Himmelstein David U, Warren Elizabeth, Thorne Deborah, Woolhandler Steffie
Harvard Medical School, Boston, Massachusetts, USA.
Health Aff (Millwood). 2005 Jan-Jun;Suppl Web Exclusives:W5-63-W5-73. doi: 10.1377/hlthaff.w5.63.
In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged dollar 11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.
2001年,145.8万个美国家庭申请破产。为调查导致破产的医疗因素,我们在五个联邦法院对1771名个人破产申请者进行了调查,随后对其中931人进行了深入访谈。约半数人提及医疗原因,这表明190万至220万美国人(申请者及其家属)遭遇了医疗破产。在那些因病导致破产的人中,自患病以来自付费用平均为11854美元;75.7%的人在患病之初有保险。医疗债务者出现保险断档的可能性比其他债务者高42%。即使是有保险的中产阶级家庭,生病时也常常陷入财务困境。