Republican, Democrat, Left, Right, Centrist… No matter how citizens in this nation may choose to politically identify ourselves, we are all pretty much in agreement about one thing: This country needs health care reform. Our suggestions as to what shape that reform should come in may not be identical but there is no denying that we are currently on the fast track to bankruptcy if meaningful reform is delayed much longer.
In fact, many individual Americans have already been bankrupted through devastating encounters with our current health care system. This past summer, the respected American Journal of Medicine released new study findings that revealed some staggering statistics that reveal the role that medical expenses play in personal bankruptcy filings. Working to reduce the margin of error in their findings, the authors applied a stringency to the study that made it a first of its kind: a truly random sample of bankruptcy filers nationwide, followed up with detailed personal interviews of participants. Medical causes of bankruptcy were defined to include medical bills and loss of income due to health issues. In conclusion, they discovered that more than 60% of personal bankruptcy filings in 2007 had significant medically related expenses that pushed individuals and families over the financial edge to file for bankruptcy.
Steffie Woolhandler, M.D., one of the study’s authors, appeared in a CNN interview saying “If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that is the major finding in our study.” As a counterbalance Dr. Woolhandler’s bracing conclusions, the nonpartisan policy research foundation, the Center for Studying Health System Change, voiced mild skepticism of the study’s weighting of medical causes for bankruptcies. But they also offered little comfort with their statistic that 1 in 5 American families are “unduly strained” by medical bills.
In the 20 year span from 1981 to 2001, there was a major jump in the percentage of families filing for medically related bankruptcy, a rise from 8% to 46%. The earlier numbers may not have accurately reflected the role of medical bills in the bankruptcy filings, because court records were the means through which the statistics were gathered. Court records do not include the origin of debt that was owed to collection agencies, quite possibly obscuring the role of medical bills. Nevertheless, the American Medical Journal’s most recent 2007 figures of nearly 62% medically related bankruptcy, indicate an unprecedented escalation over a 6 year period. Add that trend to what is still the unknown fallout of our economy’s current recession and we may have some even more frightening revelations.
The stigma that hangs over personal bankruptcy in our country is in part due to the public’s common misunderstanding of what the average filer looks like; many people have a mental image of a hapless slouch. The American Journal of Medicine’s study reveals this misapprehension for the untruth that it is. Most of the debtors surveyed were middle class, middle aged and college educated. 75% of the debtors had health insurance coverage at the onset of their financial and health problems. Typically this insurance left them with the commonplace gaps of high premiums, copayments, hefty deductibles and a range of uncovered medical services. It is important to note that policy rescission is a normative practice among medical insurance companies with 25% cancelling an individual’s policy immediately upon a disability diagnosis and another 25% of companies cancelling within one year of the diagnosis.
If “what is good for the middle class is good for America” is a useful measure of social and economic policy in this country, it is plain to see that viable and visionary health care reform is a mandate. With premiums, deductibles, institutional and procedural costs running on an unchecked course, the system will shortly be unsustainable. This year, 2009, the U.S. is predicted to spend an unprecedented 17.6% of its GDP on health care. What is not taken into account on top of this mind-boggling statistic is the hidden economic and societal costs of medically related personal and small business bankruptcies.
Do yourself a favor as a good citizen and read the American Journal of Medicine’s study in full. (You can find it quickly online at amjmed.com, Vol. 122, Issue 8, pp. 741 to 746.) Be informed, do some further fact scouting and let your congress representative and senator know that the average citizen wants and needs access to the quality of health insurance elected officials are privy to.