Health care in America: "bizarre loopholes kick in at the darkest moments"

The Atlantic has an important piece about the outrageous state of health care in America:

Medical debt is a uniquely American phenomenon, a burden that would be unfathomable in many other developed countries.

According to a survey published this month in the American Journal of Public Health, nearly 60 percent of people who have filed for bankruptcy said a medical expense “very much” or “somewhat” contributed to their bankruptcy. That was more than the percentage who cited home foreclosure or student loans. (The survey respondents could choose multiple factors that contributed to their bankruptcy.) . . .

A 2016 study found that a third of cancer survivors had gone into debt as a result of their medical expenses, and 3 percent had filed for bankruptcy. . . .

“It’s just life,” says Deborah Thorne, a sociologist at the University of Idaho who co-authored the latest bankruptcy study. “It’s not like they’ve done anything wrong.” . . .

In interviews, half a dozen consumer advocates told me they are concerned that the problem will get worse, since the uninsured rate is going up. . . .

Emergency-room visits and planned surgical procedures are the most common causes of large medical bills that patients simply can’t afford to pay, advocates told me. Often, a hospital might be covered by a person’s insurance network, but the individual doctors who work there and the ambulance company that services it aren’t, a situation that can lead to something called balance billing.

Sometimes, bizarre loopholes kick in at the darkest moments, like the fact that a baby would be covered upon birth under Medicaid or the Children’s Health Insurance Program, the government insurance program for children, but a stillbirth might not be covered. . . . (Indeed, one study found that average hospital costs for stillbirths are more than $750 higher than for live births.)

In some states, hospitals are required to provide charity care to certain low-income and uninsured patients, but several advocacy groups told me that these patients sometimes get regular bills instead. “We were seeing hospitals sending debtors to debt collections without saying anything to the debt collectors” about charity care, says Emilia Morris, the legal director of Central California Legal Services. “The debt collectors are trying to collect these debts without making charity care available. The patient sometimes gets sued, gets a judgment entered against them, without ever having heard of charity care.” . . .

[T]he current system requires people to independently negotiate on their own behalf with giant corporations over tens of thousands of dollars, often while recovering from a major illness. . . .

Read the whole thing here.