Please read this article which I agree 100% with based on my over 38 years of hospital and private practice management.http://content.healthaffairs.org/content/25/2/w74.full again that is http://content.healthaffairs.org/content/25/2/w74.full It discuss the fact that medical bills/debt owed to physicians, surgeons, labs, and other medical businesses and providers that contribute to the care of patients; are not the biggest cause of bankruptcy. IMO the health care field is the largest service group that will do everything they can to make payments toward medical bills affordable for their patients. IMO, credit card, mortgage, car loan and other unsecured loan debt is the biggest reason people resort to filing bankruptcy. And, when you get down to it, those with student loan debt whose principle continues to mount monthly, year after year are forced into financial problems because crooked loan providers such as Government sanctioned sallie mae and unregulated private lenders of school loans continued to charge interest during the years the borrower was a full-time student which resulted in a principle balance and subsequent monthly loan payment often nearly as much or more than the starting monthly salary paid an entry level worker in their field of study. There are millions of student loan borrowers that graduated 10 to 20 years ago who are still struggling to pay their student loan debt. And because of changes in the bankruptcy laws by Congress, years ago, student loans can never be erased or forgiven by filing bankruptcy. So, student loan debt is not listen as a debt on bankruptcy filings. Yet, it is perhaps for too many, the reason they struggle to pay other debts and bills resulting in using bankruptcy to get rid of those debts so they can pay their school loan(s). If you fail to pay your school loan the can legal take your pay check, file against your personal property. It is wrong that this debt is the only debt not forgiven in filing bankruptcy. IMO, medical debt is the least of financial problems causing bankruptcy. I would site Credit Care, Car Loan, Mortgage debt and student loans to be a much bigger cause.
An almost ten year old study that really only disputes methodoly of a series of studies but does not actually provide any new information. The only actual work the author seems to do is multiply two probabilities together to get his number of bankruptcies cause by medical bills and this use of probabilities makes several assumptions. And even agreeing with the authors methodology if an improved healthcare system can reduce one of the t causes of bankruptcy and improve the lives of a significant number of persons while reducing the overall cost to the economy I would suggest it is worth doing. One has only to look at healthcare in other developed countries to realize how defective both in costs and results our system is.
The point is that medical debt has seldom been the major reason individuals file bankruptcy because the majority of providers and hospitals are willing to set up payment plans that are based on what the patient is able to pay. And, many physicians simply forgive the debt where the patient is unable to pay due to loss of employment. The major reason that a person choses or is forced to file bankruptcy is due to credit card debt, loan debt, mortgage debt and IMO student loan debt. While you can not have student loan debt forgiven by filing bankruptcy(one of the only debt that can't be forgiven), it contributes highly to inability for an individual to pay their other debts, those that can be forgiven by filing bankruptcy. Medical debt on its own is not the number 1 cause of bankruptcy and providers of health care services rarely take their patients to court in an attempt to recover the amount they are owed. It simply costs to much in legal fees, takes too much time and you can't get money from someone that has none. But credit card companies have legal staff to file lawsuits against those that have not been paying their debt and do report those in arrears to credit bureaus. AS do all major lenders. When one loses their job and can't pay they bills they may decide to or be forced to file bankruptcy to have those debt forgiven. These lenders are not willing for the most part to work up payment plans with the debtor. The debtor is faceless and the lenders simply don't care. While medical providers are typically not interested in suing or destroying the trust and relationship they have with their patients. I don't care how many government backed studies are done. None of them are creditable when they claim medical debt is the major cause of bankruptcy because when one files bankruptcy they list every debt they have and the order in which they list the debts means nothing. When you file, you could list $5k total in credit card debt, $Xk in loan debt including car payments, electric, gas and other utility bills and $X in money owed to hospitals or doctors. The reason for filing is likely loss of job/income that may be due to various factors. It doesn't matter, if you can show you don't have the income/assets needed to pay your debts you can file for bankruptcy. Not all debt is always forgiven. If you have a job or means of income, you be offered lower payment plan or some debts may be partially forgiven. I guarantee that the debt owed a hospital or medical provider has never been the reason a person decides to or is forced to file bankruptcy unless they simply don't want to pay for services they agreed to pay for and were subsequently provided.
You have moved from a discussion based on facts to one based on opinion. That is OK but doesn't really provide a basis for reaching any type of conclusion. And just for your thought processes I would guess most people who incure medical costs at a doctor or pharmacy or hospital put those bills on a credit card.
The only studies completed on this subject fail to target only Medical Debit as the cause of bankruptcy. Bankruptcy normaly lists all debt. It does not distinguish what is the highest monetary debt. Medical Debit alone is not the number 1 cause of bankruptcy. Those with medical debt are afforded an opportunity, by the debtor, to make payments based on their income and ability to pay. No study has been done that shows medical providers are the number 1 cause of individuals filing bankruptcy.
Perhaps, but in my experience as an information manager at private facilities, nursing homes and my husbands medical practices; most people that have no insurance don't have much available credit and it is up to hospitals, clinics, doctors and the like to provide them with an affordable payment plan or simply write off what they owe as uncollectible. And, those amounts are not tax deductible as they are fees for service and not goods. So, while those that are determined to have incomes but simply chose not to even attempt to make a payment to providers may be reported to a credit agency, I would, in my experience say 99% of them are never sued. And, again, show me one study that deals solely with bankruptcy based on medical debt. I can't find one. To your point, maybe patients should be honest upfront and set up a workable payment plan instead of using a credit card and maxing it out when they know they can't pay the bills.
Well sorry to dispute your personal experiences but in 2008 I did not and could not get insurance due to a pre existing condition despite having a net worth in excess of two million dollars and Absolutly perfect credit. I went to India for a series of surgeries because the best I could negotiate in the US was to pay about four times what an insurance company would pay for the same procedures even though I was willing to pay cash upfront for close to eighty grand. And if you really have the qualifications and experience you claim you know perfectly well how the medical profession overcharges those who have no insurance. And don't spout the BS about negotiating a payment plan with doctors and hospitals. They will negotiate a plan but the charges will be four to five times what the procedures cost an insurance company.
I compare it to the Irish potato famine. If you think it was all just caused by the potato blight, you really don't know what happened. There were deeper underlying causes, many Irish families were already in a vulnerable position, living on the edge, before the blight happened.
"More troublingly, perhaps, a bankruptcy study by the Department of Justice — which had a sample size five times larger than Himmelstein and Warren’s study — found that 54 percent of bankruptcies have no medical debt, and 90 percent have debt under $5,000. A handful of studies that contradict Himmelstein and Warren’s findings include studies by Aparna Mathur at the American Enterprise Institute; David Dranove and Michael Millenson of Northwestern University; Scott Fay, Erik Hurst, and Michelle White (at the universities of Florida, Chicago, and San Diego, respectively); and David Gross of Compass Lexecon and Nicholas Souleles of the University of Pennsylvania. Why are Himmelstein and Warren’s findings so radically different? Aside from the fact that their study was funded by an organization called Physicians for a National Health Program, the study was incredibly liberal about what it defined as a medical bankruptcy. The study considered any bankruptcy with any amount of medical debt as a medical bankruptcy. Declare bankruptcy with $100,000 in credit card debt and $5 in medical debt? That’s a medical bankruptcy, of course. In fact, only 27 percent of those surveyed in the study had unreimbursed medical debt exceeding $1,000 in the two years prior to declaring bankruptcy." http://fee.org/blog/detail/8-goofs-in-jonathan-grubers-health-care-reform-book You may not like the source of the article above, but it backs up what I posted previously and I agree with what it says. And, I will admit that there are certainly bankruptcies caused primarily because of medical debt. But, again, IMO and personal experience, the majority of medical/surgical providers do not file in small claims court against their patients. For one reason, prior to providing treatment their office staff verifies the patients insurance coverage(if they have insurance) or set up a payment plan if they have no insurance and can't afford the total cost upfront, the staff advises the patient also on estimated co-payment cost or if the fee will go to their deductible hence they will be responsible for the total "approved" charge. Many providers will agree to accept what the insurance pays when the patient hasn't the income to pay. Many patients don't understand the willingness of many providers to do the above, they don't know the importance of shopping around for a good physician willing to help them when they have financial problems or no insurance coverage. The good ones are out their. And, can those filing bankruptcy list student loan debt? No, the Federal Government passed a law long ago denying the right to claim bankruptcy due to student loan debt. I would venture to say a significant number of bankruptcies may be cause by inability to pay this loan debt, contributing to inability to pay other debts owed. The fact is no study I can find takes into account all debt categories and their percentage contribution to the total debt owed. Do you know of one?
In my opinion, there are two reasons for personal bankruptcy---- 1)Chronic Medical sickness and 2) being irresponible
Well I think #1 is student loan and credit card debt. #2 medical debt due to the need for high cost tests, surgery and diagnosis of cancer, heart disease, liver disease, diabetes, and other conditions that require lengthy hospital stays contribute to the need to file bankruptcy, but it most likely other lenders that filed financial claims against the individual, not physicians and hospitals. And, it is also likely that even with health care insurance coverage and especially the new "exchange policies", the deductibles and out of pocket and uncovered expenses can impact their debt. So these high deductibles and out of pocket will not stop medical debt, individuals still can not afford insurance with affordable deductibles and annual out of pocket limits. Since you can't file bankruptcy on student loan payments that are often 50% of a persons monthly income and payable even if the graduate can't find a job in their field of study; they are not listed on the bankruptcy filing and therefore only all other debts, such as medical debt, credit card debt, car loans, mortgage payments and the like are listed. Yet it may have been the student loan monthly payments that caused inability to other debts. These student loans continue to accrue interest while attending school and normally become due a set period of time after graduating or quitting school. The prin. balance at that time will have increased the debt greatly and missing a payments will also considerably increase the debt amount. Student loans should be treated the same as any loan, car loan, mortgage, credit card debt. Yet, IMO the Federal Government passed the law exempting student loans from Bankruptcy, why, because a huge number of these loan were backed by the Federal Government, they didn't care if private lenders lost their money, right?
So please spell out your solution to the problem you believe exists due to high deductables. Government mandating lower deductables, perhaps? Higher government subsidies?
A large amount of hospitals will write off a big portion of the bill. My dad had over $200,000 worth of heart surgery done, ended up only having to pay about $7000 of it and he didn't even have insurance.
That is one of the key reasons why the medical community in general bills four or five times what they actually expect to get paid. They can then write off the billed amount as opposed to the amount they actually would have been paid by an insurance company. This actually encouraged not paying medical bills prior to the ACA since knowledgable consumers knew they were being overfilled if they did not have insurance.
We live in a society that believes you can have what you want when you want it as long as you have enough credit. That is the major driver of bankruptcies. I don't know of anyone that has gone bankrupt due to medical bills, I know many that have gone bankrupt due to debt driven by wants, not needs. The Dotcom bubble and the housing bubble collapses pretty much drove huge numbers of bankruptcies because people bet on an alleged sure thing using debt.
My solution is more choice and more government regulation over the products Health Insurance companies can sell. The deductibles should be based on the cost of insurance and the covered benefit, as should the out of pocket annual expense limits. The PPACA did nothing in regard to this. So people are buying what is claimed to be lower cost insurance, but the insurance companies will likely pay little as the deductibles and out of pocket are so high most policy owners will never meet it unless they have a major medical expense. And even then they will owe a large some after their insurance pays their portion of the bill. Health Insurance was never meant to cover all medical costs. It was meant to cover what the average person couldn't afford to pay. But now, they are legally responsible for paying preventative care, insuring those already diagnosed with costly illnesses and forced to pay for their medical and surgical treatment. They are a for profit business and now hijacked by the federal government and told how much they can profit, who they must insure and forcing them to pay for preventative care. How long will this last and how long can physicians and other providers lose money and barely make a profit?
there you go, supports what I have been saying. It is the Credit card, Student Loan, Auto Loan and Mortgage Loan businesses that are the biggest causes of bankruptcy. Medical debt is normal only listed in the bankruptcy documents. I guarantee you that no physician or surgeon wants to see their patient forced to file bankruptcy due to what they have billed. They are more than willing to set a payment plan or in cases where their patient has no job and a family to support, write off the debt.
actually bush changed the laws, all unsecured debt can not be claimed in BK this is why credit card companies are targeting young teens so hard now, so they can lock them into a debt train for life
You are very wrong. No medical provider including hospitals can write off the amount they were not paid as it is considered a service, not goods. (they can write off tangible goods provided that weren't paid for) Health care services simply can't be written off. The reason physicians and other providers of health care still charge fees for service that they know will not be approved by a persons insurance is because that is their fee; and it is on record when the Government and Private Insurance determine the average fee charged for specific treatments and surgery, regardless if the insurance company won't pay it. They can only charge the patient the co-pay or unmet deductible and it is based on what the insurance company or medicare approves. So if they charge $1000.00 for the surgery and Medicare or Private insurance only approves $500.00, paying 80% of that The patient will only owe the 20% of $500.00. They may owe more if part of the insurance payment went toward their deductible, so if they have a $1000.00 deductible and have not met it they could owe the entire amount. I only wish my surgeon husband could write off the amount he is not paid from his gross income. Not allowed. Just as an accountant can't write off uncollected debt or an attorney can't, or anyone that only provides a service and is not charging for a tangible good. You can only write off debt for unpaid goods. Period
They are. When you arbitrarily create a one size fits all coverage including things like old people having to carry pediatric care it raises the cost of insurance. All Obamacare did was insure that the insurance companies will stay solvent and at the same time limit coverage, make patients and doctors poorer, and degrade service but the one thing it didn't do is lower the actual cost of healthcare.
Obamacare raised the cost of practicing medicine by issuing new costly regulations that Providers must comply with, on top of the already high overhead costs of providing medical care. The PPACA only lowered the cost of the Federal Governments Medicare Program by reimbursing less and reducing covered benefits. They pay pennies on the dollar for extensive surgical procedures and medical care and follow-up of diabetes, heart disease, cancer and the like. That is not reducing the cost of providing medical care but rather is no more than reducing the fee they are willing to pay. At some point it becomes unprofitable to continuing treating Medicare patients and patients with low reimbursing private insurance, specifically a majority of "Exchange" issued policies. The private companies have two distinct types of policies now, Exchange Policies and Non-Exchange Policies that don't cost that much more yet have higher reimbursement rates. I have seen both in our practice.
Well if you had/have a net worth of $2 million you should have paid into a medical savings account as you obviously could afford paying for your medical care.
A scientific study with the hypothesis, "medical debt" "number 1 cause of personal bankruptcy", would have to review each bankruptcy in the study to determine the highest debt claimed. Obviously, if you have credit card, mortgage and or car loan debt that is reported monthly to credit bureaus, with payments that take the majority of your monthly income, it will leave you little disposable income to pay secondary medical bills, that are less likely to be reported to credit bureaus on a monthly basis. When bankruptcy is filed, all debt is listed and when previous studies and articles are written on "medical debt", they include bankruptcies that list, "any" medical debt. Sorry, my knowledge and experience tells me that medical debt is not the largest cause of bankruptcy in the major of bankruptcy filings. For most physicians, reporting debt to credit companies is as far as it goes.
That only allows you to pay for medical procedures with pretax dollars which results in a small reduction in overall cost. Going overseas reduced the cost to less than 25% of what it would have cost in the United States. Now if I could have gotten the procedures at the same cost as large insurance companies and the paid from a medical savings account the costs would have been close enough to make having the procedures done in the United States a viable option.
Well, you are certainly entitled to have an opinion but facts and data actually tend to be more persuasive.
