As It Happens

N.Y. woman clears $108M of other people's medical debt — after dying of cancer

New York book publisher Casey McIntyre's health insurance allowed her to receive cancer care without saddling her family in medical debt. But as she navigated the health-care system, she met other patients who weren't so fortunate.

Casey McIntyre's insurance kept her debt-free. Other patients, she soon learned, weren't as fortunate

A woman with freckles and long, dark blond hair stands on a sandy beach and smiles into the camera.
Casey McIntyre, 38, died from ovarian cancer on Nov. 12, 2023. Before she died, she set up a memorial fundraiser to raise money for a U.S. charity that buys and destroys people's medical debts. (Submitted by Andrew Gregory)

When Casey McIntyre was planning her own memorial service, she decided she didn't want it to be all doom and gloom.

The 38-year-old New Yorker had stage four ovarian cancer. And as her condition worsened, she knew she'd soon be leaving behind her husband and 18-month daughter.

But she decided to also leave behind a legacy — one that would change the lives of Americans saddled with hospital bills they can't afford to pay. 

"Casey is a very joyous person and we wanted there to be an element of joy to the ceremony," her husband, Andrew Rose Gregory, told As It Happens guest host Peter Armstrong. "And we had this idea for, you know: What if we raise money to relieve debt?"

McIntyre died on Nov. 12. Two days later, her husband posted a statement she had prepared ahead of time to her social media accounts, asking people to donate in her honour to RIP Medical Debt, a U.S. charity that buys up health-care debt and destroys it.

As of Wednesday, her online fundraiser had collected more than $800,000 US and counting, which the charity says is enough to wipe out $80 million US — roughly $108 million Cdn — in medical debt across the United States.

"It's pretty incredible," Allison Sesso, CEO of RIP Medical Debt, told CBC. "She'll be helping thousands of people."

How debt-buying works

McIntyre worked as a book publisher for Penguin Random House, and her husband says a robust insurance policy meant that she and her family didn't incur debt from her cancer care

That's not the case for a lot of Americans. 

More than 100 million people in the U.S. have medical debt, according to a 2022 nationwide survey by non-profit research group KFF in partnership with NPR. The survey suggests one quarter of adults owe more than $5,000 US ($6,790 Cdn), and one-in-five people with medical debt said they don't expect to ever pay it off.

According to RIP Medical Debt, it's the No. 1 factor leading to bankruptcy in the U.S.

A bearded, red-haired man in a bright blue shirt smiles brightly while standing in a garden and holding a baby girl. Next to him, a woman in a sundress grins as she places her hand on his shoulder.
McIntyre, right, leaves behind her husband Andrew Gregory, left, and their baby daughter Grace. (Subitted by Andrew Gregory)

Here's how the charity works.

Debt is a commodity that can be bought and sold. A lot of debt never gets paid off so institutions sell it in bundles, at a discount, to third-party collectors.

Those companies will then work to track down as much of the owed money as possible and turn a profit in the process.

"The way our model works is it mimics the for-profit debt buyer," Sesso said. "Except we don't actually follow up and try to collect money. We instead send letters to individuals that say you're free and clear of the debt."

Because they buy debt bundles at a steep discount, RIP says each donation relieves about 100 times its value in medical debt.

Who that impacts depends on which hospitals' debts are for sale. That means it's not something people can apply for, and RIP's letters come out of the blue.

Retired Georgia teacher Terri Logan received such a letter from the charity 13 years after a premature childbirth left her with a bill she couldn't afford. She told NPR last year that it changed her life.

"The weight of all of that medical debt — oh man, it was tough," she said. "Every day, I'm thinking about what I owe, how I'm going to get out of this."

Portrait of a smiling woman with long blonde hair and a green blazer.
Allison Sesso is the CEO of RIP Medical Debt, a U.S. charity that buys health-care related debts from hospitals and third-party collectors, and erases it. (RIP Medical Debt)

McIntyre became intimately familiar with the issue as she navigated the health-care system, her husband said. 

"Casey made the acquaintance, made friendships, with so many cancer patients that were, you know, at times choosing what bill to pay," Gregory said.

"There are people in the States that are choosing whether to receive care because of medical debt. If you are older, do you receive care and bankrupt your family? Or do you just decide ... I had a good life? People are making those decisions."

Systemic changes need, says charity

He and McIntyre first heard of RIP Medical Debt last March when they read about a North Carolina church that used the charity to erase about $3.3 million US worth of debt in their area. They immediately became monthly donors. 

When McIntyre's health started to take a turn for the worse, she came up with the idea of turning her funeral into a fundraiser for the charity.

A bespectacled woman with a buzzcut looks out over a lake while holding a baby girl and kissing her on the temple. The baby, wearing a colourful striped onesie, looks directly into the camera.
Gregory says he'll one day be able to tell his daughter Grace about her mother's generosity and impact. (Submitted by Andrew Gregory)

Her memorial next week will be a "debt jubilee," Gregory said — a nod to the ancient Hebrew origins of the word, referring to a time in which slaves would be freed, and debts and sins would be forgiven. 

"The campaign is still going and the money is still being raised, and we just don't know how much impact this is going to have," he said.

Sesso says she's acutely aware that buying up medical debt is a Band-Aid, not a solution.

The organization, she says, advocates for policies that offer free or discounted care to patients who can't afford to pay, ensure people have access to affordable health insurance and limit what companies can do to collect medical debt.

"Medical debt is unlike other debts because of the fact that you have a lot less control over whether or not you obtain this kind of debt," Sesso said. "Providers and others shouldn't be able to garnish people's wages, take them to court and, you know, potentially have a lien put on their home, things like that. We think that those things are really problematic."

For Gregory, it's less about the destroying debt and more about opening up opportunities for people. One day, he says, he'll be able to tell his daughter Grace about the profound impact her mother had on others. 

"That is a beautiful piece of this in a very, very sad moment we're living in," Gregory said.

"A really bad part of grief is thinking that the person lost won't be remembered or that people won't think of them. And I think Casey will be remembered."

Interview with Andrew Rose Gregory produced by Leslie Amminson

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