Republican, Democrat, Left, Right, Centrist… No matter how citizens in this nation may choose to politically identify ourselves, we are all pretty much in agreement about one thing: This country needs health care reform. Our suggestions as to what shape that reform should come in may not be identical but there is no denying that we are currently on the fast track to bankruptcy if meaningful reform is delayed much longer.

Bankruptcy is in fact what a growing number of Americans have already encountered through the health care system as it now functions. In June of this year, the American Journal of Medicine released a new study’s findings based on figures available from 2007. The results of this study point out the debilitating role of medical expenses in families and individuals who must file for personal bankruptcy. Labeled as the “first-ever national random sample of bankruptcy filers”, the study’s authors worked hard to maintain conservative controls on their findings and followed the numbers up with fact-finding interviews with a significant portion of the sample’s participants. Research indicated that a staggering 62% of personal bankruptcy filings were disproportionately driven by medically related expenses.

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.

Responsible citizens owe it to themselves to review this American Journal of Medicine study in its entirety and to engage in further health care reform fact finding. A brief online search at amjmed.com (Vol.122, Issue 8, pp. 741 to 746) will get you started. Let your opinions be fully informed and get in touch with your elected representatives. This is an important national subject that requires vision and a patriotic, nonpartisan commitment to our future.

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