Is US health care terminally broke?

I read an interesting article from the Washington Post today. It states that 1/2 those that file for bankruptcy do so due to medical bills. What surprised me is that 3/4's of those had health insurance. And of course, we are having record bankruptcies these days.

I am sure everyone has noticed skyrocketing health costs. Personally, I had a physical last year, with health coverage, that ended up costing me $750 out of my pocket.

I also had a conversation with a Radiology Director last year in Indiana. We talked about the health situation of hospitals in Indiana. He felt that about a 1/3 of the hospitals in Indiana would go out of business. About a 1/3 could go either way. And a third were doing OK.

So to my point, is health care in the US terminally broke? Will we ultimately go the national health route which was decisively defeated during Clinton's term?

Here is the article:

Sick and Broke
By Elizabeth Warren
The Washington Post

Wednesday 09 February 2005

Nobody's safe. That's the warning from the first large-scale study of medical bankruptcy.

Health insurance? That didn't protect 1 million Americans who were financially ruined by illness or medical bills last year.

A comfortable middle-class lifestyle? Good education? Decent job? No safeguards there. Most of the medically bankrupt were middle-class homeowners who had been to college and had responsible jobs -- until illness struck.

As part of a research study at Harvard University, our researchers interviewed 1,771 Americans in bankruptcy courts across the country. To our surprise, half said that illness or medical bills drove them to bankruptcy. So each year, 2 million Americans -- those who file and their dependents -- face the double disaster of illness and bankruptcy.

But the bigger surprise was that three-quarters of the medically bankrupt had health insurance.

How did illness bankrupt middle-class Americans with health insurance? For some, high co-payments, deductibles, exclusions from coverage and other loopholes left them holding the bag for thousands of dollars in out-of-pocket costs when serious illness struck. But even families with Cadillac coverage were often bankrupted by medical problems.

Too sick to work, they suddenly lost their jobs. With the jobs went most of their income and their health insurance -- a quarter of all employers cancel coverage the day you leave work because of a disabling illness; another quarter do so in less than a year. Many of the medically bankrupt qualified for some disability payments (eventually), and had the right under the COBRA law to continue their health coverage -- if they paid for it themselves. But how many families can afford a $1,000 monthly premium for coverage under COBRA, especially after the breadwinner has lost his or her job?

Often, the medical bills arrived just as the insurance and the paycheck disappeared.

Bankrupt families lost more than just assets. One out of five went without food. A third had their utilities shut off, and nearly two-thirds skipped needed doctor or dentist visits. These families struggled to stay out of bankruptcy. They arrived at the bankruptcy courthouse exhausted and emotionally spent, brought low by a health care system that could offer physical cures but that left them financially devastated.

Many in Congress have a response to the problem of the growing number of medical bankruptcies: make it harder for families to file bankruptcy regardless of the reason for their financial troubles. Bankruptcy legislation -- widely known as the credit industry wish list -- has been introduced yet again to increase costs and decrease protection for every family that turns to the bankruptcy system for help. With the dramatic rise in medical bankruptcies now documented, this tired approach would be no different than a congressional demand to close hospitals in response to a flu epidemic. Making bankruptcy harder puts the fallout from a broken health care system back on families, leaving them with no escape.

The problem is not in the bankruptcy laws. The problem is in the health care finance system and in chronic debates about reforming it. The Harvard study shows:

Health insurance isn't an on-off switch, giving full protection to everyone who has it. There is real coverage and there is faux coverage. Policies that can be canceled when you need them most are often useless. So is bare-bones coverage like the Utah Medicaid program pioneered by new Health and Human Services Secretary Mike Leavitt; it pays for primary care visits but not specialists or hospital care. We need to talk about quality, durable coverage, not just about how to get more names listed on nearly-useless insurance policies.


The link between jobs and health insurance is strained beyond the breaking point. A harsh fact of life in America is that illness leads to job loss, and that can mean a double kick when people lose their insurance. Promising them high-priced coverage through COBRA is meaningless if they can't afford to pay. Comprehensive health insurance is the only real solution, not just for the poor but for middle-class Americans as well.
Without better coverage, millions more Americans will be hit by medical bankruptcy over the next decade. It will not be limited to the poorly educated, the barely employed or the uninsured. The people financially devastated by a serious illness are at the heart of the middle class.

Every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem. Time is running out. A broken health care system is bankrupting families across this country.

--------
The writer is a law professor at Harvard University.

 

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US healthcare?, what is this you speak of, :bugeye:

 

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That’s not really accurate. The article says that half of the people filing bankruptcy were doing so because of medical bills or because they were too sick to work and so not receiving any income. There’s no mention of how the statistics broke down between the two categories.

Also, this page http://www.medicinenet.com/script/main/art.asp?articlekey=41780 reveals that only 25% of the people surveyed said that they were driven to bankruptcy by medical bills/inability to work; the other 25% that the article’s author needed to make his “half” claim were added in later by the people who did the study. They considered anyone who had more that $1000 in medical bills or had missed more than 2 weeks of work within a year of bankruptcy to be a ‘medical bankruptcy’, which seems somewhat questionable to me.

 

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I am not American but from what I have raed about the medical system in America I believe the problems are due to the HMO's insurance policies . The freemarket approach to insurance is one of miliking the individual and as he increases in age the annual premiums become steeper and when you retire they go through the roof with the object of having that person cancel his insurance . Thereby saving the payouts over medic care retired people usually have .

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Universal Declaration of Human Rights , Article 25. ( 1 )

 

No one has a right to anything. There are only privileges granted by those with a little bit more authority. That's life. It's the way things have always been, and the way things will always be. Get used to it.

Jeeze, you kids are stupid!

 

The White Zone is for unloading ...........................

 

What a pity for you to live in such a bleak place.

Open your mind. Once all countries have modernized and tech has caught up with theory things will have changed a lot. I'm just glad to be living in a place where access to decent healthcare is unobstructed, unlike 99% of other places

 

Hi Xerxes: I'm glad Calgary, Alberta, Canada health care is working well for you and your loved ones. Perhaps the stories of Canadians paying for health care in the USA, instead of the long wait for free (but incompetent) care in Canada are exaggerations. Truth does seem to be a rare commodity.
The USA does need to make some changes to avoid second rate health care in the near future, but I think free enterprise with the right controls and fine tuning can do it much better than the socialist approach or the the Fascist approach championed by Hillary Clinton. Neil

 

Stories. Media-hyped stories. And the truth is that things have been improving to the point where you don't even hear them anymore. One doctor I spoke to had just come back from the States where he had moved to make more $$$. Even though he was making a lot more, the gap between those who could afford and those who couldn't sickened him to the point where he came right back.

Having a minimum point of equity in things like healthcare and education is what keeps society from collapsing. And fully privatized healthcare is no different than fully privatized education.

 

The United States was founded on the principles of liberty and personal responsibility. Not on the supposed god-given right to have others pay for your medical bills. If sick people are not good for the free market, the free market will fill fix it. The US govt. has no mandate to deliver healthcare nor should it.

 

right on machaon. when discussing the best healthcare available, currently the US blows away any other country but we are slowly losing quality because of socialist bastards. people have this ignorant mentality that everyone has a right to healthcare because that is more ethical. the crux of the matter is whether healthcare is a right or commodity. its obviously a commodity just like any other service.

 

The US has the best health care in the world "if" you are a multi-millionaire. If your not, you better be with a company that offers a top notch health care plan that you can afford. Otherwise you get poor to moderate health coverage in the US.

So if you are a multi-millionaire from any country, it is a great system.

Also do some research on the number of people going bankrupt from medical bills that also have health coverage.

Do your research...

 

My philosophy on healthcare is infallible. As a commodity, healthcare quality progresses more rapidly with the incentive to create new technology and techniques than if it were a right. I dont know many current statistics about us healthcare. I know that we offer the BEST emergency care, which is available to everyone. Hospitals cannot refuse care and therefore people get to take advantage of the best healthcare without even paying for it

our healthcare will become terrible if we continue on this slow path of socializing it

 

I didn't realize you could sum up the quality of healthcare by focusing on a single aspect such as emergency care.

But since you have and you claim it is the "BEST", prove it.

Opinions are easy. You need to support your argument or you will convince no one.

PS: You also claim, "people get to take advantage of the best healthcare without even paying for it'.

Do people receive a bill for their emergency care? If they receive a bill, then it isn't free. If they don't pay it, the consequences are the same as not paying any other bill.

 

There is a mandate to provide minimum health care for children of low income parents.
No politician will deny this.
In most states if family income is under $35,000 for a family of 4, the children have state health insurance.
Slippery slope.

Well, the service can’t be repossessed like a TV or car.
Hospitals are subsidized, and expected to write off a certain amount. Small bills are not worth much effort by collection agencies.
Medical Assistance (welfare) pays many bills. In our small community of 15,000 it pays $millions$ per month to the medical field.

 

Us health care : falling down an airport staircase in the international terminal, being taken to hospital after resisting for 15 minutes and spending a night under armed security survaillence... On the second day being sent back to the airport with a medical bill of :
$ 50 000 US , wow freedom at its best... good thing I sent them a fuck you letter instead of my payment.

 

Just because existence is based on darwinism in the animal kingdom, it doesn't mean humans have to be animals. Animals have no option but to accept the death of those ill. As humans, we have options.

The question is whether survival should be based on financial means. What is the value of a damaged but retrievable human life vs paper money?

In Texas today, if you lack financial means and have an ultimately fatal condition, hospitals will remove your life support whether you agree or not. Think about that. IMO, this is a far more outrageous situation than the Schiavo case.

 

Wrong question.
Your question assumes two things to be true:
1) We have unlimited medical resources (staff and equipment) available.
2) We have an unlimited amount of paper money to pay for these resources.
We know both of these statements to be false, therefore your implied conclusion is also false.

The correct question is “Should available resources be used to continue that one life, or these (some number greater than one) lives?”
It’s all triage. With triage there is a criteria or hierarchy to determine who receives treatment and who goes without.
It is not possible to keep all persons livings as long as scientifically possible with a limited supply of resources.

You do not like the criterea of wealth, so choose another criterea.
Perhaps beauty, youth, or intelligence?
I choose the extremely complicated criterea of prognosis vs cost.

Terri cost someone (other than herself) $1M per year. Nobody wants to talk about it. It does seem to place a dollar value on human life, but does not mean to. That is $1M not spent on some dying baby.

 

Well, if you don't like that, why don't you pay for those people's healthcare, then? Why are you complaining? ...just put your money where your mouth is but keep your damned hands outta' MY pockets! None of those damned people mean anything to me at all ...nothing!

There were some 8,000 children died today, every day, because of easily-cured illnesses. 8,000 kids! If you want to talk about people dying, what about them? Saving them at a cost of a few dollars compared to hundreds of thousands to keep one old, sick bastard alive on life support. Which is it gonna' be?

Life support cost money ....if you want to keep someone alive on life support, go ahead and do it, don't just talk about it.

Baron Max

 

Interesting article comparing the social security "emergency" with the problems of health care. Krugman points out that the US healthcare system ranks near the bottom amonst industrial nations and is the most expensive. He also states that businesses are opting out of providing employees health care with 5 million jobs losing health care.

Houston, we have a problem here. Where is Bush on this issue?

From here: http://www.nytimes.com/2005/04/11/opinion/11krugman4.html?buzzflash

Ailing Health Care
By PAUL KRUGMAN

Published: April 11, 2005

Those of us who accuse the administration of inventing a Social Security crisis are often accused, in return, of do-nothingism, of refusing to face up to the nation's problems. I plead not guilty: America does face a real crisis - but it's in health care, not Social Security.

Well-informed business executives agree. A recent survey of chief financial officers at major corporations found that 65 percent regard immediate action on health care costs as "very important." Only 31 percent said the same about Social Security reform.

But serious health care reform isn't on the table, and in the current political climate it probably can't be. You see, the health care crisis is ideologically inconvenient.

Let's start with some basic facts about health care.

Notice that I said "health care reform," not "Medicare reform." The rising cost of Medicare may loom large in political discussion, because it's a government program (and because it's often, wrongly, lumped together with Social Security by the crisis-mongers), but this isn't a story of runaway government spending. The costs of Medicare and of private health plans are both rising much faster than G.D.P. per capita, and at about the same rate per enrollee.

So what we're really facing is rapidly rising spending on health care generally, not just the part of health care currently paid for by taxpayers.

Rising health care spending isn't primarily the result of medical price inflation. It's primarily a response to innovation: the range of things that medicine can do keeps increasing. For example, Medicare recently started paying for implanted cardiac devices in many patients with heart trouble, now that research has shown them to be highly effective. This is good news, not bad.

So what's the problem? Why not welcome medical progress, and consider its costs money well spent? There are three answers.

First, America's traditional private health insurance system, in which workers get coverage through their employers, is unraveling. The Kaiser Family Foundation estimates that in 2004 there were at least five million fewer jobs providing health insurance than in 2001. And health care costs have become a major burden on those businesses that continue to provide insurance coverage: General Motors now spends about $1,500 on health care for every car it produces.

Second, rising Medicare spending may be a sign of progress, but it still must be paid for - and right now few politicians are willing to talk about the tax increases that will be needed if the program is to make medical advances available to all older Americans.

Finally, the U.S. health care system is wildly inefficient. Americans tend to believe that we have the best health care system in the world. (I've encountered members of the journalistic elite who flatly refuse to believe that France ranks much better on most measures of health care quality than the United States.) But it isn't true. We spend far more per person on health care than any other country - 75 percent more than Canada or France - yet rank near the bottom among industrial countries in indicators from life expectancy to infant mortality.

This last point is, in a way, good news. In the long run, medical progress may force us to make a harsh choice: if we don't want to become a society in which the rich get life-saving medical treatment and the rest of us don't, we'll have to pay much higher taxes. The vast waste in our current system means, however, that effective reform could both improve quality and cut costs, postponing the day of reckoning.

To get effective reform, however, we'll need to shed some preconceptions - in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.

The fact is that in health care, the private sector is often bloated and bureaucratic, while some government agencies - notably the Veterans Administration system - are lean and efficient. In health care, competition and personal choice can and do lead to higher costs and lower quality. The United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results.

Over the next few weeks I'll back up these assertions, and talk about what a workable health care reform might look like, if we can get ideology out of the way.