Every election cycle seems to bring the same proposal: wipe out medical debt with the stroke of a government pen. It’s an idea that tugs at the heartstrings—after all, who could be against lifting the crushing weight of illness-related bills from struggling families? But good policy cannot be based on sympathy alone. The truth is, erasing medical debt is a tempting shortcut that fails to fix the actual problems in America’s healthcare system. Worse, it risks creating new ones. If we truly want to spare citizens from financial ruin tied to illness, there are better ways.

Why Erasing Medical Debt Misses the Mark

First, it creates moral hazard.
If hospitals and insurance companies believe the government will regularly intervene and erase debts, what incentive do they have to bring down costs? Medical pricing in the United States is already opaque, arbitrary, and wildly inflated. Erasing debts may only embolden the system to keep overcharging, knowing that someone else will eventually pick up the tab. Patients, too, may become less vigilant about questioning bills or seeking negotiated rates if they expect the government to swoop in.

Second, it’s fundamentally unfair.
Millions of Americans have done the hard work of paying off medical debts—selling homes, draining retirement accounts, or working extra shifts just to keep their dignity intact. To erase the debts of others without offering recompense to those who sacrificed is to punish the responsible and reward only the fortunate timing of default. Imagine the resentment of a family who spent ten years digging out of medical bankruptcy, only to watch neighbors have theirs erased overnight.

Third, it’s a Band-Aid, not a cure.
Medical debt is a symptom of a deeper dysfunction: unpredictable, sky-high medical costs combined with inadequate insurance. Even if we erased every penny of debt tomorrow, without structural reforms the pile would simply grow back. It’s like bailing water from a sinking ship while ignoring the gaping hole in the hull.

What We Should Do Instead

Rather than erasing debts, the government should focus on reforms that prevent people from falling into them in the first place. That means targeting the drivers of cost, the failures of transparency, and the gaps in coverage.

1. Attack the root causes of inflated costs.
Hospitals routinely charge ten times what a procedure is worth, knowing insurers will negotiate them down. Patients without leverage get the full sticker shock. The government could cap hospital chargemaster rates, just as utilities are regulated to prevent gouging. Price transparency laws must be enforced with real penalties so patients can compare costs before agreeing to treatment.

2. Strengthen the safety net.
Nonprofit hospitals already receive tax breaks for providing “charity care,” but too often they hound patients with debt collectors instead. Enforcing real charity care obligations could eliminate much of the debt at its source. Expanding Medicaid in the states that still refuse it would reduce the number of uninsured patients most likely to face catastrophic bills.

3. Make repayment humane.
Instead of blanket forgiveness, create income-based repayment plans for medical bills, similar to federal student loans. If someone is making $30,000 a year, it is absurd to expect them to keep up with $200,000 in cancer treatment costs. A fair repayment plan recognizes that health is not a luxury purchase, but a necessity.

4. Fix insurance and billing practices.
Surprise billing has been curbed in recent years, but loopholes remain. Patients should never wake up from surgery to learn that one anesthesiologist was “out of network” and therefore their coverage doesn’t apply. Insurance should be portable, predictable, and designed to protect patients—not trap them.

5. Encourage private relief programs.
Organizations like RIP Medical Debt buy portfolios of medical debt for pennies on the dollar and forgive them outright. The government could encourage and expand these efforts through tax incentives, allowing communities to help their own without shifting the entire burden onto taxpayers.

A Smarter Way Forward

The impulse to erase medical debt is rooted in compassion, and that compassion is valid. But compassion alone doesn’t build durable policy. If the goal is to help people, we must resist the easy applause line and choose the harder path: reforming a broken healthcare system so fewer people fall into debt in the first place.

Debt erasure is like wiping down a foggy window—it may clear the view for a moment, but unless we change the conditions causing the fog, it will return again and again. Americans deserve a system that keeps them healthy without bankrupting them. They deserve reforms that treat the disease, not just the symptoms.

So no—the government shouldn’t erase medical debt. It should make medical debt obsolete.