Helping Someone in Financial Distress Due to a Health Crisis

Here’s what to do when your friend cannot afford medical care.

Reviewed by Davia Sills

Key points

• Financial distress due to the costs of a serious illness can lead to a decline in mental and physical health.
• Medical debt affects well-being and may cause sleep deprivation, anxiety, depression, or suicidal thoughts.
• Friends can provide emotional and hands-on support, with or without financial assistance.
• People suffering financial distress in a health crisis benefit from having their dignity and worth recognized.

One of the most stressful ordeals of financial hardship is when we are hit with a medical emergency or a new diagnosis. Even if we have insurance, suddenly, we must dole out shocking amounts of cash for life-saving medications or procedures, often tapping our savings or maxing out our credit.

As if the illness or accident wasn’t bad enough, we are forced into a new world of priorities, not only because of our medical condition but also because of the extreme financial demands of managing that serious illness, often causing a financial crisis that spirals out of control.

Particularly if we’re living with a serious illness such as cancer, cardiovascular disease, multiple sclerosis, or kidney disease, we’re more likely to be forced into debt. Aging adults who live alone or single parents raising children with special needs are often so strapped that other essential needs like clothing or food are sacrificed for medications, transportation to medical appointments, or surgeries.

Indeed, many of us are faced with a strange paradox: The healthcare system that is supposed to save our lives can actually destroy our lives through financial ruin and distress. And that is why so many Americans deliberately avoid going to a doctor for preventative care or wait too long for intervention even when symptoms are present—especially when underinsured.

A survey by Affordable Health Insurance revealed that over half of Americans have medical debt, even those with medical insurance. As younger Americans are now being diagnosed more often with cancer (especially colorectal cancer), they find themselves forced into medical debt (on top of student debt). And further, medical debt is one of the greatest causes of bankruptcy.

A 2024 Forbes Advisor article reported on the mental health effects of debt:

• Fifty-four percent of U.S. adults with debt say they always or often feel stressed because of their debt.
• Sixty percent of respondents say financial stress has led to disagreements in their relationships.
• Due to debt-related stress, 48 percent reported sleep problems, 40 percent had higher anxiety, 38 percent led diminished social lives, and 34 percent experienced depression.

Financial Toxicity

In a 2023 study, “Financial Toxicity: A Common Problem Affecting Patient Care and Health,” this form of financial distress is defined as “the negative effects of the economic burden of medical care on patients that potentially lead to poor well-being and quality of life.” The term was coined in 2013 at Duke University when medical researchers noticed a stark pattern of patients delaying or neglecting medications or vital treatment due to medical costs. These adverse and avoidant behaviors towards essential but unaffordable and inaccessible healthcare services led to poorer health outcomes, declines in mental health, and increased social isolation (health impairments are one of the greatest barriers to social connection, according to AARP’s Connect2Effect studies).

Financial toxicity is a dangerous mix of worsening health alongside financial distress, increasing debt, and serious increases in depression, anxiety, loneliness, and isolation. It increases the risk of morbidity and mortality. Worst of all, the people who give up on their own healthcare because they cannot afford that care can feel a tremendous sense of guilt, self-blame, or shame. It is humiliating not to be able to financially care for ourselves.

It should also be noted that financial debt is one of the greatest causes of suicide. Research has shown that people who struggle with relentless stress from financial issues and debt are 20 times more likely to attempt suicide than others with more support.

How We Can Help Someone Facing Financial Toxicity

Given the emotional distress of financial toxicity for someone facing a serious illness, it can be helpful to know how to support a friend or loved one through this devastating time. The person undergoing financial toxicity can feel lonely and alienated. In survival mode, it is difficult to socialize or connect with others. Below are three essential ways we can reach out to support a person coping with financial toxicity.

1. We can allow our friend to express fear, anger, shock, and other emotions by listening and validating their raw feelings and thoughts.

The double whammy of being struck by a serious illness along with an ensuing financial crisis is downright frightening and triggering on many levels, especially for trauma survivors. We can serve as listeners with empathy and open-mindedness without judgment. We might say:

• “I’m so sorry you are going through this.”
• “Damn, you just cannot get a break!”
• “You already had enough on your plate!”
• “It seems so unfair.”

2. We can soften the harsh tendency to blame ourselves for financial hardship.

It’s likely that the person may be feeling guilt or shame for not being able to afford the healthcare that is so vital. With that understanding, we can encourage our friend not to fall into self-blame by noting the many socio-economic barriers to health care beyond the control of the individual. We might say something such as:

• “It is not all your fault.”
• “It’s crazy—who can pay $580 for one month’s supply of a blood thinner after a blood clot?”
• “I believe you’ve done everything in your power to take care of this.”
• “I’ve known you for a long time. I know how responsible you are.”

3. We might not need to offer money or a quick fix for our friend’s financial distress—but our care does help in any way we can provide.

Even in small ways, we can alleviate our friend’s sense of isolation (feeling lonely or being a “loser”) in their predicament.

Although we may feel awkward about our own ability (or inability) to offer financial help ourselves, it’s important to remember that our emotional support and care could matter more than our ability to provide money. Comforting gestures you can offer include:

• Invite your friend out for a meal—or bring over a meal to share together.
• Check-in regularly—say, once a week.
• Offer to help with finding resources, especially if you or people you know have already been through a similar experience.
• Offer hands-on help with a chore or errand.
• Share music, videos, or movies that have been inspiring.
• And if you do feel you can afford it, you might offer cash assistance or a gift, which is comforting as well.

Conclusion

It’s a common human reaction to feel helpless and powerless when facing a loved one going through financial distress or financial toxicity related to a medical condition. These feelings that arise in ourselves can make it difficult to show up to ease our friend’s suffering, especially if we feel awkward and guilty about our inability to offer financial assistance. But more than anything, most people in financial distress need our validation that they are worthy, dignified, and loved, no matter what the world is telling them.