I Did Not Get Mugged In London (But Did Get My Email Account Highjacked)

My apologies and condolences to anyone (everyone?) on my contact list who got a phishing scam email from a hacker using my hotmail account. I contacted Microsoft about it and have been changing email accounts the last couple of days.

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Some Rethinking on Health Care Costs and Bankruptcy

I had hypothesized recently that "it is hard to imagine any health care reform that won't reduce bankruptcy rates at least to some degree." It turns out I might have been completely wrong about that.

Check out what Dr. David Himmelstein, one of the authors of the famous study connecting medical costs and bankruptcy, said in a recent New York Times interview:

Q. Would any of the plans under discussion on Capitol Hill reduce the rate of medical bankruptcies?

A. Only the single-payer plan sponsored by Representative John Conyers and Senator Bernie Sanders. The others pretty clearly do little or nothing for medical bankruptcy.

Are we really likely to get health-care reform that won't reduce the rate of illness-induced bankruptcies? Perhaps, yes. Based upon what I read, a single-payer plan is not the most likely form of health care reform. I would be interested to hear why a single-payer system would reduce the rates of illness-induced bankruptcies and the other types of reform will not. I imagine that most insurance plans have sufficient co-pays and deductibles that having a serious illness ends up being a financial "death by a thousand cuts." I remember years ago when I had a serious illness that I was in the doctor's office multiple times each week. If I had to pay even $10 a visit, that would have added up in a hurry. As it was, even with excellent insurance and making a reasonable living, the financial impact of a major health scare was substantial.

Since it appears that health care reform is unlikely to affect the bankruptcy rate, it is probably is disingenuous for us to speak as if it will. Of the major reasons to change the health care delivery system, the efficiency reasons might be completely valid. So, for example, having every person covered by some sort of basic health insurance might encourage them to get routine preventative care and avoid unnecessary emergency room visits. Such routine care might generate benefits both in thew form of cost savings and improving health generally. But if the goal is, paraphrasing a popular Facebook status update, to avoid people going broke when they get sick, we might be kidding ourselves to suggest that the health care reforms currently on the table will do so.

With this additional reflection, one aspect of my original post remains unchanged and another is augmented. First, there are plenty of reasons for health care reform without considering bankruptcy rates. That point remains unchanged. Second, if meaningful health care reform is not going to reduce bankruptcy rates, making bankruptcy less punitive for people who are in financial distress though no fault of their own should be on the table as well.

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