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Personal Bankruptcy and Health Care Reform
By Meg Brown Published: 09/29/2009
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.
Many individual Americans have in fact already tasted from the bitter cup of personal bankruptcy brought on by devastating brushes with the health care system as it exists now. The American Journal of Medicine released study findings this summer that uncovered the extent of medically related causes that lay behind personal bankruptcy filings in 2007. The AJM study authors implemented conservative controls on their work, ensuring a random sample of bankruptcy filers nationwide and followed up with in depth interviews with a significant cross section of participants. This study, a first ever of its kind due to its broad sampling and well defined parameters, revealed that nearly a whopping 62% of these filers indicated medically related expenses as major contributing factors to their debt disaster.
CNN interviewed an author of the study, Steffie Woolhandler, M.D. who made this concluding comment: "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that's the major finding in our study." A comment coming from the D.C. based nonpartisan Center for Studying Health System Change in response to the American Journal of Medicine's study held some skepticism about what actually precipitated the bankruptcy filings but did own that medical expenses were a key player, considering that 1 in 5 American families are "unduly strained" by medical bills.
In 1981, only 8% of families filing for bankruptcy claimed to have done so in the wake of a major medical crisis. (The accuracy of that figure is somewhat debatable since court records do not indicate the origin of debt that is handled by collection agencies, possibly obscuring debt generated by doctor or hospital bills.) In 2001, a major study concluded that over 46% of personal bankruptcies were medically related. The American Journal of Medicine study's most recent conclusions of 61% used data from 2007, indicating an alarming trend and numbers which interestingly predate the fallout of our economy's current recession.
The popularly held mental picture of the average personal bankruptcy filer as a shiftless individual is completely dispelled by the AJM study. In this nationwide random sample, the majority of debtors were middle aged, middle class and college educated. The majority, 75%, had medical insurance policies when their debt and health problems started. Their insurance had the industry's standard gaps of copayments, high deductibles and services that were not covered. Nationally, 50% of insurance companies rescind individuals' policies within one year of being diagnosed with a disabling condition and many are immediate cancellations.
This nation's long held axiom of "what is good for the middle-class is good for the country" could serve as a helpful guideline in healthcare reform. Every day there is an increasing number of middle class families struggling under the burden of medically related expenses through spiraling insurance premiums and large coverage gaps. Businesses struggle to maintain insurance plans for their employees, insurance that may turn out to be a misnomer as benefits and guaranteed coverage are downgraded in accordance with affordability. It is projected that in 2009, the U.S. will spend 17.6% of its gross domestic product on health care. And this is without taking into consideration all the hidden economic and societal costs of medically related bankruptcies.
Responsible citizens owe it to themselves to review this American Journal of Medicine study in its entirety and to engage in further health care reform fact finding. A brief online search at amjmed.com (Vol.122, Issue 8, pp. 741 to 746) will get you started. Let your opinions be fully informed and get in touch with your elected representatives. This is an important national subject that requires vision and a patriotic, nonpartisan commitment to our future.