Health Affairs

Posting date: February 2, 2005

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Health Affairs, 10.1377/hlthaff.w5.63
Copyright © 2005 by Project HOPE

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MarketWatch: Illness And Injury As Contributors To Bankruptcy

David U. Himmelstein ^1*, Elizabeth Warren ², Deborah Thorne ³, Steffie Woolhandler ⁴

¹ David Himmelstein is an associate professor of medicine at Harvard Medical School and a primary care physician at Cambridge Hospital in Cambridge, Massachusetts.
² Elizabeth Warren is the Leo Gottlieb Professor of Law at Harvard Law School in Boston. She was chief adviser to the National Bankruptcy Review Commission.
³ Deborah Thorne is an assistant professor in the Department of Sociology and Anthropology at Ohio University in Athens.
⁴ Steffie Woolhandler is an associate professor of medicine at Harvard, where she codirects the General Medicine Faculty Development Fellowship Program. She practices primary care internal medicine at Cambridge Hospital.

^*Corresponding author.

Abstract

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.

Key Words: Business Of Health, Consumer Issues, Insurance Coverage, Legal/Regulatory Issues, Health Spending

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