JustCare

Tag: Bankruptcy

  • For-profit hospitals are causing rising medical debt and personal bankruptcy

    For-profit hospitals are causing rising medical debt and personal bankruptcy

    Axios reports new findings, in partnership with Johns Hopkins, that medical debt continues to rise. Rising medical debt should come as no surprise as insurers shift more costs onto patients through deductibles, coinsurance and more. People who need hospital care are hit with some of the largest medical bills, at times driving them into medical bankruptcy.

    Nearly six in ten people in debt (58 percent) in the US are faced with collection notices because of a medical expense. Hundreds of thousands of people have been forced to file for medical bankruptcy.

    Some hospitals sue patients. Others get liens on their patients’ income. The hospitals might claim a portion of a personal-injury settlement.

    Ten hospital chains are extremely litigious. Their lawsuits comprise 97 percent of all cases against patients. Two Virginia hospitals are the biggest offenders: VCU Medical Center in Richmond and University Hospital in Charlottesville. They claim to have now stopped suing patients.

    As it is, many hospitals charge significantly more than their cost for the services they deliver. More than half (57%) of the top 100 hospitals charge at least five times more than their cost. And, some charge ten times more than cost. Chippenham Hospital in Richmond, Virginia has the highest markup. Even when hospitals don’t collect the full amount of their bills, they find that charging higher prices leads to higher revenue.

    People generally cannot and do not price shop for hospital care. They go to the hospital with which their doctors are affiliated.  Moreover, information on the cost of their care is generally not available in advance of a procedure.  (Federal law requires hospitals to post their prices, but most are not doing so and people cannot know in advance, let alone control, which ancillary tests and procedures they will receive.)

    Here’s more from Just Care:

  • Berwick: Medicare for All lowers costs and reduces confusion and paperwork

    Berwick: Medicare for All lowers costs and reduces confusion and paperwork

    How do we keep Americans from dying for lack of health care? That’s the question every policymaker and pundit should be asking, along with which health care reform proposals will best prolong people’s lives. Don Berwick, former head of the Centers for Medicare and Medicaid Services (CMS), explains in a USA Today op-ed that Medicare for All guarantees health care for all, lowers costs, and reduces confusion and paperwork.

    Berwick is an expert, who has had a 360 degree view of our nation’s health care system. In addition to having been head of CMS, he is a pediatrician and researcher at Harvard Medical School, who has witnessed the challenges with our health care system firsthand. He has a very different perspective from the pundits and the politicians who too often parrot right-wing talking points; they don’t understand the challenge of fixing our health care system as long as private insurance companies can drive up costs and profit from denying care, Berwick appreciates that Medicare for All would sharply reduce the inappropriate denials and high costs.

    Berwick explains that Medicare for All guarantees everyone coverage and lowers costs significantly. It would let us spend our health care dollars on public health crises instead of administrative waste. It would help us invest in disease prevention. It simplifies and streamlines our fragmented health care system.

    Proposals such as Medicare for those who want it, sometimes called the public option, or Medicare Advantage for All do not simplify the system, nor is there data to suggest they deliver savings. As Elizabeth Warren suggested, Medicare for all who want it is a euphemism for Medicare for people who can afford it. It retains a complex and costly health care system that does not allow for simplification or waste reduction.

    By current estimates, Americans (federal and state governments, employers and individuals) will spend a total of $52 trillion over the next ten years on health care without Medicare for All. With Medicare for All, we will spend about $52 trillion and everyone has comprehensive benefits. Projected new federal spending (which is simply a shift from private spending) is $20.5 trillion over ten years.

    Medicare for All guarantees access to care and prevents tens of thousands of needless deaths and bankruptcies. Medicare for All reduces health care costs for families. In the last ten years, health care premiums were up 54 percent, with workers paying about 71 percent of those costs. Yet, wages have only increased 26 percent.

    Medicare for All does not change the way we get our care, only who pays for our care. We still go to private doctors and hospitals. What’s different is that we no longer have to worry about whether they are in network or what we will have to pay.

    If you support Medicare for all, please let Congress know. Please sign this petition.

    Here’s more from Just Care:

  • Overpriced health care too often means bankruptcy

    Overpriced health care too often means bankruptcy

    When Americans get sick these days, many hesitate to take an ambulance to the ER. Even with insurance, the costs can be several thousand dollars. Overpriced health care too often means bankruptcy, when it doesn’t mean large numbers of people forgoing care.

    The Atlantic reports on an uninsured woman who suffered a mini-stroke and went to the ER overnight. She received a battery of tests and was discharged.  The bill was $26,203.62 total for “observation.” On top of that. she was charged $1,301 for consultations with two doctors. She was charged $1,316 for X-rays and other diagnostic tests. And, the ambulance company charged her $1,807, which she was able to knock down to 1,084.

    Unlike citizens of other wealthy countries, Americans find themselves relatively often in medical debt. The American Journal of Public Health reports that almost six in ten Americans who file for bankruptcy do so in some part because of medical debt. Medical debt is more often given as a reason for bankruptcy than student loans or bank foreclosures.

    One in three cancer survivors go into medical debt. Of those, one in 11 file for bankruptcy. Collection agencies see more unpaid medical bills than any other type of bill. About one in five Americans have credit reports that reflect medical claims.

    Medical debt most often results from ER visits and elective surgeries. People may go into debt just paying the thousand dollar plus deductibles that are increasingly common. Or, they go into debt because their in network hospitals assign them out of network doctors, who surprise them with bills their insurers often won’t pay.

    Three in 10 Americans delay care to avoid these bills, according to a December 2018 Gallup poll. People without insurance are most likely to deny care–54 percent. But, high deductibles and coinsurance lead 30 percent of people with insurance to delay care as well. People with Medicare and Medicaid are least likely to delay care—22 percent.

    What can you do to protect yourself from big medical bills when you seek care? If you have a large bill after your Medicare Advantage or other health insurer pays, you should ask the hospital or doctor for a discount. Sometimes they will provide one.

    As important, make sure your representatives in Congress and presidential candidates support Medicare for All. Presidential candidate Beto O’Rourke and others who support what they call Medicare for America are doing little if anything to address overpriced health care or to keep people from medical debt. Only Medicare for All reins in costs, lets you see any doctor and use any hospital in the US, and eliminates deductibles, premiums and coinsurance.

    Here’s more from Just Care:

  • Social Security benefits will rise 2.8 percent in 2019, but checks may not

    Social Security benefits will rise 2.8 percent in 2019, but checks may not

    As a result of inflation, people on fixed incomes find that their incomes decline in value over time.  One extremely important feature of Social Security is that its benefits are adjusted every year automatically to offset increases in inflation, so that the modest, but vital, benefits do not erode over time.  It is important to understand that these adjustments are not increases.  They are intended to simply allow people to tread water, to maintain their purchasing power.

    Unfortunately, the government’s cost of living adjustment for Social Security is based on inflation experienced by workers and not by retirees and people with disabilities who are unable to work. Older people and people with disabilities have, on average, higher health care costs; those costs tend to rise considerably faster than overall inflation.  For that and other reasons, Social Security beneficiaries generally experience higher costs of living than workers, so Social Security adjustments are often inappropriately low.  Consequently, Social Security beneficiaries are not even treading water, but rather losing ground. Nevertheless, even inadequate adjustments are better than none.

    For 2019, Social Security beneficiaries will receive a cost of living adjustment or COLA of 2.8 percent, an average of $39 a month or $468 a year.  That is good news for Social Security beneficiaries, many of whom have little or no other income.  The bad news is that millions of people likely will not experience that full increase.

    Most people with Medicare who receive monthly Social Security benefits have their Medicare Part B premiums deducted directly from those Social Security payments.  For these people, Congress has provided that the annual increase in the Medicare Part B premium must be no larger than the Social Security cost of living adjustment or COLA.  (An exception to this rule is if you are higher income and subject to the Income-Related Higher Income Amount.)

    People who are protected can’t lose some of their Social Security benefits, but they can certainly see no cost of living adjustment, despite the 2.8 percent increase.  In 2018, about one quarter of beneficiaries saw no increase whatsoever and another 18 percent received a monthly benefit that was only $5.00 or less.

    People who do not have their Medicare premiums deducted automatically from their Social Security benefits can, indeed, wind up with less net income, despite the increase.  And, of course, in addition to premiums for health insurance covering doctors’ costs, there are premiums for prescription drugs, as well as costs for copays and deductibles.  As a result, instead of treading water, people are sinking below the surface.  Indeed, bankruptcies among those aged 65 and older are skyrocketing.

    This is unacceptable.  After a lifetime of work, Americans should have enough guaranteed Social Security to maintain their standards of living.  The solution is three-fold. First, Congress should enact a better, more accurate measure of inflation for people receiving Social Security benefits. In addition, benefits, which are modest, but vital, should be increased. Finally, Congress should improve Medicare by expanding it to cover such vital services as hearing aids, dental work, and vision care.  Premiums, copays, and deductibles should be eliminated.  And everyone should be covered.  Improved Medicare for All will improve the nation’s health outcomes while costing a fraction of what we pay today.

    It is long past time to enact a more accurate cost of living adjustment for Social Security, expand its benefits, improve Medicare, and extend it to everyone.  That is profoundly wise policy.  It also represents the views of the vast majority of us.

    If you want Congress to expand Social Security, please sign this petition.

    Here’s more from Just Care:

  • To reduce risk of bankruptcy, plan ahead for retirement

    To reduce risk of bankruptcy, plan ahead for retirement

    A new survey by the Consumer Bankruptcy project reveals that a growing number of older adults find themselves unable to pay for their basic necessities. As the social safety net shrinks, retirees are being forced to choose between their prescription drugs and their mortgage payments. Improving and expanding Medicare to cover everyone would allow everyone to get the care they need.  Without Medicare for all, to reduce the risk of bankruptcy, Americans need all the more to plan ahead for retirement

    Researchers found that retirees today are three times more likely to file for bankruptcy than retirees 27 years ago. Today, 3.6 older adults between 65 and 74, out of every 1,000, file for bankruptcy. In 1991, 1.2 people between 65 and 74, out of 1,000, filed for bankruptcy.

    Older adults also represent a greater proportion of people who file for bankruptcy. Today, almost one in eight people who file for bankruptcy (12.2 percent) are older adults. Back in 1991, only one in fifty people who filed for bankruptcy (2.1 percent) were older adults.

    Unlike retirees in 1991, whose employers were likely  to provide financially for them in retirement, retirees today are less likely to be able to depend on pensions. They are also less likely to have adequate savings to cover far higher health care costs. About one in four people over 65 have liquid savings of $3,260. The typical person over 65 has $60,600 in liquid savings.

    About three out of five older adults said that high medical expenses played a role in their bankruptcy. Out-of-pocket health care costs with Medicare average over $5,000 a year; people with the costliest complex conditions typically spend over $20,000 out of pocket. Two out of three older adults attribute their bankruptcies to a reduction in their income.

    People’s incomes pre-retirement and in retirement are not what they used to be. New retirement savings programs, such as 401(k) plans and IRAs, do not offer the same generous annual incomes that defined benefit plans–which provide guaranteed annual income–once did. Moreover, retirees today need to wait two years longer, until 67, for full Social Security benefits, than retirees in the past. And, their out-of-pocket costs have grown substantially.

    Older adults have few places to turn for help. They struggle to get a job to pay unexpected bills. Two jobs are hard to come by. So, too often they end up in bankruptcy court. What’s all the more concerning is that, for every older adult who ends up in bankruptcy court, there are several others nearing bankruptcy, in financial distress.

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