Abstract
Background
Our 2001 study in 5 states found that medical problems contributed to at least 46.2%
of all bankruptcies. Since then, health costs and the numbers of un- and underinsured
have increased, and bankruptcy laws have tightened.
Methods
We surveyed a random national sample of 2314 bankruptcy filers in 2007, abstracted
their court records, and interviewed 1032 of them. We designated bankruptcies as “medical”
based on debtors' stated reasons for filing, income loss due to illness, and the magnitude
of their medical debts.
Results
Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92%
of these medical debtors had medical debts over $5000, or 10% of pretax family income.
The rest met criteria for medical bankruptcy because they had lost significant income
due to illness or mortgaged a home to pay medical bills. Most medical debtors were
well educated, owned homes, and had middle-class occupations. Three quarters had health
insurance. Using identical definitions in 2001 and 2007, the share of bankruptcies
attributable to medical problems rose by 49.6%. In logistic regression analysis controlling
for demographic factors, the odds that a bankruptcy had a medical cause was 2.38-fold
higher in 2007 than in 2001.
Conclusions
Illness and medical bills contribute to a large and increasing share of US bankruptcies.
Keywords
References
- The Fragile Middle Class: Americans in Debt.Yale University Press, New Haven, CT2000
- Illness and injury as contributors to bankruptcy.Health Aff (Millwood). February 2, 2005; ([Web exclusive]) (Accessed August 6, 2008)
- How many are underinsured?.Health Aff (Millwood). June 10, 2008; ([Web exclusive: w298-w309]) (Accessed August 6, 2008)
Bankruptcy Abuse Prevention and Consumer Protection Act of 2005, Public Law No. 109-8, 119 Stat. 23 (2005).
- Occupational Prestige/Summary.(Accessed July 23, 2008)
- Left behind—casualties of a changing job market; parting shot: to save on health-care costs, firms fire disabled workers.Wall Street Journal. July 14, 2003; (A1)
- Did bankruptcy reform fail?.Am Bankruptcy Law J. 2008; 82: 349-405
- Borrowing to stay healthy: how credit card debt is related to medical expenses.(Accessed July 18, 2008)
- Seeing red: Americans driven into debt by medical bills.(Commonwealth Fund. August 10, 2005) (Accessed July 17, 2008)
- Why not the best?.(The Commonwealth Fund. 2008) (Accessed July 17, 2008)
- Discounting the debtors will not make medical bankruptcy disappear.Health Aff (Millwood). 2006; 25: W84-W88
- Household consumption and personal bankruptcy.(Social Science Research Network. February 2007) (Accessed July 16, 2008)
- Medical bills and bankruptcy filings.(American Enterprise Institute. July 2006) (Accessed July 16, 2008)
- The risk of bankruptcy before and after brain or spinal cord injury: a glimpse at the iceberg's tip.Med Care. 2007; 45: 702-711
- A Review of Medical Debt in Upstate New York.Empire Justice Center, Albany, NY2006
- Protecting households from catastrophic health spending.Health Aff (Millwood). 2007; 26: 972-983
- Pawning for financing health expenditures: do health shocks increase the probability of losing the pledge?.in: Wood D. The Economics of Health and Wellness: Anthropologic Perspectives. Elsevier, Oxford, UK2008
- Interviews with leading health policy experts in several nations.(Accessed July 18, 2008)
Article Info
Publication History
Published online: June 05, 2009
Footnotes
Funding: Supported by Grant #56590 from the Robert Wood Johnson Foundation, Princeton, NJ.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
