Medical Bankruptcies

Let me start off this blog entry with a couple of caveats.  One, ANY medical bankruptcy is too many.   Second, I do not want to make this a partisan political thing.  There are ways around that.

According to an analysis published in the New England Journal of Medicine, hospitalizations cause only about 4 percent of personal bankruptcies among non-elderly U.S. adults.  To me, that seems like a crime.  That is a lot of people who get their lives destroyed by an illness.  So how do we tiptoe around politics here?  Well, as you may know, I don’t believe in socialized medicine but I understand those who do and their desire to have care for everyone. I want that too but just by different means.  For the very lowest of income, there is Medicaid.  For the rest, there need to be affordable plans.  There aren’t.  That’s the problem. The model that works and should be analyzed are these “health-sharing plans”.  They can be reproduced (maybe some without the religious component) and there could be hope.  But let’s leave that debate aside.  Some people, no matter what is available, will CHOOSE not to pay anything for coverage.  They don’t want to pay for anything and they are playing with fire. They will always be at risk for a medical bankruptcy.  That being said, I repeat, 4% is just way too high.

Now the fun part.  This NEJM study “contrasts with previous research by former Harvard professor and current U.S. Sen. Elizabeth Warren and others that pointed to medical reasons as the trigger for more than 60 percent of U.S. bankruptcies.”

Yes, you read that right. Sixty percent!!  Talk about bullsh$tting.

60% vs 4%.

So, what did we learn here?  We still need a better plan.  Health-sharing models need more attention, especially when paired with a DPC practice.  Second, and please keep your party politics to yourself, politicians lie.  Politicians, on both sides, are disgusting.  We are pawns to them.  We are used by them. Do not believe any of them. It doesn’t matter if they have a persona that you despise or one that you love.  They lie to get what they want.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Medical Bankruptcies

  1. arf
    April 2, 2018 at 2:29 pm

    I said at the time, and I’ll say it again.

    The Woolhandler/Himmelstein/Elizabeth Warren paper was not an argument for national health insurance, it was an argument for national DISABILITY insurance.

  2. T Newberry
    March 28, 2018 at 4:00 pm

    Just to be a stickler, you seem to be comparing apples to oranges here. On the one hand you have bankruptcies caused specifically by hospitalizations in non-elderly adults only. On the other hand you have all bankruptcies caused by health care bills.

    Who exactly is bullshitting here?

    • Doug Farrago
      March 28, 2018 at 6:49 pm

      Absolutely. There are tons of medical bankruptcies from one visit to the family doctor. Sorry, for not clarifying.

      • arf
        April 3, 2018 at 2:16 pm

        Was that the paper that considered substance abuse and gambling addiction as “medical”, therefore counting the person who lost everything to the racetrack, casino, bottle, needle, bong, etc……..as a “medical” bankruptcy?

        Woolhandler/Himmelstein papers remind me of a variant of Star Trek-Vulcan IDIC (infinite diversity infinite combination)

        Infinite bias in infinite combination
        ……or maybe infinite BS in infinite combination…….

      • T Newberry
        April 4, 2018 at 3:25 pm

        The best way to tiptoe around politics is to answer challenges with snark. Well done!

  3. Steve O'
    March 26, 2018 at 12:53 pm

    I’d first heard about Elizabeth Warren when she was about as well known as Amelia Tyagi, her daughter and co-author of a few different books such as The Two-Income Trap: Why Middle-Class Mothers and Fathers Are Going Broke. I was impressed by her observations as an author. I haven’t followed her politics since she’s been in the Senate.

    When I was little, everyone’s mom either stayed at home, or worked a part-time job. They had a house on mortgage and a few kids. Then, in the 70’s there was a brief renaissance where women could choose to have full-time jobs or be homemakers. A little later, the glass ceiling lifted a bit, and women could have CAREER PROFESSIONAL jobs or be homemakers. But the tide has washed back since then. Now moms HAVE TO work to make approximately as much money as the man – no ifs ands or buts. And the cost of some things have risen to soak up the difference, such that if Mom OR Dad gets laid off, it’s curtains for the family finances. That’s what the book talks about.

    The points in The Two Income Trap show the biggest risk to a couple’s going bankrupt is having children. And a bigger risk is having children and then getting divorced. We have discovered this method of society-building over the last fifty years, and it hasn’t led to prosperity.

    As for families, the additional burdens to family income and costs that have skyrocketed are:
    1 – Housing.
    2 – College.
    3 – Taxes.
    4 – Medical costs.

    The worst damage to #1 and #2 was, IMHO, having the government pay for access for those who are not qualified for access. That’s different than those who cannot AFFORD the access.
    #3) is the Government itself.
    #4) is a problem which gets bigger every time it is fixed. America tends to assume that the Giant Retail Corporation model solves every problem. It certainly does in the matter of supplying children’s plastic Christmas toys, although it is going to be interesting this year when we actually try to make and market them within the United States. But in complex professional services such as healthcare, the Giant Retail Corporation model explodes. There’s no more way to make Walgreens a primary provider than there is to make a chicken hunt. Can’t.

    My deal on the numbers above is that DPC with catastrophic coverage would lead to vanishingly small terminal indebtedness. If it’s even one in 100 hospitalizations, there’s a role for the HHS to intervene in disaster-struck families, the way we do with the occasional natural disasters like hurricanes. Only fix what is broken.

    But it ain’t gonna happen.

    I certainly don’t no what sort of animal Senator Warren has become. I do respect the The Two-Income Trap: Why Middle-Class Mothers and Fathers Are Going Broke. But politicians tend to go malignant when they go to Washington. Wouldn’t surprise me.

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