คนล้มละลายในสหรัฐ 60 % มาจากค่าใช้จ่ายทางการแพทย์
   (60% of U.S. bankruptcies in 2007 were due to medical costs)
https://www.time.com/time/specials/packages/article/0,28804,1903873_1903925_1903787,00.html
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ความคิดเห็นที่ 1
   จากเว็บ https://www.healthnewstrack.com/health-news-1486.html

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Over 60% of US bankruptcies due to medical incidents
กว่า 60% ของคดีล้มละลายในอเมริกามีสาเหตุจากค่าใช้จ่ายทางการแพทย์

In 2007, before the current economic downturn, an American family filed for bankruptcy in the aftermath of illness every 90 seconds; three-quarters of them were insured. Over 60% of all bankruptcies in the United States in 2007 were driven by medical incidents.

In an article published in the August 2009 issue of the American Journal of Medicine, the results of the first-ever national random-sample survey of bankruptcy filers shows that illnesses and medical bills contribute to a large and increasing share of bankruptcies.

The share of bankruptcies attributable to medical problems rose by 50% between 2001 and 2007.

Following up on a 2001 study in 5 states, where medical problems contributed to at least 46.2% of all bankruptcies, researchers from Cambridge Hospital/Harvard Medical School, Harvard Law School and Ohio University surveyed a random national sample of 2,314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1,032 of them. They designated bankruptcies as "medical" based on debtors' stated reasons for filing, income loss due to illness and the magnitude of their medical debts.

Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. The odds that a bankruptcy had a medical cause were 2.38 fold higher in 2007 than in 2001.

According to the study, a number of circumstances propelled many middle-class, insured Americans into bankruptcy. For 92% of the medically bankrupt, high medical bills directly contributed to their bankruptcy. Many families with continuous coverage found themselves under-insured, responsible for thousands of dollars in out-of-pocket costs. Out-of-pocket medical costs averaged $17,943 for all medically bankrupt families: $26,971 for uninsured patients; $17,749 for those with private insurance at the outset; $14,633 for those with Medicaid; $12,021 for those with Medicare; and $6,545 for those with VA/military coverage. For patients who initially had private coverage but lost it, the family's out-of-pocket expenses averaged $22,568.

Because almost all insurance is linked to employment, a medical event can trigger loss of coverage. Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter does so within a year. Income loss due to illness was also common, but nearly always coupled with high medical bills.

Writing in the article, David U. Himmelstein, M.D., states, "The US health care financing system is broken, and not only for the poor and uninsured. Middle class families frequently collapse under the strain of a health care system that treats physical wounds, but often inflicts fiscal ones."

"This study provides further evidence that the US health care system is broken," according to James E. Dalen, M.D., M.P.H., University of Arizona College of Medicine, Tucson. "Medical bankruptcy is almost a unique American phenomenon, which does not occur in countries that have national health insurance. These long-time advocates of a single payer system give us another compelling reason to work toward this goal as a nation."

The article is "Medical Bankruptcy in the United States, 2007: Results of a National Study" by David U. Himmelstein, M.D., Deborah Thorne, Ph.D., Elizabeth Warren, J.D., and Steffie Woolhandler, M.D., M.P.H. It appears in the American Journal of Medicine, Volume 122, Issue 8 (August 2009) published by Elsevier.
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ความคิดเห็นที่ 2
   จากเว็บของสำนักข่าว CNN ที่
https://edition.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/ เมื่อ June 5, 2009

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Medical bills prompt more than 60 percent of U.S. bankruptcies

ยอดบิลค่าใช้จ่ายด้านการรักษาพยาบาลของชาวอเมริกันพุ่งถึงกว่า 60% ของคดีล้มละลายในสหรัฐฯ แล้ว!!!

บทความโดย Theresa Tamkins

This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills.

This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills.

Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine.

"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. "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."

Woolhandler and her colleagues surveyed a random sample of 2,314 people who filed for bankruptcy in early 2007, looked at their court records, and then interviewed more than 1,000 of them

They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically-related bankruptcy had health insurance, they say.

"That was actually the predominant problem in patients in our study -- 78 percent of them had health insurance, but many of them were bankrupted anyway because there were gaps in their coverage like co-payments and deductibles and uncovered services," says Woolhandler. "Other people had private insurance but got so sick that they lost their job and lost their insurance." Health.com: Where the money goes -- A breast cancer donation guide

However, Peter Cunningham, Ph.D., a senior fellow at the Center for Studying Health System Change, a nonpartisan policy research organization in Washington, D.C., isn't completely convinced. He says it's often hard to tell in which cases medical bills add to the bleak financial picture without being directly responsible for the bankruptcies.

"I'm not sure that it is correct to say that medical problems were the direct cause of all of these bankruptcies," he says. "In most of these cases, it's going to be medical expenses and other things, other debt that is accumulating."

Either way, he agrees that medical bills are an increasing problem for many people. Health.com: 5 quick ways to stop back pain

"I think medical bills are something that a lot of families are having a lot of difficulty with and whether it's the direct cause of bankruptcy or whether it helps to push them over the edge because they already were in a precarious financial situation, it's a big concern and hopefully that's what medical reform will try to address," he says.

The study may overestimate the number of bankruptcies caused by medical bills yet underestimate the financial burden of health care on American families, because most people struggle along but don't end up declaring bankruptcy, according to Cunningham.

"Bankruptcy is the most extreme or final step for people who are having problems paying medical bills," he says. "Medical bills and medical costs are an issue that can very easily and in pretty short order overwhelm a lot families who are on otherwise solid financial ground, including those with private insurance."

His group's research found that medical bills unduly stress 1 in 5 families.

Either way, the high cost of health care is a problem that's probably getting worse for people in the United States, particularly since the economic picture became grimmer after the study was conducted. Health.com: Yoga moves to beat stress, insomnia, and pain

"The recession didn't happen until a year after our study," says Woolhandler. "We're quite sure that the problem of bankruptcy overall is worse, the numbers have been soaring, and the number this year is expected to be higher than it was before Congress tightened bankruptcy eligibility in 2005."

In 2005, bankruptcies peaked at two million filings
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