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Health Care and Debt

This month's Health Affairs has a couple of good pieces on health care costs and debt that are worth reading. The first article, by David Dranove and Michael Millenson, argues that only about 17 percent of all bankruptcies today are caused by unaffordable medical expenses, which is far lower than the 54.5 percent figure found by David Himmelstein and colleagues about a year ago.

So maybe crippling health care costs aren't as crippling as once assumed, right? Hold on. Himmelstein and colleagues respond to the new study here, saying that Dranove and Millenson "misrepresented" their data. Among other things, Himmelstein and friends note that many people who appear before bankruptcy court give as their reason "credit card debt" or "mortgage," even though that problem had been brought about by medical expenses. Yet Dranove and Millenson didn't seem to count these people as those who go bankrupt because of medical bills, even though common sense would say otherwise.

It's a fun debate, but either way, Robert Seifert and Mark Rukavina probably have the last word on the subject in this third piece, noting that regardless of who's right, bankruptcy is really only the tip of the iceberg here. It's still the case that one of six nonelderly adults—some 29 million Americans—are currently shouldering debt caused by medical bills, and another 56 million adults are at risk of incurring heavy debt, should they happen to get hurt or fall ill through no fault of their own. Regardless of how many people are being driven to actual bankruptcy by medical costs, a lot of people are finding themselves in pretty dire straits.

Additionally, the mere prospect of being saddled with medical debt prevents many people from seeking care—they don't fill a prescription, or don't see a specialist, or don't visit a clinic for a medical problem. (Sometimes this is self-imposed, but sometimes not: some providers will refuse treat a patient with previous outstanding medical bills, so a person with too much medical debt may simply be denied care.) It's another indication that merely reducing the number of uninsured Americans won't solve the health care crisis in this country—many of those who are insured still face all sorts of problems associated with not being able to pay for necessary health care.

Posted by Bradford Plumer on 03/08/06 at 6:00 PM | E-mail | Print | Digg this | de.licio.us



Comments

No doubt, the best way to reform medical care in this country is to elect the Samuel Clemens Party--that would be, the "hang them all and start over" party. Come to think of it, it is no doubt the best way to reform the rest of the mess they've created as well.

Posted by: Richard Aberdeen on 03/10/06 at 12:57 PM

I was disabled while working for a truly disreputable company about 15 years ago. Because of some illegal maneuvering on their part, I got a $4,000 lifetime settlement, with no future medicals. Luckily, because the courts DID find they were the cause of my illness, they have to provide medical insurance for me as an employee until I am 65. BUT...because I live on disability, I often have to pay for my medications with a credit card. I have managed to pay my monthly payments, but now have credit card debt which is 75% of my annual income! I cannot get help through the pharmaceutical companies because I have insurance. In less than ten years I will lose 2/3 of my income, and my medical insurance. I have a ten year old car and I don't own a home. I am terrified!! If it weren't for the medical bills, I believe I could make it. As it is, the choice seems to be homelessness or suicide. Only big companies can file bankruptcy now. I guess I should have had the foresight to be born rich!

Posted by: Cheryl Whaley on 03/10/06 at 8:25 PM

The medical/health care problems in America will never be resolved as long as the Repubs are in control of our government. The Bush/Repub strategy for solving this problem is to tell people to simply loose weight. Were the problem only that simple it would still be very difficult to solve without massive infusions of federal taxpayer dollars to support medical research (which most Americans would be willing to support) at NIH and medical research labs at universities in America.
Once obesity/diabetes and the other top six most expensive medical problems were solved the cures would just be GIVEN to the prescription drug industries who would then just charge so much money for the medications that most people would not be able to afford them. So,in effect,the huge amount of taxpayer dollars spent on medical cures would only benefit the wealthy and therefore would be nothing more than the expenditure of tax dollars to subsidize the health needs of the wealthy.
The Bush/Repubs answer to everything is to reduce big government. "Big Government" is nothing more than a Repub code word for taking many,many services including health care and education away from the average and poor Americans, while at the same time granting huge subsidies to the military/industrial complex,the oil industry,insurance companies,health care companies and now the prescription drug industry as in the case of the Medicare Part D program. This most recent Repub disaster is nothing more than a taxpayer subsidy for the prescription drug industry.

Posted by: bob t on 03/12/06 at 1:40 PM

It is interesting to see what people WILL believe when trying to place the blame.

Unfortunately, blaming Bush, and those "evil rich republicans" isn't the answer.

Does anyone here even remotely care why healthcare prices have sky rocketed, or are you more interested in blabbering about how the goverment needs to provide healthcare for the poor?

The problem my friend, is not that the goverment isn't doing something, it is that the goverment IS. You see, although it seems natural to blame people whom are better off, or more inteligent than you, that doesn't always make it right. All the time your wonderful Democrats were paying lip service to you, all they were doing was introducing socialism isn't a capitalist system. The best way to describe America's system today is "half-assed" - and yes, Democrats are the ones who screwed it up the most.

How you ask?
Well, when the goverment was introduced into healthcare, that is what we call a command element. What this did was take away the ability of capitalism to do its job - by not allowing the American people to determine the price they would, and could pay. Instead the goverment simply handed over a blank check and told the big companies to fill in a price. What this did was allowed the companies to jack there prices up to rediculous levels - causing skyrocking insurance prices as well.

This is just an overview of what has happened with our system - but it should give you some idea who is really to blame.

The next thing to discuss is a solution - liberals are now pushing to fully socialize the system - and create a failing system that is seen in such wonderful nations as Canada and much of Europe. The best thing about doing this would be that you would ALWYAS pay for healthcare - but that didn't mean you had to receive good healthcare - or even timely healthcare. A 5 year wait isn't that long, after all!

In the end, we need to step back and realize we need to fight - and fight hard. We need to tell the liberals that we will NOT accept there demented form of economics -which have NEVER and will NEVER work. We need to tell them that everyone in America has the right to equality of oppurtunity - and that equality of income is impossible and will only create economic conditions that drag everyone down to the bottum.

Posted by: David Birchmier on 03/30/06 at 12:53 PM

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