Tuesday, June 9, 2009

A Uniquely American Tragedy

For those of us who have been fortunate enough to retain employment and health insurance coverage, it’s sometimes easy to lose track of the significance of how closely the two are tied in the United States. Lost among the stories detailing the foreclosures and other financial tragedies arising from the current recession, a recent report sheds some light on what has become a frighteningly common occurrence over the past decade, and one that remains largely unknown in most other industrialized nations. The American Journal of Medicine recently published an update to an earlier clinical research study which explores Medical Bankruptcy in the United States. The study covers the period immediately prior to the current financial meltdown, and exposes some startling and sobering facts which illuminate both the increasing fragility of the American Dream and the role that employer-provided health insurance plays with regard to family income security.
In 2001, the researchers found that medical problems had contributed to 46.2% of bankruptcies 5 states. This was significant when originally released since earlier studies in 1981 found that, at that time, only 8% of bankruptcies were the result of medical expenses. Expanding and updating the study via a random national sample of bankruptcy filers in 2007, the study found that the percentage of cases where bankruptcy was accompanied by loss of income due to medical reasons or having to mortgage a home to pay medical bills had risen to 62.1%. The share of American bankruptcies attributable to medical issues had risen by 49.6% in just six years. Some particularly interesting findings were that less than 25% of the debtors were uninsured when they filed for bankruptcy, but 40% had experience a lapse in coverage during the two years prior to filing. Most of the debtors were middle class, middle-aged and had gone to college.
I felt a sense of personal unease after reading this report. For me, it presented a stark reminder that “There, but by the grace of God, go I” and that today’s economic events must not obscure our need to address critical issues of health care in the United States.

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