[thephyber]

note this comment is likely very misleading.

> According to a study published in February 2019, about 530,000 bankruptcies filed annually are because of debt accrued due to a medical illness. The study found that even the Obama administration’s landmark Affordable Care Act (known as Obamacare) has failed to change the proportion of bankruptcies caused by medical debts, with poor health insurance cited as one of the main culprits.[1]

530k households into medical bankruptcy annually from medical costs in a country with 123,600k households. In 30 years, that would be more than 10% of the country, on average.

[1] https://theguardian.com/us-news/2019/nov/14/health-insurance...

[0xBDB]

If 92% of American households have health insurance, which they do, and by law there is an annual out-of-pocket maximum on health insurance, which there is, I find it somewhat unlikely that 10% of the country will be medically bankrupt in a generation.

I'm not saying it's impossible to go bankrupt on a capped 10k of medical bills, given that so many Americans live paycheck to paycheck. But if it happens there may be confounding factors. Or, you know, it's possible people facing bankruptcy have some incentive to exaggerate to a federal judge the reason they're standing there.

[thephyber]

You aren’t being creative enough.

Health insurance companies know about the annual caps and have strong incentives to deny as many costs as uncovered as possible. The out-of-pocket maximums only apply to covered costs. There are lots of costs that health insurance companies deny coverage for: - Incidents that the covered think are emergencies, but the insurer thinks aren’t. - Any time the insured doesn’t follow the policy procedures, such as visiting a specialist without first getting a recommendation from their primary care physician - Out of network providers. - Claims received after the insurer says the policy is cancelled

And there are dozens of reasons related to ineptitude (bad coding, mistyping, lack of cost transparency).

a blog article listing the top 10 types: https://mbamedical.com/blog/8-reasons-why-your-insurance-cla...

[0xBDB]

That's true, though as another comment in this thread points out I still don't think the math works. But also it doesn't seem to be what that study found:

"A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the research found."

So to compare the U.S. to Europe we'd need to know how many are due to bills, which only really happens in the U.S., and how many are due to being out of work due to medical issues, which happens everywhere and apparently causes 8.2% of bankruptcies in the U.K., for example.

https://balancingeverything.com/medical-bankruptcies-statist...

[TMWNN]

>> According to a study published in February 2019, about 530,000 bankruptcies filed annually are because of debt accrued due to a medical illness.

That's the same bogus study that Elizabeth Warren has been pushing for years, which attributes any bankruptcy in which medical bills are involved to mean that medical bills caused the bankruptcy. Only 4% of US bankruptcies are because of medical bills <https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0...>. A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.

[thephyber]

You bring an interesting point. I completely admit that I didn’t research the source of the study or any refutations of it.

> The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.

An obvious counter observation: Isn’t an extended medical issue likely to cause a person to lose their job and health insurance?

Remember that in the USA most health insurance is company sponsored. When you lose your job, you either pay premiums at COBRA rates or you lose coverage.

And although it is illegal, companies do fire people (or find creative substitutes) for employees who are very expensive to cover.

[TMWNN]

>An obvious counter observation: Isn’t an extended medical issue likely to cause a person to lose their job and health insurance?

You are correct in that most US health insurance is tied to employment. But the discussion point was the claim that "[insert high percentage here] of US bankruptcies are because of medical bills".

Any illness, extended long enough, is going to cause people to lose their jobs, whether in the US or elsewhere. Certainly any illness long enough to exhaust COBRA coverage. That said, in the US that's where Medicaid will step in, assuming that the loss of income is sufficient to trigger Medicaid's income-based eligibility.

[thephyber]

If you have an illness long enough to lose your job and your health insurance, you probably aren’t able to pay all of your bills. Hence medical bills are likely a distal cause.

[TMWNN]

Right. But, again, a) the job loss is going to happen anywhere, in or out of the US, and b) having medical bills among the debts one can't pay without a job is not the same thing as "American with job gets hangnail = bankruptcy!!!", which is what one would believe based on the typical rhetoric on the subject.