• U.S. health care – a sick system U.S. health care – a sick system St. Louis Post-Dispatch Saturday, February 5, 2005 It used to be people talked about being one paycheck away from bankruptcy. Today, it’s more likely one
• U.S. health care – a sick system
U.S. health care – a sick system
St. Louis Post-Dispatch Saturday, February 5, 2005
It used to be people talked about being one paycheck away from bankruptcy. Today, it’s more likely one illness away.
Nearly half of the personal bankruptcies filed during 2001 – affecting more than 1.8 million debtors and their dependents – were caused by medical expenses.
That’s a 23-fold increase from 1981, when such expenses caused about 8 percent of personal bankruptcies. The absolute number of so-called medical bankruptcies almost certainly has grown since 2001, as bankruptcy filings have increased and employers have shifted more and more health care costs onto their workers.
The largest and most comprehensive study of medical bankruptcies ever undertaken was published this week in the journal Health Affairs. It details the devastating personal toll of a health care system whose lifesaving breakthroughs are increasingly out of reach for growing numbers of Americans.
And we are not talking about the poor or the 45 million uninsured Americans. The new bankruptcies are overwhelmingly filed by middle-class Americans. More than half of them attended college. And three-quarters had health insurance, most through their jobs, when they became ill or were injured.
Debtors in medical bankruptcies were less likely to be uninsured than those filing for bankruptcy for other reasons. But they were more likely to have gone without health insurance at some point during the two years prior to their bankruptcies, most because they lost their jobs or couldn’t afford the insurance premiums. They also were more likely to have failed to fill a prescription or visit a doctor for necessary care.
In his State of the Union speech on Wednesday, President George W. Bush touted health savings accounts, which combine tax-free funds in a special account with high-deductible insurance policies. The current version of Mr. Bush’s plan would allow workers to deposit up to $5,000 a year in health savings accounts. Expenses above that would be covered by high-deductible health insurance plans.
But there are two problems: One is that it would be hard for ordinary people to come up with that kind of money for health savings accounts. The other is that debtors in medical bankruptcies go broke before they reach the levels where the catastrophic coverage would kick in. They had paid an average of just $3,686 in out-of-pocket costs during the 12 months before filing for protection.
It will take a lot more than tinkering at the edges of our sick health care system to fix this mess. Unless that happens soon, more Americans will find themselves in the same precarious position.
