Editore"s Note
Tilting at Windmills

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November 25, 2009

ADDING INSULT TO INJURY.... Most modern democracies would never let their own citizens go bankrupt because they got sick. The phrase "medical bankruptcies" is an outlandish concept in most of the industrialized world. There's simply no reason for the United States to tolerate this.

Some of the debtors sitting forlornly in [Nashville's] old stone bankruptcy court have lost a job or gotten divorced. Others have been summoned to face their creditors because they spent mindlessly beyond their means. But all too often these days, they are there merely because they, or their children, got sick.

Wes and Katie Covington, from Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills. For Christine L. Phillips of Nashville, it was a $10,000 trip to the emergency room after a car wreck, on the heels of costly operations to remove a cyst and repair a damaged nerve.

Jodie and Charlie Mullins of Dickson, Tenn., were making ends meet on his patrolman's salary until she developed debilitating back pain that required spinal surgery and forced her to quit nursing school. As with many medical bankruptcies, they had health insurance but their policy had a $3,000 deductible and, to their surprise, covered only 80 percent of their costs.

"I always promised myself that if I ever got in trouble, I'd work two jobs to get out of it," said Mr. Mullins, a 16-year veteran of the Dickson police force. "But it gets to the point where two or three or four jobs wouldn't take care of it. The bills just were out of sight."

Although statistics are elusive, there is a general sense among bankruptcy lawyers and court officials, in Nashville as elsewhere, that the share of personal bankruptcies caused by illness is growing.

We're not talking about families that took unnecessary risks or who are looking for a handout. These are just folks, most of them middle-class, who played by the rules, needed medical attention, and slipped into financial ruin because they couldn't pay their medical bills.

If policymakers pass health care reform, it wouldn't entirely fix the problem, at least not right away, but it would make a significant difference: "Bills in both houses would expand eligibility for Medicaid and provide health insurance subsidies for those making up to four times the federal poverty level. Insurers would be prohibited from denying coverage to those with pre-existing health conditions. Out-of-pocket medical costs would be capped annually."

Just one more reason to get this done.

Steve Benen 9:15 AM Permalink | Trackbacks | Comments (29)
 
Comments

...and no evidence that it will get done, what with the current lot of bought and owned drones in Congress and the feckless hoper in the White House.

We're supposed to love our country? I think not.

Posted by: Susan on November 25, 2009 at 9:23 AM | PERMALINK

The best reason, by far, IMHO.

Posted by: Matt on November 25, 2009 at 9:24 AM | PERMALINK

I don't think the medical bankruptcy problem will be solved by either of the health care bills before congress. That would take a real single payer plan. Of course, they both contain provisions that will help some, but solve the medical bankruptcy problem, not a chance.

Posted by: Ron Byers on November 25, 2009 at 9:29 AM | PERMALINK

It's the people with insurance that make the stupidity of the current system so obvious. You or your employer pay a huge pile of money, and that basically just gets you in the door so that you will be allowed to pay even more money later.

Posted by: paul on November 25, 2009 at 9:30 AM | PERMALINK

The described here had health insurance. I don't see how making sure everyone has the same crappy insurance will change any of this.

Posted by: jkruse on November 25, 2009 at 9:31 AM | PERMALINK

I'm with Susan. This country is lost, hopeless, damaged beyond repair. Blame who you want as to who or what got us here, but the fact is our government is no longer capable of governance. American politics is now simply a tool of industry to keep the masses squabbling about shit like this while we continue to edge closer and closer to a third world country.

Posted by: citizen_pain on November 25, 2009 at 9:31 AM | PERMALINK

"To becoming a third world country"... that is

Posted by: citizen_pain on November 25, 2009 at 9:33 AM | PERMALINK

Now would be a good time for Democrats to remind voters that it was Republicans who brought bankruptcy "reform," which made it harder for individuals to get out from under debts. Better still would be for Congress to correct their earlier mistake.

Posted by: Bob on November 25, 2009 at 9:33 AM | PERMALINK

It's only a recession when your neighbor loses their house and a depression when you lose yours seems to apply here. Don't those nasty bankruptcy lawyers, as do all shyster lawyer types lean democratic? Ya think republicans would support this just for the fact nasty lawyers are involved and making money and funneling it to democrats.

Posted by: Dave on November 25, 2009 at 9:34 AM | PERMALINK

Medical bankruptcy is a uniquely American institution. We are number one!

www.medicynic.com

Posted by: Cycledoc on November 25, 2009 at 9:35 AM | PERMALINK

My boss specializes in bankrutpcy from the creditor's point of view. He strenuously objected to the rewritten bankruptcy laws, stating that they would hurt both debtors and creditors, and you know what? He was right.

Posted by: Personal Failure on November 25, 2009 at 9:50 AM | PERMALINK

Somewhere in the past-one, ten, a hundred years ago- we went from from one nation "of, by, and for the people" to, "of, by, and for the corporation".

Posted by: DAY on November 25, 2009 at 9:50 AM | PERMALINK

The out-of-pocket deductibles on most of the "affordable" plans Big Insurance will roll out in response to this legislation will put many folks into bankruptcy--we're already seeing $5k/$10K per year on family plans. This problem isn't going away with the love letter to the insurance industry they're contemplating in congress right now.

Posted by: dr. bloor on November 25, 2009 at 9:53 AM | PERMALINK

When it comes to explaining the logic of a public health care option I have found no easier comparison to make than to the Maryland Automobile Insurance Fund (MAIF). Check out https://www.maif.net/emaif/.

Maryland drivers who have been denied coverage by two or more insurance carriers can buy into a state-managed car insurance program. Car insurance, of course, is mandatory in Maryland.

MAIF is entirely funded by participant premiums. It costs less than private insurance and generates millions of dollars in extra revenue for the state of Maryland that the legislators fight over at the start of each new budget. Once accepted into the program participants don't want to leave.

Insurance companies hate MAIF which must make it a pretty good idea. Hardly what you'd call socialism.

Posted by: pj in jesusland on November 25, 2009 at 9:59 AM | PERMALINK

Personal failure, you're boss was right. A lot of us who handle personal bankruptcies knew at the time that the bill was so bad it hurt creditors almost as much as it hurt debtors. I know one bankruptcy judge who made the observation that nobody benefited from the new law except people collecting child support and maintenance.

I think we should repeal the whole damn thing and go back to the law in 2004. Then Congress can make some technical reforms aimed at improving the process.

Posted by: Ron Byers on November 25, 2009 at 10:00 AM | PERMALINK

recently there was a rating of health care systems around the world. The US came in at 37; we in Canada were 30th. Sure think our single payer system is better than yours, but why aren't you studying the countries in the top 10?
Maybe if these bills fail -the govt might set up a commission to study- and then propose a really better system.

Posted by: Johnny Canuck on November 25, 2009 at 10:04 AM | PERMALINK

recently there was a rating of health care systems around the world. The US came in at 37; we in Canada were 30th. Sure think our single payer system is better than yours, but why aren't you studying the countries in the top 10?
Maybe if these bills fail -the govt might set up a commission to study- and then propose a really better system.

Monkeys with typewriters could come up with a better system than we have now as well as the proposals in either of the bills in Congress. But when you're limited to working within a framework that sanctifies for-profit, minimally regulated insurance companies, the top ten are out of your league.

Posted by: dr. bloor on November 25, 2009 at 10:13 AM | PERMALINK

Johnny Canuck,

It sounds like you are unfamiliar with American politics. Democrats who make comparisons between America and other countries on any measure of national performance are generally viewed as weak-kneed appeasers. America is exceptional, not internationalist, according to the GOP. We do things "our way."

The only exception to this rule I can think of is when comparisons are made between US student test scores and scores by students in other countries. This typically leads to vituperative attacks on teachers' unions and non-native speakers. This fits GOP ideology so international test score comparisons are OK with them.

Posted by: pj in jesusland on November 25, 2009 at 10:16 AM | PERMALINK

"expand eligibility for Medicaid"

Medicaid? "Eligibility?" Correct me if I'm wrong, but "eligibility" is just that - actually receiving Medicaid coverage is a totally different animal, and depends upon the financial condition and cheapness of the state in which a person resides.

Medicaid is basically free money to the states - so long as they put up some amount of matching funds. Many have elected to cheap out, leaving millions of federal dollars on the table. New Mexico went through this under Gov. Gary Johnson (now planning to run for president) - a Republican, of course.

Expanding Medicaid may look good on paper, but it can curdle badly at the point of delivery - the state legislature.

Posted by: Zandru on November 25, 2009 at 10:21 AM | PERMALINK

Let's face it, the GOP, which is an extension of older, white America, is against anything at all that would remotely benefit anyone that is non-white. It's that simple.

This is why when states have serious budget shortfalls, what gets cut? Public education. Why? Becasue non-whites are getting free services from the supposed hard working real American white people. Same for the public option in the health care debate. You can pick ANY political issue and break it down to basic racist supremecy.

Yup, that's the good 'ole U.S. of A. for ya.
And I am a American born white guy.

Posted by: citizen_pain on November 25, 2009 at 10:26 AM | PERMALINK

A nation of shiteaters?

"I always promised myself that if I ever got in trouble, I'd work two jobs to get out of it," said Mr. Mullins, a 16-year veteran of the Dickson police force. "

A culture where one job isn't enough?
He certainly appears to know his place.

Would anybody be amazed if he, and others in this article, were opposed to HCR too?

We live in a truly extraordinary country. I have a hard time wrapping my head around what is going on inside the heads of Americans. Are they just stupid, and have no idea how "insurance" works; or are they so lacking in self-esteem that they will eat shit and thank the lord for not doing them meaner?

It is almost enough to push me into hoping HRC fails. Call it an experiment: How much can you step on the face of Americans in the name of capitalism before they will revolt?

I suspect...
You can cram a lot more shit down their gaping throats.

Posted by: koreyel on November 25, 2009 at 10:52 AM | PERMALINK

WASHINGTON — As the debate over a health care bill enters a critical stage, a new USA TODAY/Gallup Poll finds Americans inclined to oppose congressional passage of the legislation this year.
The survey, taken Friday through Sunday, finds 42% against a bill, 35% in support of it. Despite nearly a year of presidential speeches, congressional hearings and TV ad campaigns by interest groups, more than one in five still doesn't have a strong opinion.

When pressed about how they were leaning, 49% overall said they would urge their member of Congress to vote against a bill; 44% would urge a vote for it.

Posted by: Rick on November 25, 2009 at 11:01 AM | PERMALINK

"Despite nearly a year of presidential speeches, congressional hearings and TV ad campaigns by interest groups, more than one in five still doesn't have a strong opinion.

When pressed about how they were leaning, 49% overall said they would urge their member of Congress to vote against a bill; 44% would urge a vote for it. "

And in 2012 when polled a majority of americans will put reforming the healthcare system in the top five or higher of their concerns. Really, this country deserves what it gets.

Posted by: SaintZak on November 25, 2009 at 11:16 AM | PERMALINK

Well, speaking of adding insult to injury, I am still balking hard at the individual mandate absent some meaningful consumer protections and benefits. I can get on board with a bill that isn't perfect, in hopes the reform can be refined subsequently, but I am concerned that this bill is too much of a giveaway to the same institutions that oppress Americans.

Posted by: Algernon on November 25, 2009 at 11:28 AM | PERMALINK

Regarding Medicaid, a friend of mine found out after her sister had a grand mal seizure and broke two front teeth that Medi-Cal no longer covers dental work. She had to spend all day yesterday scrambling to try and find a free or sliding-scale clinic that could at least evaluate her sister and get the cost to have those teeth fixed.

But, hey, I guess conservatives would say that her sister shouldn't have been so dumb as to be born with a seizure disorder, so it's her own fault when she injures herself after she has one that breaks through her medication.

Posted by: Mnemosyne on November 25, 2009 at 11:36 AM | PERMALINK

and there on the local Faux news station the other night with the irony meter going off the scale was a heartwarming story of a woman who is doing a walkathon for herself so she can get a heart transplant without which she will die.She complains that the drugs will be $2000 a month if she gets the $100,000 transplant. No need for health insurance in this country...I don't know why the silly woman just doesn't go to the emergency room and get herself fixed right up

Posted by: john R on November 25, 2009 at 11:36 AM | PERMALINK

dr. bloor - "already seeing"?? I think you're understating the cost.

I work for a pretty big US company. My health insurance contribution is $2200 a year for me and my spouse. The company is picking up 80% of the total cost. So the actual cost is $11K a year.

Now that's WITH a big company driving the hardest bargain it can get to keep the price down and no preexisting condition exclusions. An individual trying to buy the same insurance is highly unlikely to get as good a deal OR coverage for preexisting conditions.

Posted by: Butch on November 25, 2009 at 12:58 PM | PERMALINK

re: ""The phrase "medical bankruptcies" is an outlandish concept in most of the industrialized world."" perhaps it's because we are not a part of the "industrial world" any more?


Posted by: billie on November 25, 2009 at 2:36 PM | PERMALINK

Butch--

The 5K/10K number I kicked out was for the deductible alone--what some families have to pay out of pocket before the insurance they're paying for actually, you know, covers anything. Add the premiums to that, and yeah, HC costs for a self-pay family is already in the teens for many folks (my family included).

Posted by: dr. bloor on November 25, 2009 at 5:10 PM | PERMALINK
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