E D I T O R’ S
Q U E S T I O N
E D I T O R’ S
Q U E S T I O N
SHALVI SINGH, FOUNDER OF HEALTHENGINE. US AND SENIOR PRODUCT MANAGER AT AMAZON AI
hile digital Buy Now, Pay Later( BNPL) and installment
W plans are promoted as tools to enhance healthcare affordability, their increasing uptake highlights potential systemic risks that may worsen costs and inequities.
1. Masking prices, not fixing them
By allowing patients to make installment payments, BNPL transforms steep healthcare prices into something manageable – for example, a dental procedure costing US $ 6,000 sinks to US $ 100 monthly payments. This provides little real financial help because it perpetuates charted, unregulated care pathways and payment structures. In elective care sectors like cosmetic surgery or LASIK, BNPL enhances payment uptake but keeps pricing stagnant, which remains dissociated from the actual care value provided. This in turn creates an ominous feedback loop where payment plans facilitate pricing medians driven by profit instead of challenging them.
2. Debt cycles in disguise
Incorporating charging mechanisms masked by the term“ interest-free” propagates modern forms of unmet, medical debt. Allowing plan revisions to remove grace periods and subject borrowers to credit score penalties due to missed payments places patients in unrecognised forms of medical debt. With many providers outsourcing payment plans to third-party platforms, patients confront consented opaque terms and undisclosed price risks. Vulnerable groups geographically located in low gentrification zip codes are further disadvantaged since approval algorithms used in socioeconomic gated communities replicate biases seen in other lending domains.
3. Eroding Healthcare Financial Solutions
The adoption of Buy Now Pay Later( BNPL) models supports the use of high-deductible health plans where patients have to pay upfront costs. The use of BNPL is strategically placed to complement deductible coverage, enabling greater shifting of financial responsibility to patients which eliminates catalysts for devising more comprehensive insurance systems or scaling coverage for vision, chronic care, and even dental services. The industry exploits this further by using BNPL as a marketing tool to sell excess procedures without prior assessment on whether the services rendered are treatment-worthy or reasonably priced.
4. Policies Gaps, Inequitable Access
There is minimal legislations regarding BRNPL which places it in a neutral political space. Unlike traditional medical debt which comes with some level of consumer protection, non-medical debt incurred using FinTech services entails other harsh penalties of late payment, and other abuses to patients. There is also the risk of creating a discriminatory system for consumer health services where patients with dependent children are strategically advantaged over those without through lopsided approval rates across systems.
My path forward...
There is a need to reconsider the linking of BNPL in healthcare services and financialisation, and retain policies the system’ s stakeholders must:
• Foster information control: Stop leading to abuse of discretion on disclosure of terms in considering contracts related to BNPL.
• Monitor price control: Restrict onboarding other providers to those actively looking to slash costs first before using BNPL arrangements.
• Recreate policies: Resolve deductibles and underexplored areas of coverage that make BNPL“ necessary.”
BNPL is harmless per se, but the way it is integrated into the US healthcare system is profit-driven without any intention to transform the system. If left unchecked, these models could become yet another sign – not a solution – to the policy’ s crisis of affordability.
26 www. intelligentfin. tech