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Personal Bankruptcy and Health Care Reform

09.22.2009 · Posted in Home and Garden Articles

[I:18:J]If you want to thicken the air in any given room these days, bring up the subject of national health care reform. Opinions and emotions are guaranteed to fuel a heated conversation while at the same time some key issues are often left out of the informal debate. It is hard to blame participants for these oversights because of the subject’s extreme complexity. But the bottom line remains that this is a subject our country needs to intelligently tackle before it bankrupts us. nnMany 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.nnSteffie 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.nnIn 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. nnThe 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.nnIt is hard to ignore that the middle class’ back is being gradually broken under the weight of the current insurance system. Health insurance premiums skyrocket every six months and deductibles on most policies follow a similar skyward pattern annually. Proponents of the American Dream have traditionally contended that what is bad for the middle class is bad for the nation as a whole. Currently, it is estimated that the U.S. will spend 17.6% of its GDP (Gross Domestic Product) on health care in 2009. The future holds an ever upward spiral if reforms are not soon brought into play. A further consideration of this staggering GDP statistic is to realize that it does not and cannot take into account all the associated costs that medically related bankruptcy of individuals or small businesses impose on the economy and society. nnResponsible 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.

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