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JSUCamel
06-05-2009, 08:14 PM
http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/index.html

This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills.
Expert: "Medical bills ... are an issue that can very easily and in pretty short order overwhelm a lot families."

Expert: "Medical bills ... are an issue that can very easily and in pretty short order overwhelm a lot families."

Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.

"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that's the major finding in our study."

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them. Health.com: Expert advice on getting health insurance and affordable care for chronic pain

They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically-related bankruptcy had health insurance, they say.

"That was actually the predominant problem in patients in our study -- 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services," says Woolhandler. "Other people had private insurance but got so sick that they lost their job and lost their insurance." Health.com: Where the money goes -- A breast cancer donation guide

However, Peter Cunningham, Ph.D., a senior fellow at the Center for Studying Health System Change, a nonpartisan policy research organization in Washington, D.C., isn't completely convinced. He says it's often hard to tell in which cases medical bills add to the bleak financial picture without being directly responsible for the bankruptcies.

"I'm not sure that it is correct to say that medical problems were the direct cause of all of these bankruptcies," he says. "In most of these cases, it's going to be medical expenses and other things, other debt that is accumulating."

Either way, he agrees that medical bills are an increasing problem for many people. Health.com: 5 quick ways to stop back pain

"I think medical bills are something that a lot of families are having a lot of difficulty with and whether it's the direct cause of bankruptcy or whether it helps to push them over the edge because they already were in a precarious financial situation, it's a big concern and hopefully that's what medical reform will try to address," he says.

The study may overestimate the number of bankruptcies caused by medical bills yet underestimate the financial burden of health care on American families, because most people struggle along but don't end up declaring bankruptcy, according to Cunningham.

"Bankruptcy is the most extreme or final step for people who are having problems paying medical bills," he says. "Medical bills and medical costs are an issue that can very easily and in pretty short order overwhelm a lot families who are on otherwise solid financial ground, including those with private insurance." Health.com: Where to find money to pay for your major health bills


His group's research found that medical bills unduly stress 1 in 5 families.

Either way, the high cost of health care is a problem that's probably getting worse for people in the United States, particularly since the economic picture became grimmer after the study was conducted. Health.com: Yoga moves to beat stress, insomnia, and pain

"The recession didn't happen until a year after our study," says Woolhandler. "We're quite sure that the problem of bankruptcy overall is worse, the numbers have been soaring, and the number this year is expected to be higher than it was before Congress tightened bankruptcy eligibility in 2005."

In 2005, bankruptcies peaked at two million filings.

Emphasis mine. Scary, scary stuff.

Neilbert
06-05-2009, 11:04 PM
Someone on another forum made the point which I shall paraphrase:

Only in America can corporations escape medical debt by declaring bankruptcy, while individuals can not.

Let's face it, the current system is literally designed to screw over the individual for the benefit of large medical and insurance corporations.
This is not an exaggeration in the slightest.

I'm 24 years old, and I've already discovered that my (dirt cheap) medical coverage has almost literally zero value.

To give an example, I was referd somewhere. The bill was $205 if I payed cash/check, and $235 if I payed with a credit card.

My insurance covered $30... of the credit card price.

Davian93
06-06-2009, 08:38 AM
Only in America can corporations escape medical debt by declaring bankruptcy, while individuals can not.


Medical debt can be included in a bankruptcy. There are certain exceptions that cannot (student loans, tax liens, types of judgments (need to file before your creditors go to court against you) but all other debt can go into a Chapter 7 bankruptcy.

John Snow
06-06-2009, 09:18 AM
in many company problems right now - GM for example (besides their cultural mindset and determination to make inappropriate products) - is the cost of health insurance for their employees. This isn't the fault of unions or anything else, but the whole health insurance scam is a disaster for both individuals and business.

Neilbert
06-06-2009, 12:42 PM
but all other debt can go into a Chapter 7 bankruptcy.

Isn't chapter 7 the really bad one? And chapter 11 the not so bad? I really don't know much about bankruptcy law... obviously, but I could see that (potentially) being an important distinction.

IIRC most companies don't ever file chapter 7, they just do 11 and restructure. I could be totally off base here though.

Davian93
06-06-2009, 12:48 PM
Isn't chapter 7 the really bad one? And chapter 11 the not so bad? I really don't know much about bankruptcy law... obviously, but I could see that (potentially) being an important distinction.

IIRC most companies don't ever file chapter 7, they just do 11 and restructure. I could be totally off base here though.

Chapter 7 is a complete liquidation, Chapter 11 is for companies to reorganize under the shield of bankruptcy while Chapter 13 is called a "wage-earner" bankruptcy one. Under a Chapter 13, the court appoints a trustee to whom you make monthly payments and the trustee then pays each of your creditors. I guess if you were looking at them, 7 is the worst one as it completely absolves all your debts.

There's also Chapter 12 bankruptcies but those are for farmers. A chapter 12 allows a farmer to reorganize his/her debts without having to deal with creditors (its basically a Chapter 11 but strictly for farmers instead of corporations) A lot of times a person will become significantly behind on their debt and they will file for Chapter 13 to help resolve the delinquencies. There is a 60 month limit on Chapter 13s so you have to pay off the debts within that 5 years. If you cannot, you will often be forced to file for Chapter 7. So you'll see a DISMISSED chapter 13 and a DISCHARGED chapter 7 on a person's credit report one after the other.

Dragon Thief
06-06-2009, 02:40 PM
Beeing someone who's going throw a BK right now - from many folks I've talked to - lawyers to two family friends who run bank/loan departments - as far as your credit goes, there's not much difference between a Ch7 and Ch13. 13 mitigates you somewhat because you are paying back all of your principal debt (minus 100% interest accumulated) as garnished wages, and 7 equally mitigates you because although you paid no debt, you have no debts currently with the same basic income as before. 7 does have some extra bits to it - you have to submit your yearly incomes for the duration of the BK, you don't get your tax returns, etc.

Oh, and just a warning. The wife and I joined one of those debt reduction deals a few y ears ago. They were supposed to pool up a lot of our money and pay our bills in lump sum settlements. All nice and stuff. Then the fine print (which I read the entire contract, and still didn't manage to see) is that they take 100% of their fees before they pay any bills, so we ended up paying them $6000 over the course of a year and a half while they paid 0 of our bills, and thus even though we have enough money to pay our bills, we didn't have enough to fix the fuck-up this company did, so we had to file BK. We only got like 1,400 of our money back - the rest was "nonrefundable fees" that again I did not see in our contract. I think the company was Debt Relief of America or some such - but I'd sure now that all of these companies are scammers.

Davian93
06-06-2009, 02:43 PM
Unless its a certified non-profit (you can research that) then yeah, those companies (ALL THE ONES) you see advertising such a service are complete and utter scams. Some of the non-profit credit counseling groups are legit...most are not.

Ozymandias
06-06-2009, 05:36 PM
I think most of the problem with health care in this country isn't its cost but its waste.

You hear all the time about people who have like chest pains or something going through thousands of dollars of tests and scans just to find out its some normal thing.

The point being people in this country can be a little neurotic about their health, and that the medical community as a whole is too eager to profit off that by recommending far too many unnecessary and expensive tests.

Neilbert
06-06-2009, 05:54 PM
Or it could be the insanely profitable health insurance and pharmaceutical industries.

Though I'm sure your point isn't completely without merits.

The US spends more per capita on health care than pretty much any other nation (I can't find a chart or statistic where America isn't the top) in the world, yet it doesn't rank in the top 10 in most health ratings. (Heart disease, obesity, infant mortality rate, that sort of thing.) What gives folks?

Ozymandias
06-06-2009, 07:42 PM
Or it could be the insanely profitable health insurance and pharmaceutical industries.

Though I'm sure your point isn't completely without merits.

The US spends more per capita on health care than pretty much any other nation (I can't find a chart or statistic where America isn't the top) in the world, yet it doesn't rank in the top 10 in most health ratings. (Heart disease, obesity, infant mortality rate, that sort of thing.) What gives folks?

Again, its because we spend so much to do so little. Diagnosing simple problems cause thousands upon thousands because doctors insist on the most advanced and expensive medical techniques and treatments, even when they're not necessary. I mean... look at House. Look at all the tests and shit they do. They probably spend half a million dollars in equipment on every episode.

Not that we should go by fictitious TV shows, but if you've ever been in the hospital, you know your getting a ton of gratuitous tests and such.

Neilbert
06-06-2009, 08:47 PM
It's not only because of expensive tests, and one must examine the cause of doctors feeling a need to give expensive tests as well. (Hmmm perhaps expensive malpractice insurance and a sue happy population?)

JSUCamel
06-07-2009, 04:06 AM
In addition, sometimes the small symptoms can return big results. Got a headache? It could potentially be brain cancer. Start itching all of the sudden that won't go away? Might be allergies, or you might have primary sclerosing cholangitis (what I had).

I do agree, though, that doctors feel the need to cover their asses with expensive blood tests. Went to a doc about something a few weeks ago, and he said "I don't think you have anything to worry about. If you had this and this or this and that, then maybe... but you only have this, and it is not, in and of itself, a problem. But just in case..." and then I got the insurance bill for the test, and it cost (on paper) $500 ($25 co-pay for me). Still... nuts.

Neilbert
06-07-2009, 06:44 AM
Shouldn't numerous expensive medical tests be having some positive impact on health?

I mean, if they are even catching some small percentage of people like Camel, you would think that there would be some corresponding small increase in health or life expectancy or something.

Since we are still well below everyone else in life expectancy (45th going by CIA factbook) even with a small percentage increase, there must be more to the story. Christ, were behind Signapore, and Austraila the incredibly flammable island packed to the gills with deadly species.

Brita
06-07-2009, 01:02 PM
Lifestyle. Lack of exercise and poor diets. They seem like small things, but these two factors affect your whole body in many, many ways. In North America we do not function as we should as a species. We are designed to move and work physically everyday, and to eat natural food full of nutrients that we need. Instead we fill up on food that either has very low nutritional value or even has harmful ingredients, and allow our machines to do all our work for us.

I realized this when we went to the Dominican Republic. The people that lived in the country-side have a life expectancy of 90 years old! They work hard, totally relax at night and eat beautiful, natural food: cocoa and fruit and lean meat.

All the progress we make scientifically, we are negating by our terrible, collective lifestyle.

Now I'm off to eat my Kraft Dinner for lunch. And I only wish I'm joking.

Gilshalos Sedai
06-08-2009, 08:58 AM
Don't look at me, man. I ate our garden veggies and chicken and whole wheat pasta all weekend.


Course, I didn't exercise enough, but my foot is still too injured to wear anything but sandals from when Bryan tried to break it a few weeks ago. ;)

GonzoTheGreat
06-08-2009, 09:08 AM
Course, I didn't exercise enough, but my foot is still too injured to wear anything but sandals from when Bryan tried to break it a few weeks ago. ;)That's where wooden shoes are useful: if someone steps on them, he merely glides of.

Gonzo muses: considering the crazyness of fashion, high heeled wooden shoes might be the next big thing. This is your opportunity to jump ahead of the fashion crowd, Gil. Go for it.

Gilshalos Sedai
06-08-2009, 09:23 AM
I prefer to not have splinters in my toes, thanks.

Ozymandias
06-08-2009, 09:34 AM
[QUOTE=Brita]
I realized this when we went to the Dominican Republic. The people that lived in the country-side have a life expectancy of 90 years old! They work hard, totally relax at night and eat beautiful, natural food: cocoa and fruit and lean meat.
QUOTE]

There is no way that is true. Maybe the way upper classes.

In fact, that sounds like a typical tourist view of an island paradise. No offense, but there is no way an undeveloped nation like the DR has a life expectancy of NINETY

Gilshalos Sedai
06-08-2009, 09:58 AM
Dominican Republic 73.2 69.7

That's according to this site. (http://geography.about.com/library/weekly/aa042000b.htm)


Here's (http://www.who.int/countries/dom/en/) the data according to the WHO.

Brita
06-08-2009, 10:07 AM
In fact, that sounds like a typical tourist view of an island paradise. No offense, but there is no way an undeveloped nation like the DR has a life expectancy of NINETY


Maybe you are right. It was a local that told us- a tour guide though, so to be taken with a grain of salt to be sure.

From the U.S. Census Bureau's International Data Base the overall life expectancy in the DR is 73.2 years in 2008. The guide told us that the urban population had a life expectancy of 70 years. The urban population is 68% of the total population. So, assuming he was relaying a fact, what would the rural population life expectancy be to bring the average to 73 years? Someone who is good at math please solve for me.

JSUCamel
06-08-2009, 10:19 AM
Maybe you are right. It was a local that told us- a tour guide though, so to be taken with a grain of salt to be sure.

From the U.S. Census Bureau's International Data Base the overall life expectancy in the DR is 73.2 years in 2008. The guide told us that the urban population had a life expectancy of 70 years. The urban population is 68% of the total population. So, assuming he was relaying a fact, what would the rural population life expectancy be to bring the average to 73 years? Someone who is good at math please solve for me.

Assuming those figures are correct, then according to my calculations, the average expected lifespan of the rural population of the Dominican Republic would be 80 years. Still a far cry from 90 years.

Sarevok
06-08-2009, 10:20 AM
From the U.S. Census Bureau's International Data Base the overall life expectancy in the DR is 73.2 years in 2008. The guide told us that the urban population had a life expectancy of 70 years. The urban population is 68% of the total population. So, assuming he was relaying a fact, what would the rural population life expectancy be to bring the average to 73 years? Someone who is good at math please solve for me.
80

(70 * 0.68 = 47.6
73.2 - 47.6 = 25.6
25.6 / 0.32 = 80)

Gilshalos Sedai
06-08-2009, 10:20 AM
I love doing research no one looks at.

Davian93
06-08-2009, 10:43 AM
I love doing research no one looks at.

Pretty much sums up my job on a daily basis. Parts of it at least.

Terez
06-08-2009, 10:51 AM
That's where wooden shoes are useful: if someone steps on them, he merely glides off.
I'm still disappointed I didn't get any wooden shoes. Perhaps I'll get you to send me some. :)

John Snow
06-08-2009, 10:56 AM
Shouldn't numerous expensive medical tests be having some positive impact on health?

I mean, if they are even catching some small percentage of people like Camel, you would think that there would be some corresponding small increase in health or life expectancy or something.

There is an impact of that stuff - but as you said, those conditions are rare, and the incremental gain in health is often small. And meanwhile, where we lose big time is on the everyday care, the people who are underinsured and uninsured, who have creeping problems like insulin resistance developing into diabetes and heart disease, and so on. Lot's of common problems that really need ordinary but regular care. The fancy stuff has its place, but doesn't have that much in the way of broad impact.

John Snow
06-08-2009, 11:00 AM
The other trick is that life expectancy includes the whole population, in particular the little ones, who often have a hard time of it. Brita's guide may have meant, once people get past 5 years of age, then the life expectancy is 90. This has been true in a number of "primitive" societies, although the DR is not in nearly as bad a shape as the other side of the island.

Davian93
06-08-2009, 11:11 AM
The other trick is that life expectancy includes the whole population, in particular the little ones, who often have a hard time of it. Brita's guide may have meant, once people get past 5 years of age, then the life expectancy is 90. This has been true in a number of "primitive" societies, although the DR is not in nearly as bad a shape as the other side of the island.

The numbers are actually much worse if they keep the under 5's in there...I believe one of Gil's links shows that the life expectancy drops to 58 and 60 with the under 5 year olds included.

Ozymandias
06-11-2009, 12:47 PM
http://www.cnn.com/2009/HEALTH/06/11/teen.self.diagnosis/index.html?iref=mpstoryview


This just highlights the absolute insanity of the US medical community. That a 18 year old girl can spot a serious disease with nothing more than a (relatively) cheap microscpe and a few minutes in biology class proves how ineffective and stagnated our medical establishment has become.

Not that they're infallible... but think of the cost in tests that were probably run for this girl in order to find this disease, when it took her almost no time to figure it out. Thats just disgusting. Probably thousands of dollars flushed down the tube, for no result.

And its not that I disagree with the fact that they didn't find it... but that they COULD have found it just as effectively at a fraction of the cost, and that is probably the case in most situations.

Brita
06-11-2009, 01:53 PM
This story points specifically to a pathologist to me. The proper testing was done, the pathologist missed the diagnosis. Here in Canada, there have been a few high profile cases of health professional incompetence, especially in the diagnostic realm. A physician relies heavily on the results of these tests.

However, that being said, I know the Surgeons and Oncologists here at my hospital will ask for a second opinion if the patient's symptoms strongly point to a certain diagnosis and the pathology comes back as normal. I've seen them do it many times. They can look at the CT images themselves, so they can be their own second opinion in that area.

It is interesting that the solution this article points to is regular second opinions in certain cases. That will burden the health care system even more...