt for people. Also

3:28

University of Minnesota health care economist

3:30

Jennifer Schultz. We have some highlights

3:33

this week starting today with medical

3:35

credit cards where health care companies

3:37

can have people sign up to

3:39

borrow for care. There are documented

3:41

cases around the country where hospitals

3:43

have offered the cards instead of

3:45

checking to see if the patient

3:47

qualified for charitable care programs that

3:49

many nonprofit hospitals are expected to

3:51

provide. Here's Alison Sesso. The

3:53

problems are that there's not a lot

3:55

of regulation around the fact that nonprofit

3:58

hospitals are required to have a charitable

4:00

approach. A lot of the details are left up

4:02

to the hospitals to figure that out. And

4:05

to be honest, they're dealing with revenue cycle

4:07

and billing and it's a lot of regulation

4:09

and if you talk to the people who

4:11

are actually in the billing cycles at the

4:14

hospitals, they are overwhelmed. We want them to

4:16

invest in the care, not over billing, but

4:18

yet we want them to have strong, solid

4:20

billing approaches that get people the charity care

4:23

that they need. There are solutions to this.

4:25

There's things like presumptive eligibility. That's what we

4:27

do. There's absolutely no application process. And so

4:29

hospitals can do the same thing. Well,

4:32

there you go. And that's what I think should happen. Jennifer

4:35

Schultz. 90% of people

4:37

in these United States have health care

4:39

coverage. So what's with the debt? Well,

4:41

even though people have health insurance

4:43

coverage, they may have very high

4:45

deductibles. They're what we call underinsured.

4:48

And there's what's called surprise billing.

4:51

There's price gouging. And the fundamental

4:53

problem is our high prices. This

4:55

is why we pay more than

4:57

twice the amount per person for

5:00

medical care compared to other wealthy

5:02

countries. I did see a figure, 819 billion, and

5:04

that figure

5:07

was total profits expected by all for-profit

5:10

health care companies in America by the

5:12

year 2027. And that will be up

5:14

40% from 2022. So some of the

5:16

cost is

5:20

due to that system. Yeah,

5:22

we shouldn't even call the system because that's not what

5:24

we have in the US. We use that word. Even

5:26

at nonprofit hospitals, we pay our CEOs

5:31

a lot, millions of dollars. That's

5:33

not all of the blame. If we

5:36

paid them less, we would drastically reduce our

5:38

$4.3 trillion spending per year on health care.

5:40

But we just have to pay providers in

5:42

a different way. And I've been arguing for

5:44

many years that we have to pay them

5:46

to show us good health

5:49

outcomes since we're not doing

5:51

well on population health in our

5:53

country. We have over 200 people

5:55

watching on Zoom right now. Thank you for

5:57

joining us at home. Some

6:00

have sent in some questions, and we're going to bounce

6:02

them off the panel here. Carol is

6:04

looking for some pointers. Carol's lucky enough

6:06

to have good medical insurance on paper,

6:08

but they need tips for getting insurance

6:11

companies to actually pay claims for out-of-network

6:13

coverage. You've looked at the billings. Is

6:15

there any tricks you've

6:17

come up with in your own life?

6:19

In 2020, Congress passed and the

6:21

president signed the No Surprises Act. So

6:24

you were not responsible for out-of-network

6:27

costs if you did not have

6:29

the choice of provider

6:31

or of an ambulance service. But

6:34

right now, this is being litigated,

6:36

but the other big problem is

6:38

that hospitals are buying a lot

6:40

of provider groups, and that is

6:42

so they can charge hospital prices

6:44

for outpatient care. And

6:46

there's a bill that passed the U.S.

6:48

House with bipartisan support called Lower

6:50

Costs More Transparency. This

6:53

bill needs to pass the Senate.

6:55

It does not allow hospitals to

6:57

charge outrageous prices for outpatient care.

7:01

Healthcare economist Jennifer Schultz from the

7:03

University of Minnesota and president and

7:05

CEO of nonprofit R.I.P. medical debt

7:07

Allison Sesso from a marketplace audience

7:10

discussion in St. Paul called Health

7:12

and Wealth, Why Americans Are Drowning

7:14

in Medical Debt. Tomorrow

7:16

hear views on medical debt from a

7:18

state attorney general. More at

7:20

marketplace.org. I'm David

7:23

Brancaccio. You're listening to the Marketplace Morning

7:25

Report. We're

7:31

from APM, American Public Media. Hey

7:35

there, I'm Bridget, co-host of Million

7:37

Bazillion, Marketplace's podcast for kids about

7:39

money. I want to tell you about our email

7:42

newsletter course, Million Bazillion Academy.

7:45

In this new and improved course, we'll help

7:47

your kids learn about crypto, credit

7:49

cards, and inflation in just six

7:51

weeks. Each lesson comes with

7:53

a podcast episode, a fun cartoon, discussion questions,

7:55

and an activity that lets kids apply with

7:58

their learning in the real world. Sort

8:00

of any size. And look at your own

8:02

face. Leaders today near the police and appeared

8:04

flash.