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"Get sick and get out." The travesty of medical foreclosures and bankruptcies

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Today's news describes yet another study noting how often illness and medical expenses drive people into financial hardship. Researchers surveyed 128 recently-foreclosed households in four states. They found that medical bills were a factor in 23 percent of home foreclosures. Overall, illness and injury contributed to about half of the foreclosures examined.

These study findings match patterns reported by other bankruptcy researchers: Medical debt is central to the story. This is hardly surprising. Times are hard for everyone. Throw in a chronic illness or an injury that knocks you or your spouse out of work, mix in a $50,000 medical bill, and you've lost the family home.

I encounter many caregivers who live under a constant overhang of financial worry. This is particularly true among parents caring for children with special healthcare needs. These parents know they will shoulder many financial burdens even after they themselves are gone. Most have public or private health coverage. Yet they quickly discover that key services are uncovered. They exhaust visit limits for physical and occupational therapy. They need new equipment. They have copayments and deductibles. Maybe they pay a babysitter for a younger child and then $10 for parking to see some academic medical specialist. It all adds up.

Living near the waterline, parents take night jobs. They cut back on the niceties. They put medical bills on the VISA, take home equity loans, Sometimes, this isn't enough. One prominent advocate for disabled children and their caregivers describes her journey this way:

I became involved with this organization more than 10 years ago, as I cared for my two sons, both of whom were diagnosed about the same time. We scrambled to find services for them, and we quickly found ourselves falling further and further into debt. I became involved in many state boards and other opportunities... What kept me driven is we were not seeing the answers we so desperately needed or were seeking. Hence the passion was not only to find answers for us but for the many other families who were left out there, struggling as we were.

There is another thing I don't talk much about to others. Essentially we were robbing Peter to pay Paul. After balancing and working and balancing some more, I ended up filing medical bankruptcy. We had stuck all of the medical bills on a credit card, and when the interest rates kept going up and up and up I just couldn't do it anymore. What started off as $160 payment ($35,000+ medical bills over 18 months) ended up being $1000 per month ten years later. I never missed a payment or was late for the payment. Of course, nothing much came off the bill in that 10 year time span. But it was down to buying milk and putting it on the table or paying for therapy....

I know many other families in the same boat. Sadly, it feels like failure when it happens. You have all these emotions anyway having a child with special health care needs but add this kind of guilt, and at times it is overwhelming. Of course at the time there was no one who guided us, which is the core of what we do here: guiding families through this maze that is sometimes preposterous. I work with many other families who have the same struggles.

The 2008 election presents the disability community with a stark choice. On one side, Barack Obama's health plan would provide affordable health coverage to every citizen, regardless of ability to pay, disability, or preexisting condition. It would bar insurers from rejecting consumers or charging higher premiums on the basis of a prior health condition. If you like your current coverage, you can keep it. If you don't, he proposes a new option based on what is offered to federal employees.

On the other side, Senator McCain would not bar insurers from discriminating against consumers with costly conditions. He has proposed working with the states to cover high-cost patients. He hasn't provided any details, and the money he proposes to spend doesn't come close to accomplishing this task. He would tax employer-based health coverage, replacing the current deduction with a $5,000 family tax credit. This doesn't come close to covering the costs. The average cost of health coverage for an American family of 4 is about $12,000. Persons with disabilities often pay far more.

Senator McCain seeks to move millions of families from employer-based coverage to a different system in which more people would have lower-cost, but much less generous, high-deductible plans within the nongroup market. It's hard to imagine a worse idea for Americans living with disabilities. Surveys documented the experiences of people with health concerns who seek coverage in the non-group market. One-third of these men and women were denied coverage or were charged higher premiums because of pre-existing conditions.

Senator McCain supports the disability community rhetorically. Yet he votes differently on key matters that require public resources. He opposed the Community Choice Act, which would expand people's access to personal assistance services within their family homes. Last year, President Bush vetoed the bipartisan compromise that would have expanded state children's health insurance programs (SCHIP) to cover an additional 3.3 million kids, many with special health care needs. Many Republicans opposed the President. McCain called Bush's veto "the right call."

The bill of particulars goes on, but key issues remain hidden. Senator McCain proposes to retain or enact large tax cuts for people who earn more than $250,000 annually. Nonpartisan experts estimate that McCain's tax plan would accumulate $1.2 trillion more in federal debt than Obama's by 2018. Yet McCain has pledged to balance the budget. He won't accomplish this, but he will face great pressure to cut Medicare and Medicaid to offset these unwise tax cuts.

America spends $2.1 trillion on health care. Families still lose their homes when someone gets sick. Millions are contacted by collection agencies over medical bills. Others send their kids to schools that lack the proper resources to implement legally-mandated services and accommodations. Senator Obama is trying to fix these problems. I don't see what Senator McCain has proposed that would help.

Postscript: For readers who don't always read the threads, I want to alert you. Here is one below:

My family went through a medical crisis in February when my husband caught pneumonia and was in ICU for 4 weeks and spent a total of 6 weeks in the hospital. The problem is even though we had insurance, lifetime max was $50,000 and that was swallowed up within the first few DAYS he was in the hospital. With hospital bills totaling close to $500,000, how can a family ever survive? Through no fault of his own, my husband is constantly apologizing for becoming ill and even goes as far as saying he sometimes feels he would have been better off dying in the hospital. It hurts so much to hear him say that!

Here is another:

Wow, I'm a registered Republican who has had juvenile diabetes for 18 years. I will be voting Obama because McCain's "health care" plan is terrible and puts people like me at serious risk. It is an immoral plan. I also work as a credit analyst at a bank and talk to people every day who have major debt due to illness. We need to take care of our citizens, and if it means paying higher taxes, that is a small price to pay.

Everyone gets sick. It's a matter of "when," not "if."

Every time I write a piece like that, I receive responses like this. They do my job better than I can.