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Morally bankrupt
26 Sep 2008 09:28 pm
I cannot address all the patently untrue things that McCain and Obama are saying, but I must protest when Barack Obama claims that people are going bankrupt because of health expenses. There is no evidence to suggest that this is a widespread phenomenon. The Eliabeth Warren study purporting to show that amazing numbers of bankruptcies were caused by medical problems was, to put it politely, garbage; she broadened the definition of a "medical bankruptcy" far beyond that used by the bankrupts themselves, including things like gambling problems. The overwhelming causes of bankruptcy are divorce and job loss; even the medical bankruptcies are, the experts say, a problem of income loss rather than medical bills. Hospitals and doctors hate to sue people for large bills, because it always seems to end up on local television.
Sorry, you make an interesting small point in service of avoiding the main issue of reforming 20% cost bloated medical system that fences in the healthy & wealthy and fences out those with "pre-existing conditions" and 47m others who can't afford health care.
Possibly you admire "George" McCain's healthcare proposals and will parse them with similar small-mindeded fervor.
When I worked in the mortgage lending industry just prior to 1990 (when a bubble was popping, though not on today's scale), the conventional wisdom was that divorce was by far the single leading cause of defaults and foreclosures.
I don't dispute that medical bankruptcies are less common than Obama says, but at least in my neck of the woods, hospitals and doctors have no problem at all filing lawsuits to recover large bills. In fact, of all the creditors I deal with as an attorney, hospitals and doctors are by far the most aggressive and least cooperative, even more so than credit card companies.
Your basing your view on the elitist assumption that medical expenses must exceed at least 10,000 in a year in order to be a "genuine" reason for bankruptcy. Your basing your disdain of the study because you're assuming that something like 1,000 or 3,000 owed can't possibly lead to bankruptcy.
When a family is barely making it, barely getting by, something like a medical bill for 1,000 can be enough to drive the family over the edge into bankruptcy.
The Harvard study documented instances where medical expenses are one of the factors leading to the bankruptcy. Rarely is there only one thing leading to most bankruptcies -- it is a series of events, including loss of job, loss of spouse, and yes, including medical expenses that leads to most bankruptcies. In over a quarter of the bankruptcies, it was the leading reason.
As for hospitals and doctors not willing to sue -- are you for real? Hospitals and doctors contract with specialized collection firms specifically to collect the money, up to an including taking the people to court. In fact, there's been investigations into some of the collection firms because of the excessive interest rates they charge -- sometimes exceeding 100% of the actual amount owed.
Next time, fact check, first.
Democrats love to throw out the number 47 million without healthcare. But a couple of points they fail to mention is that part of that 47 million include illegal immigrants (ask California about this problem and the hospitals that have had to close because they couldn't afford to care for illegals) and people who don't have health care because they have enough money to cover their health expenses when they arise. As for the rest of them, why should I pay for their healthcare? This is pure socialism. I like McCain's plan of giving people a tax incentive to go out and purchase their own healthcare. After all, they are much better capable to choose who their healthcare providers should be than the government is. Do we really want the same people providing healthcare who can't even manage to keep the government as a whole running efficiently? I think not.
Count this Canadian citizen as being against a single-payer system. Wait times for MRIs will be measured in months, unless you happen to be someone important (like the head of a union, for instance).
As for hospitals and doctors not willing to sue -- are you for real?
No kidding, I just attended a pathology conference and a lot of exhibitors were "billing solutions" One of the anecdotal quotes is "such and such company, found $200,000 worth of unpaid bills in our accounts and collected them"
Secondly, unless there is strict legislation on how and when insurance companies can raise their premiums then it can be impossible to purchase insurance. Otherwise at the first sign of a major illness the company either drops you, or jacks your premiums way up. One of the advantages of employer-based insurance is the risk pooling that comes along with it. Unless we mimic this in the private insurance market, it won't work.
Megan,
The loss of a job would certainly be a bigger reason for a bancruptcy than a stack of medical bills. The problem is that unemployed with a stack of medical bills are much more likely to declare bancruptcy that the unemployed who are lucky to be healthy. All the while, the employed with medical problems may avoid filing bancruptcy, but feel no better having to pay gargantuan amounts to health providers because they are being denied coverage or treatment by insurance companies.
If there is no evidence to suggest that medical bancruptcies ar a widespread phenomenon, as you claim, than you should not be concerned about Obama's likelihood of winning the election, since he is making a pretty big stake on the message about medical coverage.
Literal bankruptcy due to health care costs is certainly very uncommon.
But if you view this thru the lens of political hyperbole, it's a not too inaccurate statement: lots of people, if they don't happen to have health care thru their job, are having serious problems paying for helath insurance (I know I am). Or are simply doing without and praying that nothing serious crops up.
Politicians always overstate things. Perhaps they think for some reason that it clarifies them. But this particular statement is not unusually wide of the mark for a politician talking.
Uhm... Megan?
If you're going to make a reference to a stay, the least you could do, is spell the woman's first name properly!
D'oh!
-Pat
Shelley,
There's a law in most if not all states that if a patient makes a "good faith effort" to pay their medical bills they are immune from lien or lawsuit. Here in Georgia that's defined as $1/month.
And that 47 million without health insurance number has been so roundly debunked that using it in a debate is displays ignorance or a rabid disregard for the truth.
I have worked in the debt management, debt settlement and bankruptcy arena for ten years. The number of clients in these programs due to unpayable medical expenses is considerable. People do make decisions of whether to eat or forgo medicine every day. Your selfish smugness is quite frankly appalling.
That's ridiculous, Bob. Either the numbers support medical bills causing a significant proportion of bankruptcy or they do not. Saying that they don't is either correct or not, and has nothing to with smugness or selfishness.
Re: but I must protest when Barack Obama claims that people are going bankrupt because of health expenses. There is no evidence to suggest that this is a widespread phenomenon.
While Elizabeth Warren certainly exaggerates the phenomenon there's solid data to show that medical costs are a significant factor in anywhere from 1/4 to 1/3 of bankruptcies, which I think qualifies as "widespread". By the way you can't just analyze debts owed directly to hospitals and doctors to arrive at those figures; you have to pour through credit card line items since many, many people pay for healthcare expenses (even large expenses) by plastic, which can easily mask the underlying cause of their high balances.
Re: And that 47 million without health insurance number has been so roundly debunked
That number is fairly accurate, to within the usual statistical uncertainties. Yes, people cycle in and out to that population, but the simple fact is that every other remotely civilized and prosperous nation does not have that sort of population at all. If there were 47 million people homeless (even cyclically), 47 million people malnourished, an equivalent fraction of minors with no access to schools, etc. Most Americans, even rabid rightwingers, would be up in arms. There is no reason we should toleate this sort of dysfunction when tested adn workbale solutions are readily avaialable.
OK. You're 55 years old. You have a heart attack. Your company health insurance pays some of your medical bills, but you can't go back to work for a few months, so they lay you off and hire a cheaper 26-year-old. And then, you have complications from the heart attack. Your Cobra payments are $1600 a month. Your health insurance maxes out. You have no job. No one wants to hire a 55 year old who had a heart attack. You're too young for Medicare. Is your subsequent bankruptcy due to medical problems or job loss?
My husband and I are middle class, savings, solid equity in our house, two college-educated professionals. He just got laid off, I am recovering from thyroid cancer and have rheumatoid arthritis. We lose health insurance on November 1. Any idea how much our COBRA payment will be? Any bets on how insurable I am? Our grown daughter is struggling to pay off a co-pay from a hospital bill from a still birth, my brother-in-law is watching his wife die of colon cancer, already over $100,000 in debt in treatment. He's 65. Right, none of us are filing bankruptcy, but I would bet there are a lot of people like me who are hearing and living these stories.
As for the rest of them, why should I pay for their healthcare?
Because you'll benefit, in the long run.
If you're the kind of person, though, that would cut off your nose to spite your face, and turn down the long-term gains of a healthier population out of pique at the thought of picking up some part of someone else's tab, then I submit to you that you are a fundamentally broken and selfish person, and it's in the interest of society as a whole that you be completely marginalized from the decision-making process.
Chet, you are a pompous idiot. Just because someone doesn't want to pay for other people's foolishness, that neither makes them broken nor selfish. The only one that needs to be MARGINALIZED from the decision making process are people like you, who would make such decisions for everyone. You ever hear of live and let live? By definition, that includes live and let die. For the small percentage of the population that cannot provide for themselves, for whatever reason, some form of care should be provided. Whether that be through private subscription, or through government support is beside the point. Who elected YOU as the prime arbiter?
Gene
Just because someone doesn't want to pay for other people's foolishness, that neither makes them broken nor selfish.
It's the description of misfortune as "foolishness" that makes it broken and selfish. I know that in your magical-thinking worldview, nobody gets sick unless they deserved it for some reason, but here in the world of science we recognize that health conditions are as much about bad luck as they are about bad lifestyle; you can live clean all your life and still get cancer, for instance.
A prudent society observes the categorical imperative and shares that risk.
You ever hear of live and let live?
Ever hear of "herd immunity"? You, as an individual, benefit personally from healthier peers. Reasonable people have no problem paying for that benefit. You're just selfish and broken. Since you can't be trusted to act in reasonable self-interest, you and your party should be kept as far away from power as possible.
I'm pleased by the recent research that is showing how conservativism isn't just one of several political ideologies, but rather a specific (and genetic) personality disorder. (Look it up, if you don't believe me. Start with Bob Altemeyer and look up the recent research from the University of Nebraska.) I'm not saying you guys need to be rounded up into "reeducation camps" or something - for one thing, I'm not convinced you can be educated, and secondly, that's what conservatives do - but I think we need to question whether a fundamentally malign party, consisting entirely of persons with a recognized mental illness and those who gain power by exploiting them, should be allowed to flourish in American society. Ideally, American politics should be a conversation between different aspects of liberalism.
It's aways easy to be altruistic with other people's money - right Chet?
And you double your fun when at the same time you can accuse the other person of being selfish or mentally incompetent if they balk at giving up their property at the point of your gun.
I mean, how can you be wrong? You have the force of the majority behind you, right?
We voted didn't we?
I was a loan officer in a department that dealt specifically with people who had had credit problems - while divorce was definitely the most common root problem, medical expenses were a significant cause. While they may not cause outright bankruptcy, they definitely sent a lot of my clients' credit scores plummeting to hell. And that doesn't even count the auxiliary costs that can lead to bankruptcy - for example, lack of medical coverage preventing people from seeking treatment, thus becoming unable to work, etc. This is especially true of mental illness.
However, the question "is your subsequent bankruptcy due to medical expenses or job loss" is more interesting. Although your example is underspecified (you don't state income or assets) I'd lean toward the job loss side, since you'll have other, non-medical, obligations to meet, and, assuming the you can't absorb 1600/month without a job for the rest of your re-estimated life-expectancy you may well be headed to insolvency even if your medical bills were covered.
That's the real trick. Even fully socialized medicine won't necessarily impact the bankruptcy rate that much unless you're including fully socialized Aflac-style income loss payments along with it.
Shelly - Re: "When a family is barely making it, barely getting by, something like a medical bill for 1,000 can be enough to drive the family over the edge into bankruptcy."
In that situation the $1000 medical bill isn't the reason for their bankruptcy, all the other expenses are. If you spend say $30k a year, the $29k is much more of a problem than the $1k.
If your that close to the edge, than anything can come along and push you over. The reason for the bankruptcy is being that close to the edge, not the final "straw that broke the camel's back"
Who cares? The bottom line is, regardless of whether it's the medical bills themselves or the job loss accompanying a major medical problem, you have medical bills you can't pay. Therefore you are bankrupt, and the proximate cause is your medical bills. If you didn't have the bills, you wouldn't be bankrupt because of them (though you might be bankrupt due to other causes, just not medical bills). Seems pretty straightforward to me.
I don't see how this qualifies as "patently untrue," and I'm not prepared to accept your say-so that it's not "a widespread phenomenon." Of course, you're not really trying to persuade me...
So certain are you...
How much is "that much?" 1%? 10%? 50%?
LiberalRob -
How many times do you have to be told the same thing?
If your income is $30000 per year, and you're spending $28500, the $1000 medical bill isn't what made you bankrupt.
It may be *part* of what made you bankrupt, but it isn't the *cause*, it isn't the "proximate cause" - and I'm not sure that's the term you wanted to use anyway, but... - it's a *contributing factor* and there's a world of difference.
You can't just ignore the rest of the debt and spending and blame it on the medical bill(s).
All you people who claim to work with credit counseling firms and want to tell us all how healthcare is driving folks to bankruptcy - how many of your bk sob stories have *only* medical debt that drove them into thier predicament?
If your income is $30000 per year, and you're spending $28500, the $1000 medical bill isn't what made you bankrupt.
If your income is n dollars per year, and your "regular" spending is k dollars, you'll avoid bankrupcy if n - k is a sufficiently large enough amount to cover unexpected expenses.
For most unexpected expenses - car repairs, parking tickets, whatever - n - k can easily be large enough for most people to absorb. That's not true for medical expenses, which are as likely to be $100,000 as $1000. Only the truly wealthy can have n - k values high enough to absorb the panoply of possible health expenditures.
So, in that sense, it is the medical expenses that are causing bankrupcy. That's obviously true when 2k
It's aways easy to be altruistic with other people's money - right Chet?
In fact, if you'll actually read, you'll see that I was talking neither about other people's money nor about altruism.
This is pure self-interest. Individuals have a self-interest in living among healthier peers, as well as being insulated against ruinous health expenses of their own.
Your position is pure pathological anti-self-interest. Completely irrational, and thus must be marginalized.