NASHVILLE - As lawmakers in Tennessee and other states grapple with budget deficits, one public-health and medical researcher is cautioning against cuts to medical coverage as a budget-balancing tool because the consequences may be even more costly.
David Himmelstein, who has researched medical-related bankruptcies for the past decade, says those bankruptcies went up substantially between 2002 and 2007, even before the Great Recession hit. Himmelstein, a professor of public health at City University in New York and an associate professor of medicine at Harvard Medical School, says the vast majority of those bankruptcies involved people who had some level of insurance.
"Most people who are driven into bankruptcy by illness and medical bills actually have coverage, but it's such inadequate coverage that it doesn't keep them from financial ruin. They're facing huge premiums and copayments and deductibles - and things that aren't covered by their insurance."
Last year's reforms probably will help but won't eliminate the problem, Himmelstein says. In a report released earlier this month, Himmelstein and his fellow researchers looked at Massachusetts in 2009, three years after it had passed a state health-reform law that served as a model for the national law.
"What Massachusetts did was to give people really inadequate coverage. It traded uninsurance for underinsurance. That really didn't work. When people were seriously ill, they ended up with such huge medical bills that they really didn't have coverage that could keep them out of the bankruptcy court."
The report suggests that substantial improvement in coverage and better disability insurance would better protect families. It points to Canada's model, where national health insurance provides universal, first-dollar coverage.
The national medical-bankruptcy study is online at http://bit.ly/AAsE0. The Massachusetts medical-bankruptcy study is at http://bit.ly/fiygJT.