Medical Debt and Personal Bankruptcy: Time for Reform

By Meg Brown

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.

Bankruptcy is in fact what a growing number of Americans have already encountered through the health care system as it now functions. In June of this year, the American Journal of Medicine released a new study's findings based on figures available from 2007. The results of this study point out the debilitating role of medical expenses in families and individuals who must file for personal bankruptcy. Labeled as the "first-ever national random sample of bankruptcy filers", the study's authors worked hard to maintain conservative controls on their findings and followed the numbers up with fact-finding interviews with a significant portion of the sample's participants. Research indicated that a staggering 62% of personal bankruptcy filings were disproportionately driven by medically related expenses.

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.

It is hard to fathom the aggressive rise in medical costs and their burden on families in the past 30 years. 1981 statistics indicate that only 8% of personal bankruptcy filings were in the aftermath of medical crisis. (These numbers were extracted from court records which did not indicate the origin of debt handled by collection agencies.) In 2001 findings, the number of medically related bankruptcies had jumped to 46%. In the short gap of 6 years, the American Journal of Medicine's findings for 2007 rose to nearly 62%. What the numbers will be after the effects of the current economic recession are tallied gives reason for pause.

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.

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.

Do a quick online search for this American Journal of Medicine study and review it in its entirety for yourself (www.amjmed.com, Vol. 122, Issue 8 pp. 741 to 746). As a citizen, you owe this brief time investment to both you and your country. Inform yourself and do not leave decision making of this kind solely and silently in the hands of your elected officials. It doesn't hurt to remember that your representatives have plump health insurance packages that the average Joe is barred from participating in. - 29958

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