Welcome to Current Affairs. My name is Nathan Robinson. I'm the editor-in-chief of Current Affairs

Magazine. I am joined today by Dr. Luke Massack. He is an emergency physician and historian. He's the

author of the new book, Your Money or Your Life, Debt Collection in American Medicine.

He has also written about medical debt for the excellent magazine Current Affairs,

and you can check him out in The Nation, where he has a new piece on why doctors should organize.

Luke Messack, thank you for joining us on current affairs today.

Thank you so much for having me. It's great to be here.

Well, it's nice to talk to you finally. I suppose you're a historian. You've gone into the

archives, you've looked at the entire history of medical debt, you've looked at all the trade journals, you've interviewed tons of people for this book, this book, you've gone into the archives, you've looked at the entire history of medical debt,

you've looked at all the trade journals, you've interviewed tons of people for this book,

this book, you know, there's a mounted of research that went into this book, and you have many,

many, many stories of people experiencing medical debt. But I want to go to the story that

you opened the book with, because clearly you opened it with a reason.

So you begin with a particularly disturbing story from the 1990s of a bit of indentured servitude

branded as a humane innovation.

And maybe you could tell us about that.

Absolutely.

And this is part of what kicked off this research project,

realizing that these kinds of stories were out there. This particular story was of a woman who was a widow, a recent

widow. Her husband had recently passed after a prolonged hospitalization at a hospital in

Southern Virginia. And facing a bill for his care that she could not hope to pay,

the hospital offered her what it's called its service credit program in which she could work in the

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