Senator Bernie Sanders holds up a vial of insulin as he talks about the high cost of healthcare in the US at a rally outside a pharmacy in Windsor, Ontario. Photograph: Rebecca Cook/Reuters
Health insurance that we have today is a defective product, said Dr David Himmelstein, distinguished professor of public health at City University of New Yorks Hunter College and a lecturer in medicine at Harvard Medical School.
A lot of people, a little over 60%, are filing bankruptcy at least in part because of medical bills. Most of them are insured. Its clear that despite health insurance, there are many, many people incurring costs not being covered by their insurance, said Himmelstein. Medical debt is incredibly common, its the
main cause of calls from collection agencies, and the vast majority of people with it have insurance, said Himmelstein, lead author of the studyMedical Bankruptcy: Still Common Despite the Affordable Care Act.
One out of every six Americans has an unpaid medical bill on their credit report, amounting to $81bn in debt nationwide, while about one in 12 Americans went without any medical insurance throughout 2018. Even as many Americans struggle to afford health insurance coverage in the first place, those that have it are not insulated from facing massive debt due to medical bills.
I have insurance through my job but it has a high premium and high deductible. I have to pay $450 a month. When you think about living paycheck to paycheck, $450 is a lot of money. Im barely making it. Some bills dont get paid every month, said Mary Cross of Detroit, Michigan, who has filed for bankruptcy twice since early 2013 when she was admitted to the hospital for pneumonia, required lung surgery and was diagnosed with sarcoidosis, an inflammatory disease.
Im currently struggling to stay afloat now due to having surgery this past January, added Cross, 51. Ive been getting constant calls from the billing department at the hospital where I had surgery.
In Savannah, Georgia, a 35-year-old man who requested to remain anonymous to avoid being associated with a bankruptcy, recently found himself homeless and jobless due to prolonged hospital stays and hundreds of thousands of dollars in medical debt.
A type 1 diabetic for years, he had to reduce his work hours for a cellular retail store when trouble regulating his blood sugar resulted in a toe amputation in April 2019.
I had to cut my work hours so bills were harder to pay. But in July 2019 I was admitted to the hospital again and I was fired from my job because I was in the hospital. I lost my insurance. They amputated my leg, which means I still cant work, he said.
When he lost his job due to the prolonged hospital stay and leg amputation, his employer offered Cobra, a health insurance program for employees who lose their job or have a reduction in work hours, but he couldnt afford it. He is currently working on trying to file bankruptcy to release the medical debt hes accrued from amputations this year and he lost his house in October 2019 as a result.
I have amassed over $400,000 in medical bills I need to pay, and still have at least six months before I get a disability hearing. So I owe over $400,000 in medical bills, have lost my house and I live on the street now, with no end in sight, he said.
Jessica Hillman. Photograph: Courtesy the family
Just outside of Chicago, Illinois, Jessica Hillman filed for bankruptcy in 2016 due to medical debt accrued from battling a seizure disorder, despite having health insurance coverage for the majority of her treatment.
I had thousands of dollars in various medical debt which made the majority of my claim. The last bill I got that really pushed me toward the bankruptcy was for a routine lab test that my insurance refused to approve because of a billing mistake. That bill was about a thousand dollars, Hillman said. I couldnt work and had no way to pay these.
At the time, Hillman was receiving several collection notices in the mail for past hospital stays and tests amounting to several thousand dollars, often having no knowledge of the bills that health insurance didnt cover until receiving the collection notices.
One of the biggest hurdles you face as a patient is just the sheer confusion of the process. You think you just show up and present your card, sometimes pay a copay, and thats it. You dont expect all these plan limitations and authorizations, Hillman added. What are you going to do if your authorization gets denied? You dont really have a choice to not go get care. All these processes that are in the finest of fine print. And sometimes it feels like you are literally paying for nothing.