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Unequal Health Outcomes in the United States

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The Extent of Racial Health Disparities in the U.S.. Unequal Health Outcomes in the United States. The U.S. report acknowledges that “a number of ...

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New Study: Bankruptcy Tied To Medical Bills

By Sarah Lovenheim
Sixty-two percent of all bankruptcies filed in 2007 were linked to medical expenses, according to a nationwide study released today by the American Journal of Medicine. That's nearly 20 percentage points higher than that pool of respondents reported were connected to medical costs in 2001.
Of those who filed for bankruptcy in 2007, nearly 80 percent had health insurance. Respondents who reported having insurance indicated average expenses of just under $18,000. Respondents who filed and lacked insurance had average medical bills of nearly $27,000.
Since 2007, the number of Americans without insurance has increased and filing for bankruptcy has become more difficult due to more stringent laws, according to the report.
The authors of the study, David Himmelstein, Deborah Thorne, Elizabeth Warren and Steffie Woolhandler, say their findings "reflect the U.S. health care financing system is broken." Middle class families, they conclude, "frequently collapse under the strain of the health care system that treats physical wounds, but inflicts fiscal ones."
• Read the report.
By Sarah Lovenheim  |  June 4, 2009; 5:22 PM ET
Categories:  Daily Dose

Employer-Sponsored Health Insurance
Trends in Cost and Access By Mark W. Stanton, M.A. By Mark W. Stanton, M.A. Introduction For decades, Federal and State policymakers have sought ways to offer affordable health insurance coverage, but this goal has been elusive. The number of uninsured remains high and costs for health care insurance keep growing, even though legislation has been enacted and regulatory changes have been made that affect both public and private programs. The U.S. employer-based health insurance market provides insurance coverage to nearly two-thirds of the population under 65. In addition, nearly 80 percent of the uninsured live in a family where at least one adult is employed. Therefore, building on these programs might be an attractive component of any solution. But it is essential to have sound, evidence-based information about that system to make informed decisions. This Research in Action is intended to answer questions that might arise during discussions about options. Based on data obtained by the Federal Agency for Healthcare Research and Quality (AHRQ) in the Medical Expenditure Panel Survey (MEPS), an ongoing series of annual surveys, it answers the questions: What are the recent trends in offer, eligibility, and enrollment rates? What impact does firm size have on whether or not employers offer health insurance? What factors affect whether employees enroll in insurance programs? Who is less likely to have employer-sponsored insurance?.... Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care May 15, 2007 | Volume 59 Author(s): Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea Editor(s): Deborah Lorber Overview Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report—an update to two earlier editions—includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations—Australia, Canada, Germany, New Zealand, the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill..... Date: November 25, 2008 Contact: Dave Lemmon, Director of Communications Geraldine Henrich-Koenis, Deputy Director of Communications Robert Meissner, Press Secretary 202-628-3030 Press Release U.S. Has 8.6 Million Uninsured Children and the Economic Downturn Is Likely to Drive the Number Higher New Families USA Report with State Specific Information Highlights That More than One Child in Nine is Uninsured Washington, D.C.—There are 8.6 million uninsured children in the United States, according to a new report released today by Families USA, the national organization for health care consumers. The report, based on new Census Bureau data, reflects the three-year period 2005-2007 and therefore does not reflect the worsening economic situation in 2008. The Families USA report, titled "Left Behind: America's Uninsured Children," spotlights the following facts about the 8.6 million uninsured children in the United States: One in nine children in America is uninsured. Uninsured children come from working families. The vast majority of uninsured children (88.2 percent) come from families where at least one parent works, and more than two-thirds of uninsured children—or 68.5 percent—live in households where at least one family member works full-time, year-round. More than half, or 60.4 percent, of the nation's uninsured children come from low-income families (families with incomes below twice the poverty level, or $35,200 for a family of three in 2008) who are likely eligible for Medicaid or CHIP. The five states with the largest number of uninsured children are Texas, California, Florida, New York, and Georgia. Together, the uninsured children in these five states account for nearly half of all uninsured children in the country (48.3 percent). The five states with the highest rates of uninsured children are Texas, Florida, New Mexico, Arizona, and Nevada. More than 15 percent of children in each of these states are uninsured, compared to a national median of 9.2 percent. Last year, the Congress voted to reauthorize the State Children's Health Insurance Program (CHIP), which would have expanded health coverage throughout the nation to approximately 4 million uninsured children. Although Congress passed the legislation with broad bipartisan support, the legislation failed when President Bush vetoed it. "The children's health legislation vetoed by the President would have provided much-needed relief to uninsured children across the nation,” said Ron Pollack, Executive Director of Families USA. The CHIP program is now scheduled to expire on March 31, 2009. As a result, the reauthorization of CHIP will be one of the earliest policy issues facing the next Congress and President.   "For the numerous children who count on CHIP as their health lifeline and for the 8.6 million children who are uninsured, support for continuing and expanding CHIP is critically important,” said Pollack. “It will determine whether children get the preventive care they need so that they can remain healthy, learn in school, and become productive citizens.” Due to the current economic downturn, Congress is also likely to consider providing higher federal matching funds to the states for the Medicaid program—the other key health safety net program for children from low-income families. Such a measure may be part of the next economic stimulus package debated in Congress, thereby enabling states to retain and expand health coverage as more families become uninsured. "As state budgets are becoming increasingly precarious due to the looming recession, this is exactly the time that states need an increase in funding,” said Pollack. “This measure would help not only those already uninsured but those who are likely to join the ranks of the uninsured due to the state of the economy.” ### Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans. 1201 New York Avenue NW, Suite 1100 · Washington, DC 20005 202-628-3030 · E-mail: info@familiesusa.org · www.familiesusa.org   Real Reform in an Election Year March 23, 2010 Editorial The White House and Democratic leaders in Congress won’t have much time to savor their victory on health care reform if they hope to achieve the next big goal: enacting financial regulatory reform before the midterm elections. A year and a half after the country’s banking system nearly imploded, it is still operating under the same inadequate rules and regulations. Unless President Obama throws himself fully into the fight, there is not much chance of pulling this off in an election year, when many lawmakers are more focused on deep-pocketed donors than on the public interest. The House passed a flawed reform bill last year. After months of talks that led to some compromises between Democrats and Republicans, no Republicans voted for the Senate’s version when the banking committee passed it on Monday. That bill, too, is flawed, and the banks are lobbying relentlessly to water it down even more. Here are the areas that must be fixed: PROTECT CONSUMERS The administration has called for an independent Consumer Financial Protection Agency, with power to police banks and nonbanks for bad lending in mortgages and other forms of consumer debt. Caving to the lenders, the current Senate bill would instead house the new bureau in the Federal Reserve, a diminution of status at odds with robust regulation. The proposal does take steps to isolate the bureau from Fed influence, including making the new regulator a presidential appointee. But that is a consolation prize for loss of autonomy, not a guarantee of independence. Mr. Obama will also have to push back against the Senate’s proposal to give other regulators the power to veto the agency’s rules in certain circumstances. To protect consumers, the new agency must be truly autonomous and have full rule-making and enforcement authority. REIN IN DERIVATIVES Even bankers couldn’t understand these largely unregulated instruments that were supposed to reduce risk, but ended up spreading it throughout the system. The Senate bill would still allow many derivatives to continue to trade outside of transparent and fully regulated exchanges. It also gives regulators too much discretion to exempt derivatives from full regulation. And it continues to block the states from imposing antigambling rules on unregulated derivatives deals, although many are purely speculative. ENDING TOO BIG TO FAIL The Senate bill contains “resolution authority.” Much the same way that the Federal Deposit Insurance Corporation shuts down failing banks, this authority would allow the government to seize and dismantle bank holding companies and major financial firms — like Lehman Brothers or the American International Group — if their imminent failure threatens the system. That is a start. But more is needed, including derivatives regulation. Unless derivatives trading is made vastly more transparent, regulators would be at a loss to understand how derivatives link one troubled firm to other firms. That could make it nearly impossible to determine how seizing a firm would affect the broader system. True reform must also shrink firms that are too big to fail and prevent others from becoming too large and complex. The Senate proposal instructs regulators to impose higher capital standards, limits on borrowing, and other measures to make it costlier for banks to engage in activities that increase their size and complexity. Those are important safeguards. But the bill punts on the so-called Volcker rule, endorsed by Mr. Obama, which would begin to restrict the size and activities of big banks. The Senate proposal calls for a six-month study of the rule, followed by a nearly three-year long implementation process. That’s needless delay, and the president should call lawmakers on it. A watered-down bill could be easier to move through the Senate, and certainly would be welcomed by bank lobbyists. But weak reform would be worse than no reform, because it would entrench the status quo under the guise of change.