A riveting exposé of medical debt collection in America — and the profound financial and physical costs eroding patient trust in medicine For the crime of falling sick without wealth, Americans today face lawsuits, wage garnishment, home foreclosure, and even jail time. Yet who really profits from aggressive medical debt collection? And how does this predatory system affect patients and doctors responsible for their care? Your Money or Your Life reveals how medical debt collection became a multibillion-dollar industry and how everyday Americans are made to pay the price. Emergency physician and historian Luke Messac weaves patient stories into a history of law, finance, and medicine to show how debt and debt collection are destroying the foundational trust between doctors and patients at the heart of American healthcare. The fight to stop aggressive collection tactics has brought together people from all corners of the political spectrum. But if we want to better protect the sick from financial ruin, we have to understand how we got here. With wit and clarity, Your Money or Your Life asks us all to rethink the purpose of our modern healthcare system and consider whom it truly serves.

Dismal spending on government health services is often considered a necessary consequence of a low per-capita GDP, but are poor patients in poor countries really fated to be denied the fruits of modern medicine? In many countries, officials speak of proper health care as a luxury, and convincing politicians to ensure citizens have access to quality health services is a constant struggle. Yet, in many of the poorest nations, health care has long received a tiny share of public spending. Colonial and postcolonial governments alike have used political, rhetorical, and even martial campaigns to rebuff demands by patients and health professionals for improved medical provision, even when more funds were available. No More to Spend challenges the inevitability of inadequate social services in twentieth-century Africa, focusing on the political history of Malawi. Using the stories of doctors, patients, and political leaders, Luke Messac demonstrates how both colonial and postcolonial administrations in this nation used claims of scarcity to justify the poor state of health care. During periods of burgeoning global discourse on welfare and social protection, forestalling improvements in health care required varied forms of rationalization and denial. Calls for better medical care compelled governments, like that of Malawi, to either increase public health spending or offer reasons for their inaction. Because medical care is still sparse in many regions in Africa, the recurring tactics for prolonged neglect have important implications for global health today.

Dismal spending on government health services is often considered a necessary consequence of a low per-capita GDP, but are poor patients in poor countries really fated to be denied the fruits of modern medicine? In many countries, officials speak of proper health care as a luxury, and convincing politicians to ensure citizens have access to quality health services is a constant struggle. Yet, in many of the poorest nations, health care has long received a tiny share of public spending. Colonial and postcolonial governments alike have used political, rhetorical, and even martial campaigns to rebuff demands by patients and health professionals for improved medical provision, even when more funds were available. No More to Spend challenges the inevitability of inadequate social services in twentieth-century Africa, focusing on the political history of Malawi. Using the stories of doctors, patients, and political leaders, Luke Messac demonstrates how both colonial and postcolonial administrations in this nation used claims of scarcity to justify the poor state of health care. During periods of burgeoning global discourse on welfare and social protection, forestalling improvements in health care required varied forms of rationalization and denial. Calls for better medical care compelled governments, like that of Malawi, to either increase public health spending or offer reasons for their inaction. Because medical care is still sparse in many regions in Africa, the recurring tactics for prolonged neglect have important implications for global health today.