Are Half of American Bankruptcies Really Due To Medical Bills?
January 2005: A study published in the journal Health Affairs (www.healthaffairs.org) estimates that half of all U.S. bankruptcies are the direct result of increasingly out-of-control medical costs, even though 75% of the patients studied had health insurance at the onset of illness. Led by Harvard Medical School professor Dr. David Himmelstein, the study paints a horrific picture of financial desperation, and appears to challenge the financial industry's long-standing assertion that all personal bankruptcies are due entirely to debtor's fiscal irresponsibility and fraud. A PDF version of the study is available online at http://content.healthaffairs.org/cgi/reprint/hlthaff.w5.63v1.pdf.
While I applaud any and all attempts to demonstrate that the health care "industry" has transformed the traditionally noble profession of medicine into a for-profit abomination that allows poor people to suffer and die for no good reason, I would like to suggest one alternative to this kind of expensive, grant-funded academic research: Open your eyes, look at the world around you, believe what your senses tell you, and use that grant money instead to help Americans who are struggling to stay alive in the American Debtors Prison. It is more than obvious that poor Americans cannot afford adequate health care, and that many debtors became inmates in the American Debtors Prison not because they are fiscally irresponsbile, but because they had the audacity to become seriously injured or ill while living in poverty.
The fact is, Health Affairs is an organ for discussing health care policy. It is primarily a political tool, not a medical research laboratory or financial consultant. The authors of this study certainly mean well, but it appears to be yet another instance of statistics being applied to junk science in an effort to influence public policy. By the researchers' own admission, they studied only 1771 out of 1,451,000 American families that filed for bankruptcy in 2001, and from this intensive research extrapolated the bombastic estimate that approximately 700,000 of those total bankruptcies in 2001 were the direct result of medical bills. And they only interviewed 931 out of the 1771 cases studied--the remaining "research" of real human beings' very real experiences was done entirely on paper. Unfortunately, the road to hell is paved with good intentions....
Yes, medical costs are wildly out of control, and can obliterate many American families' life-savings literally overnight. Yes, urgent medical treatment can result in overwhelming debt that was forced upon the patient against their will, merely because they exercised their instinctive will to live--not because they casually chose to sign a debt agreement. But the American Debtors Prison does not exist because of debt. It exists because creditors themselves prevent prisoners from repaying their debts. This academic study makes it appear that medical bills alone were the reason for so many personal bankruptcies, which implies that the first thing honest, hard-working Americans do when confronted with debt is to file for bankruptcy. There is no consideration at all for the ruthless, terrorist collections practices that force drowing debtors to file for bankruptcy when they would usually prefer to reach some kind of reasonable settlement with creditors--especially when repaying the people who saved their lives. The distinction is subtle, but very important.
All the best,
Paul
While I applaud any and all attempts to demonstrate that the health care "industry" has transformed the traditionally noble profession of medicine into a for-profit abomination that allows poor people to suffer and die for no good reason, I would like to suggest one alternative to this kind of expensive, grant-funded academic research: Open your eyes, look at the world around you, believe what your senses tell you, and use that grant money instead to help Americans who are struggling to stay alive in the American Debtors Prison. It is more than obvious that poor Americans cannot afford adequate health care, and that many debtors became inmates in the American Debtors Prison not because they are fiscally irresponsbile, but because they had the audacity to become seriously injured or ill while living in poverty.
The fact is, Health Affairs is an organ for discussing health care policy. It is primarily a political tool, not a medical research laboratory or financial consultant. The authors of this study certainly mean well, but it appears to be yet another instance of statistics being applied to junk science in an effort to influence public policy. By the researchers' own admission, they studied only 1771 out of 1,451,000 American families that filed for bankruptcy in 2001, and from this intensive research extrapolated the bombastic estimate that approximately 700,000 of those total bankruptcies in 2001 were the direct result of medical bills. And they only interviewed 931 out of the 1771 cases studied--the remaining "research" of real human beings' very real experiences was done entirely on paper. Unfortunately, the road to hell is paved with good intentions....
Yes, medical costs are wildly out of control, and can obliterate many American families' life-savings literally overnight. Yes, urgent medical treatment can result in overwhelming debt that was forced upon the patient against their will, merely because they exercised their instinctive will to live--not because they casually chose to sign a debt agreement. But the American Debtors Prison does not exist because of debt. It exists because creditors themselves prevent prisoners from repaying their debts. This academic study makes it appear that medical bills alone were the reason for so many personal bankruptcies, which implies that the first thing honest, hard-working Americans do when confronted with debt is to file for bankruptcy. There is no consideration at all for the ruthless, terrorist collections practices that force drowing debtors to file for bankruptcy when they would usually prefer to reach some kind of reasonable settlement with creditors--especially when repaying the people who saved their lives. The distinction is subtle, but very important.
All the best,
Paul
posted by Paul at 1:21 AM
1 Comments:
Thank you for your response.
I don't want to sound like Dr. "Bones" McCoy, so I'll just quote him instead: "My God man! Math won't save him!"
The topic of this blog is debtors imprisonment, so it is not my purpose or desire to engage in a technical debate on junk or politically-motivated science, except to raise the issue in layman's terms when academia acts first to help perpetuate the atrocity of debtors imprisonment, even when that is not their intention. Steve Milloy already publishes a website devoted to bad science, www.junkscience.com.
You have perfectly illustrated why I will not turn debtors imprisonment into an academic debate. By invoking "confidence intervals" and other terminology that is beyond the grasp of the average person, you confound the issue to the point of absurdity, and count on the fact that humans tend to give undue credibility to anyone who speaks to them with authority, using esoteric language. I won't play that game.
Experience makes a stronger argument than statistics when it comes to human responses to overwhelming emotional trauma. For example, I am horrified by statistics of the Nazi Holocaust. But I would have learned much more about the reality of that atrocity by getting to know individual death camp inmates as real people, than by "interviewing" them as a detached, objective researcher who cannot allow himself to feel emotion while watching a fellow human being suffer, all in the name of science. That is how the eugenics movement for ethnic cleansing got started in the first place, by replacing humanity with (bad) science. However, I do trust Viktor Frankl when he says that individuals in Nazi death camps exhibited dramatically different responses to the exact same ritual torture, because he was actually there to witness this as an Auschwitz prisoner himself. The same is true of American debtors prisoners, and I have witnessed this for myself.
This academic study implies another story, that just like Pavlov's dog, indivuals who suddenly find themselves faced with overwhelming medical debt will file for bankruptcy for relief from debt (as opposed to bankruptcy protection from creditor harassment). The study does not state this, and I never said it did. In fact, much to their credit the authors opened their paper with a brief description of the American Debtor Prison itself.
There is no need to be so defensive, or to put words in my mouth. I never said "Academics are out-of-touch ivory tower types'. You wrote that. What I said was that some apparantly well-meaning people drew some bad conclusions, and that the money spent on this study could have been used to help suffering people instead. I was lamenting the rather obvious fact that ending poverty and suffering is not a priority in American society, but funding research like this is.
Lastly, please allow me to translate part of your comment so that every reader will understand: an "ad hominem attack" means to make no rational argument at all, and merely to assassinate the opponent's character instead. Readers may judge whether or not I assassinated the researchers' characters, but I should point out that I did say I applaud efforts to reform the health care industry, and that "The authors of this study certainly mean well". If that is character assassination than God help them if I ever decide to get nasty!
All the best,
Paul
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