Most doctorsrefrain from harmfulBut our medical institutions harm patients every day. They charge patients unaffordable medical bills, and in many cases patients cannot pay rent or mortgages and buy enough food.
That accusation is not an exaggeration. That’s a finding from our analysis. JAMA network open — Census Bureau study of health care debt. More than 1 in 10 of her U.S. adults and nearly 1 in 5 of her households were found to have unaffordable medical bills. It wasn’t just the poor and uninsured who were at risk. Adults who went to college were just as likely to have health care debt as adults who hadn’t finished high school, and middle-income people had the same risk as the poor. The uninsured have the highest proportion of medical debt (15.3%), but 10.5% of privately insured people have medical debt, probably due to high copayments, deductibles and denials of coverage. Yes, and the proportion of Medicare Advantage participants was particularly high. Nor was the debt trivial. In 2018, he averaged $21,687 per borrower.
Our findings add to a growing body of research showing that health care costs are a major problem for Americans. and sociologist Deborah Thorne) found that illness and medical costs were to blame. more than half Of all bankruptcies, 62% in 2007. a Kaiser/NPR Survey This year suggests that health care debt estimates (based on the 2017-2019 survey) may be too conservative. Kaiser/NPR estimates that 100 million Americans have medical debt.
But whatever the number, the consequences are often severe. Because the Census Bureau surveyed the same individuals repeatedly over three years, he was able to assess the consequences of newly acquiring medical debt, unlike previous analysts (who used a one-off survey). rice field. Among individuals with no health care debt in 2017, those who had new such debt in subsequent years were either newly food insecure or unable to pay their rent, mortgage, or utility bills. and more than doubled the chances of being evicted or foreclosed. years after that.
Additionally, detailed income and wealth data collected by the Census Bureau allowed us to isolate the impact of health care costs. It was not the loss of income due to illness or the depletion of non-medical assets that drove people out of their homes and the hardships they had to buy groceries, but rather the cost of medical care. It often exacerbated clinical determinants (non-medical factors that influence health outcomes).
Medical leaders and policy makers like to blame these non-medical factors Yawning disparities in health outcomes Our life expectancy is three to four years behind other wealthy countries. they are right Poverty and all the hardships that come with it undermine health.but in 80% of hospitals “Leadership is committed to establishing and developing processes to systematically address societal needs as part of clinical care,” but they are wary of admitting they are part of the problem. The bills they send often contribute to a vicious cycle of increasing poverty, a known cause of poor health.
So doctors are trying to clean up the mess our healthcare system creates. As I discovered in the article on Recent research Led by Sam Dickman, M.D.).
Dickmann’s study examined ED records of sexual assault victims across the country. Of these survivors he had over 17,000 uninsured. Their charges for his ED care averaged $3,600.Moreover, even rape victims who have private insurance are (on average) delinquent in their payments. 14% of the cost Rape-related medical bills — nearly $1,000. This is a particularly high price for low-income women and girls, who face the greatest risk of sexual assault. Fear of cost is definitely part of the reason. 1 in 5 rape victims Seek medical care.
Physicians can take a few small steps to reduce financial risk for their patients. You can check if a veteran is eligible for veterans services, or encourage needy patients to enroll in Medicaid or connect with hospital financial assistance programs. In some practice settings, doctors can waive copayments and deductibles that cause hardship. But even with these measures, with or without insurance, millions of Americans will be buried in debt if they get sick.
The hard truth is that unless you’re Elon Musk, health insurance is a flawed product, so even if you have insurance, you can still get one serious illness from a financial disaster. is.
It is a uniquely American policy choice for our healthcare system to inflict economic (and thus medical) harm. In most wealthy countries, national health insurance or national medical services protect patients from harm. Taxpayers pay for everyone’s treatment so that the sick do not suffer double.That’s the approach — in general Medicare for All – that Over half of American voters and about half of doctors support. This allows doctors to do good without worrying about doing harm.
David U. Himmelstein, MD and Steph Woolhandler, MD, are Distinguished Professors at CUNY’s Hunter College in New York City, Lecturers in Medicine at Harvard Medical School in Boston, and Research Fellows of the Civic Health Research Group. I have.