Covered by health insurance, but still vulnerable
People buy health insurance so they won’t be bankrupted by unexpected illness. But for increasing numbers of Americans, that’s not how things are working out.
A new national survey estimates that 62 percent of all personal bankruptcies in 2007 — nearly 451,000 cases — were caused by medical debts or serious illness.
That’s a substantial increase from just six years earlier, when the same researchers found about 46 percent of bankruptcies resulted from sickness or the costs of treating it.
One reason may be higher out-of-pocket spending. A separate study published last week estimates that average out-of-pocket spending for people with health insurance increased by 34 percent from 2004 to 2007.
That study also found the number of “under-insured” Americans — those who face unaffordable out-of-pocket expenses if they become seriously ill — has grown significantly.
“If you are sick and earn a modest income,” the study’s authors noted, “you are probably under-insured — even if you have (insurance) coverage.”
On average, Americans spend twice as much per person on health care than people in other developed nations.
Conservative policy analysts have long argued that’s because insurance insulates us from the true costs of care. It’s increasingly difficult to square that assertion with the facts.
On average, an American with private health insurance spent $729 out-of-pocket in 2007. About a third paid more than $1,000. Those in the top 10 percent on spending — people with serious, chronic illnesses — shelled out nearly $3,400. About one in five Americans said they had trouble paying medical bills.
In the United Kingdom, 62 percent of people paid less than $100 in 2007. Just 4 percent paid more than $1,000 out of pocket for their medical care.
Most Americans driven into bankruptcy by medical expenses are college graduates and middle-class homeowners. More than three-quarters had health insurance when they got sick. It didn’t provide protection.
Their medical costs averaged nearly $18,000. For certain illnesses, researchers found average spending was even higher. Those diagnosed with heart disease who filed bankruptcy, for example, reported medical expenses averaging nearly $22,000. People with neurological illnesses like multiple sclerosis had out-of-pocket expenses averaging about $34,000.
Theirs are uniquely American stories. In other developed nations, it’s simply unheard of for middle class families to be bankrupted by medical expenses.
Health spending has grown more slowly in Europe than it has in the United States — even though the same medical care generally is available and health outcomes are often substantially better.
In many European countries, Germany for example, the more serious your illness, the less you pay in deductibles and co-payments. Here, sicker patients face the highest medical expenses.
It’s tempting to blame insurance companies for the problem. Deductibles and co-payments have increased on most health insurance policies over the past decade.
But researchers concluded that the biggest reason for higher out-of-pocket spending is that overall health costs continue to soar.
U.S. national health spending doubled between 1997 and 2007. Yet study after study shows there is no association between high spending and high quality.
That’s why debate about health reform in Washington this summer will focus on more than just expanding coverage. It will, and must, focus on controlling costs.
For two out of three Americans — 161 million privately insured Americans facing higher out-of-pocket expenses and the nearly 50 million uninsured — it’s a very timely discussion. For hundreds of thousands of them, bankruptcy court could await.
The health care industry is like OPEC, only less organized. They gouge the customers, because they know they can. Congress which can regulate the market is held hostage by campaign funding and advertising dollars of the insurance industry, and the pharmaceutical industry. Why else would they stifle competition in the Senate hearings on the subject by stonewalling the advocates of a single-payer government option to spark competition? The American public is outraged.
In other countries, economies are bankrupted by the taxes needed to pay for socialized medicine, or patients simply suffer and/or die because care is denied to them. In the United States, individuals can be treated successfully for conditions that the rest of the world gets little or no care for. I would like to see proof that equivalent quality of care is readily availabe across Europe. In the UK alone, those with the means purchase private health insurance so they can avoid the nightmare of the British National Health Service (Canadians don’t even have that option!). As for lower costs, the majority of medical expenses are accumulated in the last few years of a person’s life, so maybe you’d like to institute a discussion on what Roy Roemer called the elderly’s “duty to die” to save money? If so, be ready for angry letters from AARP members.
The United States is a very diverse society compared to the members of the EU, and measurements of health outcomes of Americans by socioeconomic status, ethnicity, and geographic demographics show completely different results than studies looking at our population as a whole. Rather than bring everybody down to a level of mediocrity, maybe we could work on elevating those in need. Let’s commit to greater economic opportunity for all Americans, so people don’t have to beg for assistance from a “benevolent” government. Nothing empowers a person like a paycheck, unless there’s a socialist government in power that steals every spare dime to feed its ever-growing appetite.
The , “studies” cited in the editorial do not reveal the total financial portrait of those filing for bankruptcy, either. How many of those college graduates filing were in hock to their eyeballs even before the medical bills arrived? Aren’t we constantly being told that one of the causes of our current economic difficulties is that, as a nation, we have lived far beyond our means for far too long? Maybe we should be looking at the spiraling costs of higher education in the US. How many graduates start out with tens of thousands of dollars of debt (and no job) from college loans?
We need more competition in the health care marketplace, and less bureaucracy. Allow individuals and small businesses to pool together to get discounts on policies and deduct the cost from their taxes like big corporations do. Allow people to buy their health insurance across state lines to get the best deal, and forbid the states from setting minimum coverage standards as they do now. Why should a middle-aged couple have to pay for childbearing or substance abuse coverage they will never need? Expand Health Savings Accounts to build the reserve patients need for unexpected medical bills.
The worst possible scenario is for the same system that brought us Fannie and Freddie, TARP, the Community Reinvestment Act, Barnie Frank, Chris Dodd, Nancy Pelosi, Harry Reid, etc, etc (ad nauseum) controlling one-seventh of the US economy. If you think healthcare is expenisve now, wait until it’s “free”.
I dispute the figure that 62% in the UK paid less than $100 when 40% of the entire country buys private healthcare coverage because the NHS system is so bad. How does that work? Do you mean that 62% of people on NHS pay less than $100? If so, I would suggest that is the case because they can’t get in to see a doctor. There was a report last week about a man charged with assault when he threatened a dental hospital worker with a chair because the bureacrat in charge would not treat his tooth abcess. The report said the infection had infiltrated his entire head and neck and his face was swollen to twice its size, but it was not considered an emergecy. I read several British newspapers on line every day and the stories of how clinically bankrupt the NHS system is are legion.
To Murky Man,
If ever anyone needed a reason to disbelieve anything you write. This posting was it. I’ve never seen such a stinking pile, and I’ve run sewage treatment plants.
You say-”In other countries, economies are bankrupted by the taxes needed to pay for socialized medicine, or patients simply suffer and/or die because care is denied to them.”
Please name them, and the dates of their bankruptcies, and please note the economists that attributed it their heslth care systems. You just make stuff up. You must be a retired speechwriter for the Bush administration. You’re too late. He can’t give out Medals of Freedom anymore.
You say-”You In the United States, individuals can be treated successfully for conditions that the rest of the world gets little or no care for. I would like to see proof that equivalent quality of care is readily availabe across Europe.”
Look up the World Health Organization’s rating of health care by country. I looked it up earlier today and the U.S. is rated 37th. Plus you in one part of your post suggest that Europe is homogenious and in another part diverse. Which is it? and what countries are you including and excluding in your definition of Europe? Just EU members?
You say-”In the UK alone, those with the means purchase private health insurance so they can avoid the nightmare of the British National Health Service (Canadians don’t even have that option!).
Yet another lie. Private health insurance is available in Canada. Not many buy it. Mostly it covers dental and optical, things the national health care system doesn’t cover. Canadians buy it also for when they travel to the U.S., because they know the medical bills in the U.S. should they have a medical emergency might bankrupt them.
You say-”The United States is a very diverse society compared to the members of the EU, and measurements of health outcomes of Americans by socioeconomic status, ethnicity, and geographic demographics show completely different results than studies looking at our population as a whole.”
This is the statement where you depart from reality altogether and enter some narcotic induced dreamworld. Can you cite any census data for the EU countries to prove that bizarre statement?
You say-”Rather than bring everybody down to a level of mediocrity, maybe we could work on elevating those in need. Let’s commit to greater economic opportunity for all Americans, so people don’t have to beg for assistance from a “benevolent” government. Nothing empowers a person like a paycheck, unless there’s a socialist government in power that steals every spare dime to feed its ever-growing appetite.”
That’s a laudable goal and sentiment, how do you propose to do that? Republicans have killed some of the best programs of the Great Society.
Head Start has never been fully funded. Without exception they oppose affirmative action and minority set asides. They refuse to change the formula for funding public schools and have done their best to kill public education with a phony voucher system. They cut off funding for day care for the working poor, and insurance is unaffordable for the poor now. Yeah lets elevate those in need, but you don’t say how. Are you that clueless?
You say-”The , “studies” cited in the editorial do not reveal the total financial portrait of those filing for bankruptcy, either. How many of those college graduates filing were in hock to their eyeballs even before the medical bills arrived? Aren’t we constantly being told that one of the causes of our current economic difficulties is that, as a nation, we have lived far beyond our means for far too long? Maybe we should be looking at the spiraling costs of higher education in the US. How many graduates start out with tens of thousands of dollars of debt (and no job) from college loans?”
Yeah lets stop loaning money to people willing to study and get a degree so they can have a better chance at rising above poverty.
You say-”We need more competition in the health care marketplace, and less bureaucracy.”
Of course you don’t mean the bureaucracy of bean counters, actuaries, CEO’s, salesmen, accountants, bill collectors, lawyers, PR people, and advertising men, that private insurance has to pay along with stockholder dividends for the record profits they keep raking in. You mean a government bureaucracy that costs a fraction of the private industry’s bureaucracy.
The rest of your post is a diatribe against Democrats that inaccurately lays the blame for our financial woes at their feet. Your solution private health care savings accounts? Great if you make enough money to spare and don’t encounter any catastrophic illness before you’ve amassed a fortune equivalent to your retirement plan. We should listen to republicans they wanted us to turn Social Security over to Wall Street. They are full of ideas, or rather they are just full of it.
20 bucks says Rich Brown hits 4000 words in this thread.
Presently sitting at 883.
Lots of words… little lucidity.
To Seditious Sum,
That all depends on how many lies you and cronies tell that I have to refute. You all seem to have stopped posting on the other threads. I was just getting started. But you don’t seem to have the nerve to post an actual argument with logic and truth and data to back you up. You just make snide little comments from the sidelines, cause you got nothing, including a pair.
If Canadians will likely have to go to Thailand once world-class medical care is no longer available just south of their border, where will Americans have to go once Obamacare is imposed ??
Medical care rationing in England.
Medical care rationing in Canada.
Now medical rationing on our horizon. Mon dieu!
Quickest way to cut health costs is to reform the medical tort system… an immediate savings of as much as 20%.
What’s funny is just this morning on TV, I heard an expert in this say that health care spending has actually decreased since 2004. So who is right?
Has the P-D Editorial Board run out of topics? This is the 7th “healthcare crisis” editorial in two months: 4/14, 4/24, 4/29, 5/3, 5/13, 5/14, and 6/1. Isn’t this rather obsessive? Between this and using blog comments as “editorials,” are you have trouble finding new topics under the Obamation? Interesting!
Here is a real editorial on the “healthcare crisis” from a real newspaper:
http://www.ibdeditorials.com/IBDArticles.aspx?id=329096675894197
on the same topic.
Tomorrow’s P-D editorial will be on the “global warming crisis.” And they say the Republicans “play on our fears.” Hah!
To Seditious Sum,
You say-”If Canadians will likely have to go to Thailand once world-class medical care is no longer available just south of their border, where will Americans have to go once Obamacare is imposed ??”
Americans will not have to go anywhere. We will actually be able to improve health care, under single-payer. Single-payer will allow doctors use the appropriate treatments, that insurance companies in their quest for profits routinely deny. I don’t know what Obamacare is like and neither do you since no plan has yet been worked out by congress. But as a conservative republican your track record for predicting leaves much to be desired. After all your guys controlled most of the government for the last 8 years and look what a mess they left.
You say-”Medical care rationing in England. Medical care rationing in Canada.
Now medical rationing on our horizon. Mon dieu!”
The medical care rationing we have in the U.S. today is far worse. 45 to 50 million with no insurance and the knowledge that if they have an accident or a catastrophic illness, it’s instant bankruptcy. No chance of ever escaping a job they might hate if they have a pre-existing condition. That’s not just rationing that’s virtual slavery.
You say-”Quickest way to cut health costs is to reform the medical tort system… an immediate savings of as much as 20%.”
I don’t know where you get your figures, must be some more use of that prostate calculator you have. Lawsuits and malpractice insurance are not even near 20% or the administrative costs that instituting single-payer would save, because they aren’t 20% of the difference in admin cost between private health care insurance and Medicare! You want tort reform for cost savings, then take away the licensing function of the AMA. Repeat offenders in malpractice suits seldom get their licensing revoked. If you let drunk drivers continue to drive it raises your car insurance rates. Most of these malpractice cases are settled out of court, so judges don’t get the chance to revoke a license, and insurance companies can say this is the cost of malpractice so we’re raising your rates.
Maybe if you took the time to look things up, or understood the way the medical businesses are run, you wouldn’t write such ridiculous tripe. Instead of listening to catch phrases and bumper sticker slogans of the republican spin machine, get some mental exercise and do the research. Exchange that mental flab for gray matter.
So, where is it then… Mexico, Cost Rica, Chile ?? Where will Americans have to go to avoid the lengthy queues brought on by single-payer Obamacare?
We know the single-payer socialized medical scheme in England denies timely treatment. Look it up.
The same timely treatment denials occur in Canada. Look it up.
Where does a single-payer scheme actually work? Surely there must be at least one city-state-country you can identify that hasn‘t also brought medical rationing.
1,366 words.