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Since everyone is @'ing me on the dispute between the Bernie campaign and our Fact Checker on medical bankruptcy, I will make a few brief notes.
First, the researchers whom Sanders is relying are the cofounders of Physicians for a National Health Program, an organization which long predates (timesmachine.nytimes.com/timesmachine/1…) their interest in bankruptcy, medical or otherwise.
They're activists. There's nothing wrong with being activists. But they are not disinterested researchers, and you shouldn't treat their work as if they were.
Second, their work appears to be purpose-built to deliver the result that all bankruptcies are caused by medical events.
Third, Woolhandler and Himmelstein have not been as strenuous as they might in correcting the incredibly common misreading of their work, in which careless readers transmogrify "illness related" into "caused by medical bills".
Those are not the same thing. Canada has medical bankruptcy, despite "medicare for all", because if you get sick and can't work, and you have a lot of debt, things go south pretty quick.
Which is how we get to the statistic--falsified *even by the studies that allegedly support it*--that more than half of all bankruptcies are caused by medical bills.
Note that these studies do not say that the bankruptcies are caused by medical bills; their design can't possibly establish causation. But somehow people get that impression! Multiple times! And no one really corrects it! It is a puzzle!
A couple more notes: first, the studies they did showed that having insurance did very little to protect you from a medical bankruptcy (under their definition of a medical bankruptcy).
They say that shows that American health insurance is garbage. I say that shows their data is garbage.
There is a non-trivial difference between having a high deductible and being on the hook for the entire cost of your quadruple bypass. If your study doesn't detect one, you did something wrong. Whatever you're studying, it isn't "medical bankruptcy".
Or at least, you're not studying medical bankruptcy, caused by *medical bills*, which is the only problem that their national health program can solve. No health insurance program in the world fixes the problems of a self-employed plumber with a $500k house and multiple sclerosis
To believe that all of the "medical bankruptcies" they found are caused by medical bills--in the sense of "none of these people would have declared bankruptcy except for having high medical bills"--you have to believe that income loss is irrelevant.
But also you have to believe that in the entire united states, only about 250k people declare bankruptcy for every other reason: job loss, divorce, small business failure, predatory lending, fraud, etc. Does that seem ... likely?
Keeping in mind that the majority of the very-high-cost patients are ... already on Medicare? Because they're old?
That stat should never have passed the sniff test. It's crazy.
This is not to say that medical bills never cause bankruptcies, or that that isn't a problem worth addressing. But 500k is way too high for that number.
Not least because bankruptcy is almost always multi-factorial. It's people who had a lot of debt and *then* got divorced, or sick, or fired, or sued. If they hadn't piled on the payments, they wouldn't be bankrupt, and also, if they hadn't been unlucky, they wouldn't be bankrupt.
There's this endless debate in bankruptcy that boils down to "unlucky or unwise?" and the answer is "Embrace the healing power of 'and' ".
