Income Tax Rates

If you want to thicken the air in any given room these days, bring up the subject of national health care reform. Opinions and emotions are guaranteed to fuel a heated conversation while at the same time some key issues are often left out of the informal debate. It is hard to blame participants for these oversights because of the subject's extreme complexity. But the bottom line remains that this is a subject our country needs to intelligently tackle before it bankrupts us.

In fact, many individual Americans have already been bankrupted through devastating encounters with our current health care system. This past summer, the respected American Journal of Medicine released new study findings that revealed some staggering statistics that reveal the role that medical expenses play in personal bankruptcy filings. Working to reduce the margin of error in their findings, the authors applied a stringency to the study that made it a first of its kind: a truly random sample of bankruptcy filers nationwide, followed up with detailed personal interviews of participants. Medical causes of bankruptcy were defined to include medical bills and loss of income due to health issues. In conclusion, they discovered that more than 60% of personal bankruptcy filings in 2007 had significant medically related expenses that pushed individuals and families over the financial edge to file for bankruptcy.

CNN interviewed an author of the study, Steffie Woolhandler, M.D. who made this concluding comment: "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." A comment coming from the D.C. based nonpartisan Center for Studying Health System Change in response to the American Journal of Medicine's study held some skepticism about what actually precipitated the bankruptcy filings but did own that medical expenses were a key player, considering that 1 in 5 American families are "unduly strained" by medical bills.

In 1981, only 8% of families filing for bankruptcy claimed to have done so in the wake of a major medical crisis. (The accuracy of that figure is somewhat debatable since court records do not indicate the origin of debt that is handled by collection agencies, possibly obscuring debt generated by doctor or hospital bills.) In 2001, a major study concluded that over 46% of personal bankruptcies were medically related. The American Journal of Medicine study's most recent conclusions of 61% used data from 2007, indicating an alarming trend and numbers which interestingly predate the fallout of our economy's current recession.

There is often a common misunderstanding about the majority of individuals who must file for bankruptcy; it is that they are society's shiftless or hapless members. The AMJ study indicates a profile of personal bankruptcy filers that is quite different from this perception. Most debtors in their random sample were middle aged, among the middle class and had gone to college. 75% of filers did have medical insurance at the outset of their health and debt problems. However, they had the norm of coverage gaps such as co-payments, deductibles and uncovered services. This brings up the unavoidable correlation of how 25% of insurance companies nationwide cancel coverage immediately when an individual suffers a disabling illness and another 25% of insurance companies rescind policies within one year.

This nation's long held axiom of "what is good for the middle-class is good for the country" could serve as a helpful guideline in healthcare reform. Every day there is an increasing number of middle class families struggling under the burden of medically related expenses through spiraling insurance premiums and large coverage gaps. Businesses struggle to maintain insurance plans for their employees, insurance that may turn out to be a misnomer as benefits and guaranteed coverage are downgraded in accordance with affordability. It is projected that in 2009, the U.S. will spend 17.6% of its gross domestic product on health care. And this is without taking into consideration all the hidden economic and societal costs of medically related bankruptcies.

Do a quick online search for this American Journal of Medicine study and review it in its entirety for yourself (www.amjmed.com, Vol. 122, Issue 8 pp. 741 to 746). As a citizen, you owe this brief time investment to both you and your country. Inform yourself and do not leave decision making of this kind solely and silently in the hands of your elected officials. It doesn't hurt to remember that your representatives have plump health insurance packages that the average Joe is barred from participating in.