Posted on 02/23/2005 4:26:17 AM PST by Miami Vice
“Medical costs lead more people to bankruptcy,” proclaimed one headline. “Half of personal bankruptcies caused by medical bills,” announced another.
These headlines referred to a report about medical bills and bankruptcies. It was featured – with a great sense of urgency – in TV, radio, magazine, and newspaper stories across the nation. The idea that medical costs incurred by people who have little or no insurance caused half the bankruptcies in the United States was alarming to those who heard the news, just as it was meant to be.
The source of this shocking announcement was an article published in the journal Health Affairs. The study was conducted by: Harvard professor David Himmelstein, an associate professor of medicine at Harvard Medical School and a primary care physician at Cambridge Hospital in Cambridge, Massachusetts; Elizabeth Warren, at Harvard Law School professor and chief adviser to the National Bankruptcy Review Commission; Deborah Thorne assistant professor of Sociology and Anthropology at Ohio University; Steffie Woolhandler, an associate professor of medicine at Harvard, where she co-directs the General Medicine Faculty Development Fellowship Program.
An abstract of the study states:
In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs average $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.
Health Affairs is a seemingly credible journal. The study’s authors apparently have sterling credentials. Given the authoritative nature of this study one can only concur with the statement, quoted by the Tribune-Review that, “National health insurance is the only solution to the problem in America of having the world's costliest health care.”
Of course, this was exactly what the distinguished professors wanted people to conclude. The actual purpose of the study was to influence public opinion to favor socialized medicine. The study’s authors are fervid advocates of Canadian-style, single-payer healthcare systems.
A cursory examination of the backgrounds of the authors leaves no doubt about the purpose of this study: it was an attempt by liberal academicians to rationalize government control of the healthcare system, one-seventh of the nation’s economy.
If one were to actually read the study and the section about methodology, he would notice a caveat. The study noted, “Even when data are reliable, making causal inferences from a cross-sectional study such as ours is perilous. Many debtors described a complex web of problems involving illness, work, and family. Dissecting medical from other causes of bankruptcy is difficult. We cannot presume that eliminating the medical antecedents of bankruptcy would have prevented all of the filings we classified as ‘medical bankruptcies.’” It also stated, “more-stigmatized causes of bankruptcy (such as addiction, mental illness, or profligate spending) may be underreported.”
That’s certainly not so black-and-white. If the report is not one-sided, its compilers are, consistently manipulating data to support their most recent political agenda.
One of its authors, Harvard Law Professor Elizabeth Warren, is recognized as an expert in the causes of bankruptcy. She lends authority to the claim that medical expenses comprise almost half of all bankruptcies. However, in April 1998, Warren testified before Congress that single parents are the people most affected by bankruptcy. Then again, in July 2004, the Christian Science Monitor quoted Warren as saying, “more than 90 percent of bankruptcies arise from job loss, onerous medical bills not covered by health insurance, and divorce.” Yet, in a 2002 New York Times article she wrote, “Women are more likely than men to seek bankruptcy in the aftermath of a divorce or a medical problem, though both men and women cite job problems as the biggest difficulty.” (Emphasis added.) To further muddy the waters, an October 2003 Salon article noted:
Elizabeth Warren, a professor at Harvard Law School, and her daughter, Amelia Warren Tyagi, a former McKinsey consultant, studied nearly 2,000 families that had gone bankrupt in the U.S. They analyzed myriad federal data detailing what Americans are actually spending their money on today compared to the legendarily more austere 1970s. What they discovered shocked even themselves: the effort to keep the kids in a good school district when one parent is laid-off is the main factor driving Americans into bankruptcy court…. (Emphasis added.)
Precisely this sort of tendentious scholarship is the hallmark of Drs. Himmelstein and Woolhandler, the study’s two other principle authors. Although Health Affairs did not identify them as such, this husband and wife team of Harvard Medical School physicians are the founders of an organization dedicated to the implementation of socialized medicine in the United States: Physicians for a National Health Plan (PNHP). They have been as disingenuous as a Michael Moore movie regarding their positive portrayal of the Canadian healthcare system.
Himmelstein published a proposal for a national health plan in the New England Journal of Medicine (NEJM) in 1989. The monograph extolled the merits of the monopsonistic/monopolistic Canadian healthcare system. However, Himmelstein’s tome did not mention the disadvantages of the Canadian system. It never mentioned that it is a prospective budgeting system. This means that each year the government allocates a certain amount of money for hospital and physician services. If the funds are depleted before the fiscal year then the providers will either render free care or close. It is not unusual for Canadian hospitals to temporarily cease operations or for Canadian doctors to go on strike.
Another feature about the Canadian system are the waiting lists for medical care. These problems are well documented, yet Himmelstein and Woolhandler deny their existence. During a 1993 edition of The MacNeil-Lehrer Report, Dr. Himmelstein said that waiting lists at Canadian hospitals were a myth, largely the invention of insurance companies in the United States. He modified this declaration somewhat in a 1995 essay in which he wrote, “While there are waits for a handful of expensive procedures, there is little or no wait for most kinds of care in Canada…There are virtually no waits for emergent coronary artery surgery in Canada….”
Nine years later, Steffi Woolhandler, appearing on the September 8, 2004, edition of “The O’Reilly Factor,” stated (in response to a claim that people in Canada would have to wait six weeks to have the same type of by-pass surgery that former President Clinton did), “waits for urgent care in Canada is only one day” [sic.]
Waiting lists have been a persistent problem for the Canadian system. In 1989, the government of British Columbia contracted with hospitals in Washington state because of the waiting times for bypass surgery.
Drs. Himmelstein and Woolhandler’s claims for the past 15 years that Canada is not plagued with waiting lists for surgeries definitely do not comport with the newspaper reports I read during my recent visit to Canada. According to the August 18, 2004, editorial page of the Toronto Globe and Mail, Prime Minister Paul Martin wants to reduce waiting time in five key areas, cardiac care being one of them.
An article by Murray Campbell, in the August 19, 2004, Globe and Mail mentions the Saskatchewan Surgical Care Network, a think tank which Campbell says is, “a leader in wait-time assessments.” The article states that the network “has needed nearly two years to develop a framework that allows patients and doctors to know the length of queues…a common language had to be created so that…everybody understood what constituted an urgent operation.” If Woolhandler’s claims were true, such an institute would be unnecessary: the waits are largely mythological and last at the longest one day.
Other data also refutes Woolhandler’s claim. According to a study done by the Canadian government in 2001-2002, the average wait for urgent in-patient coronary artery bypass graft (CABG) surgery for the province of Alberta was 7–13 days. For urgent outpatient CABG’s, it was 93–153 days.
According to Peter Singer, Director of the University of Toronto’s Joint Centre for Bioethics, writing for the Globe and Mail, “The Western Canada Waiting List Project…is developing tools to manage waiting lists.”
The September 8 edition of the Toronto Star features an article about how one Canadian citizen had to wait six months for initial consultation with a cardiologist.
Indeed, so much anxiety surrounds the viability of the Canadian system that there was a major conference on September 13, 2004, to address the problems – chief among them the waiting periods for care.
As is usually the case with those who advocate any variant of socialism, Himmelstein and Woolhandler do not provide the American public with the facts.
The single-payer faction is a well-organized, well-financed, well-educated group, with great access to the media. They are featured much more than those who advocate a more market-oriented approach to the healthcare conundrum.
Himmelstein and Woolhandler are at the vanguard of the left-wing academics proposing a socialized healthcare system that will not work. Like so many in the academy, these two use their status as professors to foster their political ideology. One can only imagine what they teach their students.
I hate to sound callous, but if $11,854 is going to bankrupt somebody, his bankruptcy is not a really big deal in the scheme of things.
Also, since this is self reported, I would be very interested to hear how much these folks had out on consumer credit cards and car loans when they declared bankruptcy. Since medical expenses are largely beyond one's own control, they are a much more socially acceptable reason for financial difficulty.
I would not be at all surprised that the typical story is more or less, "I had $60,000 on the credit card and owed $32,500 on the Lexus, but was that $11,854 from the hospital that put me over the edge..."
I only had to read this far to conclude that the study wasn't a study at all, but rather an advertizement for socialized medicine. The only thing the "study" shows is that approximately 466 out of 1.458 million personal bankruptcy filers (.03196%) may -- and I repeat -- may -- have filed for bankruptcy, in whole or in part, to avoid paying medical bills. There is nothing to indicate that the initial "survey" of 1,771 filers or the subsequent selection of 931 filers is a statistically valid sample of the enire population of 1.458 million filers, and therefore, any conclusions drawn with respect to the survey group cannot be statistically extended to the enire population with any degree of acceptable confidence.
This is not surprising.
However, since the elimination of Prohibition it has been impolite to say so.
And behind these two is the worship of self which is rampant in this country. When one worships themselves and one finds that he or she is not perfect, one logically turns to addictions as a means of medicating oneself out of pain.
The forgiveness one finds in Christ and the worship of a loving creator, instead, gives joy and freedoms from such slavery forever.
Bankruptcy, Alcoholism and drug addictions are mearly symptoms of sick souls in bondage.
Canada's system has provided me with a far greater sense of security for my family than did the ever changing, take more out of your pocket system that I lived under in the United States. Canada's system has flaws and is underfunded but still has always been there for me and my family in times of need.
Unlimited awards to plaintiffs and their attorneys are a hidden tax, paid as part of the cost of medical care and health care insurance.
"I would not be at all surprised that the typical story is more or less, "I had $60,000 on the credit card and owed $32,500 on the Lexus, but was that $11,854 from the hospital that put me over the edge..."
Nail meet hammer. Got it in one.
People can't seem to wrap their thick heads around the idea that all of their income isn't disposable.
"I hate to sound callous, but if $11,854 is going to bankrupt somebody, his bankruptcy is not a really big deal in the scheme of things."
Grin. there's an ocean of difference between callousness and accuracy.
I know a top cardiac surgeon in Canada. The dirty secret behind the scenes that the Canadian public does not know is that people are selected for surgery- based on their age and their chances of survival long term. According to this top surgeon, the doctors know some will die waiting for surgery and for medical tests so they are forced to make selections.The surgeon once supported the national health insurance and because of what he sees first hand- he is 'sickened by the direction' (his words).
The Toronto Globe and Mail reported that a cardiac patient has a ten times greater chance of dying waiting for an operation than they do on the operating table. But, you'll never get a bill. Philadelphia has more MRI machines than ALL of Canada.
Socialized Medicine: Here's a Q-Tip, now go home and die.
Then you are the exception.
That is definitely part of the problem. The other part of it is that insurance, by becoming an insulating layer between the consumer (patients) and the producer (doctors, hospitals, etc.) has removed free-market forces from the equation. Sure, health insurance companies attempt to get the most for their money, but it is nowhere near as effective as people making their own buying decisions. How many people go to doctors all the time, for very minor things, simply because "it's covered" under their health insurance?
I have a friend who, whenever he felt like he might have a cold or - gasp! - the flu coming on, would go to see his doctor. Totally unecessary, and a total waste of the insurance company's money. Did he care? Of course not, because a) he felt that because he had coverage, he was entitled to go, and b) because he didn't care how much it cost. And how often, when a doctor charges an outrageous fee, do the people complain about it to the doctor? They don't. Instead they bitch about the insurance company that doesn't pay the entire amount, but only what is considered "resonable and customary" for that service, in that area. If it weren't for health insurance, that doctor wouldn't be able to charge that much, and if it weren't for lawyers and their ridiculously frivilous lawsuits, the doctors wouldn't HAVE to charge that much.
For example, a couple of years back, I went to a dermatologist about a cyst on my head. I had to wait almost an hour to see him (even though I was on time for my appointment), and he spent all of (and I am not exaggerating here) one minute and 30 seconds with me, during which time he glanced at the cyst, and said, "You'll need to go to a hospital to have that removed." He gave no recommendation, no referral, nothing. The bill for my 1.5 minute audience with the good doctor? $250. Had I been paying with my own money, and had known how much the clown was going to charge me (for doing nothing) before I went to him, you can be sure I would have shopped around and found another dermatologist who would have seen me for half that much money.
THAT is how you control medical costs, not by whining and moaning and crying to the world that you have a "right" to medical care, and making the insurance companies out to be the bad guys for simply trying to do what you yourself would do if you were in their shoes (in other words, if YOU were actually paying the bills).
The only one? So any health care survey that is done up here is accurate only if 100% of the repondents say they dislike the Canadian Health care system. You are so far off its ridiculous. Counter Point?
SO any healthcare survey done in Canada is only 100% accurate if they love teh Canadaian healthcare system?
You are devoid of reality.
Many Canadians like your system. Many hate it. Undeniably there are problems with it. Now you may like it despite those problems. So what? Keep it. Nobody is asking you to change.
I like the system we have here. It is better. Proponents of your system in the US don't tell the truth about it. That is what this article is about.
Learn how to read!!!
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