The problem with medical credit cards

And other stuff I've been doing

Hello readers! Happy New Year and sorry it’s been so long since my last post. I published a story today and figured it would be a good time to restart the Substacking. The story is about medical credit cards, which I had never heard of until I started reporting on them.

How Doctors Are Pushing Medical Credit Cards on Patients

As the cost of medical and dental procedures and veterinarian visits rise, more providers are offering medical credit cards, which are basically credit cards that you sign up for at your doctor’s office and can be used for medical stuff. They may sound like a good idea on the surface because they allow people to pay for procedures they might otherwise have to forgo, but once I started looking into them, I found a lot of problems.

First off, the interest rate. Many medical credit cards are ‘deferred interest’ products, which means there’s no interest on the balance for a promotional period. Great, right? But when the promotional period ends, if you have not paid off the balance, you get charged for all the interest that has accrued during the promotional period. At rates of between 26 and 33%. (There’s currently a lawsuit arguing those rates violate state usury laws.)

Second, there’s how many providers talk about these cards. They sometimes tell patients that they’re a payment plan, rather than disclosing that they’re a credit card with terms and obligations. And they have been known to sign up people while they’re supine in a dentist’s chair or about to go under anesthesia.

Third, there’s the impossible choice they foist on many people in America’s f*ed up medical system. People can forgo treatment—for themselves, for loved ones, for their pets—or they can take out a credit card they might not be able to pay off, with pretty bad terms. That’s a fault of the medical system more than the medical credit cards, but you get the idea.

You can read more about them in my story: How Doctors Are Pushing Medical Credit Cards on Patients

I also had a book review in the Sunday New York Times in … October. I did not love the book but it was fun to see my byline in the Sunday Times. Freeports, Free Zones, and Other Places With Perks— for the Rich.

Other recent stories include one about why cats are taking over urban neighborhoods in America’s big cities, why the LA fires present such an insurance conundrum, and the rise of silent services like hair cuts where you can sit and know no one will talk to you.

Lastly, I have been thinking a lot about the L.A. fires, since I lived in L.A. for about eight years while working for the Los Angeles Times. So many friends have been displaced or have had to evacuate, and some of the fires have been near beloved hiking trails or beautiful places like Runyon Canyon. It must be terrifying to be there right now, though the journalist part of me wants to be there so I can see what’s going on and write about it. I think a lot of Angelenos are having the moment that many San Francisco residents like me had in 2020 when the sky turned orange and we wondered, “Can we really live here forever?”

California is a little bit of paradise, but it asks a lot of its residents. Is it worth it? I think so — it is the most beautiful place in the world, in my opinion. But I’d understand if, this week, many Angelenos are questioning the tradeoff. Ending with a picture I took from behind the Hollywood sign many many years ago in greener days.