the moral math of medical debt.

Some people carry the weight of a hospital bill for years. Not because they forgot to pay it, but because they couldn’t. Because insurance didn’t cover enough. Because the numbers never added up. Because survival came first.

Eventually, that medical debt gets sold off to a collector. You may start receiving letters, frequent calls, and maybe even harassment if you’re lucky. But then, one day, the letters slow down. The calls stop entirely. And when you check your credit report, the debt is gone. Not because it was paid, but because the clock ran out.

There’s a strange kind of relief in that. A feeling like the system finally let go of your ankle. But alongside the relief, there’s discomfort. Sometimes even a little guilt. Not because we did something wrong, but because we’re taught that owing and not paying makes us irresponsible.

But what if the system itself was never responsible to begin with?

For about five years, I earned $14 an hour working full-time. My raise to $16.50 only came after everything else, from groceries to rent and gas, had already spiked. I was always just barely keeping up.

And then there was the cost of my medication. Most of it wasn’t covered by insurance. Even before I started antidepressants, I was already spending around $120 a month on uncovered prescriptions just to get by. And to continue those medications, I had to see specialists. My endocrinologist appointments alone cost $150 to $200 per visit every other month just so I could get refills and avoid getting dizzy again, like what had led me to the hospital in the first place over seven years ago.

At the time, I thought I paid off that hospital bill. Most of us don’t forget paying thousands out of pocket just to settle a hospital bill. But I couldn’t find any clear proof of payment on my end. And about five years later, it randomly reappeared in collections.

By then, I had landed a remote job and was struggling financially more than ever. To get by, I was living on one meal a day, sometimes stretching just $10 to last as long as possible. Every other dollar I had went to keeping the electricity on and making sure my pets were fed.

Once those priorities were handled, I’d stretch whatever was left into a single meal, often splitting it into halves or a third to make it last. One of the strange perks of living completely independently is that you learn how to make one item stretch into multiple meals. Not because it’s clever or sustainable, but because sometimes that’s just what survival demands. So when the bill came back, there was no room for it, mentally or financially.

Things look different now, and I’m more financially stable, with a little more breathing room. One of my credit cards is paid off, and the other is under $1,000 and steadily going down. It’s still a work in progress, but for once, it feels like progress is possible.

That doesn’t include student loans, though those sit in a different category. They didn’t come without stress, but they were the only real way I could get through university. Thankfully, they weren’t the kind of debt that left me skipping meals or afraid to open the mailbox.

Still, it’s strange to remember how close it all came. How easily survival could turn into punishment. And how long it took for that one bill to stop following me. Bills like that shouldn’t have the power to shape so much of anyone’s life. I didn’t beat the system. I just waited long enough for it to let go. And that’s not how healthcare should work.