The Numbers
A Run at the Latest Data from ABC's Poobah of Polling, Gary Langer
Gary Langer is director of polling at ABC News, where he's covered the beat of public opinion for nearly 20 years - conducting and analyzing ABC News polls, evaluating data from other sources and setting the news division's standards for poll reporting. Langer has won two Emmy awards for ABC's reporting of public opinion polls in Iraq, and The Numbers blog was honored this year as winner of the 2008 Iowa Gallup Award for Excellent Journalism Using Polls.
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"Medical Bankruptcies:" a Data Update
June 04, 2009 3:08 PM
The academic group that put out a much-covered and deservedly much-debated study on so-called "medical bankruptcies" a few years ago has released an update today. In some important ways it improves on the earlier version, which I’ve blogged about before. But in other, fundamental ways, reservations remain in order.
The study again was led by a Harvard professor who co-founded an advocacy group for a single-payer national health care system. From my perspective, it makes leaps, inflates numbers and questionably characterizes results. Its authors clearly have a different view; since these are the sorts of numbers that can inform presidential pronouncements and policy directions alike, a good look is warranted.
The study, published in The American Journal of Medicine, concludes that "62 percent of all bankruptcies in 2007 were medical." In fact, though, the survey on which it’s based asked respondents if medical expenses or problems were one of “a number of different reasons” for their bankruptcy. (“People file for bankruptcy for a number of different reasons. Why did you, or a spouse or partner, file for bankruptcy? Check all that apply.”)
It strikes me as a mischaracterization to portray any one item or group of items in the list that followed as the sole or even chief cause of bankruptcy. The study seems to me to do just that, using phrases such as “medical debtors,” “medical bankruptcies” and, in the accompanying news release, “bankruptcies attributable to medical problems.” Its key data table, titled “Medical Causes of Bankruptcy,” lists various items as “reason for bankruptcy,” dropping the qualifying word, “a” reason.
In reality there could be any number of equally important or more important contributors. The survey could have asked respondents to rank them in importance; it didn't. Given what was asked, I can see saying that medical bills or problems contributed to bankruptcies - not suggesting they caused them.
A next question is how the researchers got to that 62 percent. The number of respondents who actually said medical or health care bills were among the reasons for their bankruptcy was 29 percent. Thirty-two percent also said their or a spouse’s medical problems (not specifically bills) were among the reasons, and 11 percent cited another family member’s medical problems (not specifically bills). Aggregating these, the study says 44 percent cited medical bills or medical problems as a reason for bankruptcy.
That’s a plenty big number, and cause for real concern. At the same time, sticking with what the survey actually asked, it’s not about medical costs per se, but about either medical bills or undefined “medical problems.” And again these are not the reason, but one of a number of reasons, for bankruptcy.
It’s also not 62 percent. The researchers arrive at that sum by adding in people who do not report a medical reason for their bankruptcy, but fit other conditions - e.g., lost two weeks or more of income because of their or a family member’s illness, or had more than $5,000 in uncovered medical expenses in the previous two years. These people are counted as having a medical problem among the reasons for their bankruptcy even though, when given an opportunity to say so themselves, they did not.
In another headline result, the authors report a nearly 50 percent increase since 2001 in bankruptcies for which medical problems were among the reasons. I’m having trouble seeing how they got there, because the two surveys asked different questions (as well as being done among different populations). We’ve asked for details, and I’ll update this note when we learn more. (Separately, the study describes people who used a home equity line of credit to pay medical bills as having “mortgaged [their] home” to do so.)
As I noted at the start, this study is in some ways better than its 2001 predecessor. It uses a national sample as opposed to a sample in just five federal court districts. The “greater-than-$5,000 in medical expenses” condition is less bad than the greater-than-$1,000 threshold used in '01. And some of the most debatable ’01 conditions have been dropped, such as a gambling problem or the death of a family member, both previously included as a reason for “medical bankruptcy.”
Again, the lead author, Dr. David Himmelstein, is a co-founder of the “Physicians for a National Health Program,” an advocacy group calling for a “public or quasi-public” single-payer health system. One wonders whether other researchers, with other perspectives, might have presented the data differently.
June 4, 2009 in Problem Polls | Permalink | User Comments (12)
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One more time class!
Figures don't lie, but, liars figure.
Posted by: azcowboy | Jun 4, 2009 3:51:27 PM
I imagine in the next 2 years the 62% will be dwarfted by a much larger number with all the unemployment. If medical expenses played some part in a bankruptcy, it doesn't matter whether it was the sole cause or not. It contributed to the bankruptcy.
Dan B
Posted by: Daniel J. Brupbacher | Jun 4, 2009 4:01:04 PM
I disagree with the findings. I'm being forced into file bankruptcy due in part to medical but my coverage is excellent and have a small co-pay. I'm still being treated and no longer can do the work I was performing after surgery. The problem is I lost my job after six months of being out of work (FMLA only protected me for 2 months). Living on 60% of your salary, its hard to make ends meet. So yes, Medical was a cause but not for the reasons the report would assume.
Posted by: Roger | Jun 4, 2009 5:05:34 PM
Sounds like Harvard is willing to continue tolerating slipshod research from its Professors. I wonder how long their sterling reputation can hold with such obvious data manipulation by their staff.
Posted by: sfcpoll | Jun 4, 2009 5:11:42 PM
I wonder if this study from Harvard was gov't funded? You can play with numbers, ask questions in a way the is misleading to come up with the results you want. Sorry but I think the Harvard study is VERY, misleading
Posted by: camp50 | Jun 4, 2009 5:18:49 PM
Misleading polls and contrived data will lead us into socialized health care. Take it form a retired NP who worked with Medicaid/Medicare (socialized health care) patients ,you do not want the government dictating any aspect of your health care. Example, government devised HIPPA law makes everyone jump hoops, durable medical equipment can be purchased cheaper on line than obtained through government authorized vendors, elders who forget to pay part D premium have to wait til enrollment period of every November 15th and then get penalized 7% for their mistake of forgetfulness.If socialized health care comes to be, will rich politicians/hollywood stars be able to go overseas for their health care while the the masses endure a long wait for government run care? Will the masses be given quick, safe treatment for brain tumors like Ted Kennedy, or will they have to wait for a months to year like in Canada?
Posted by: Downwithsocialism | Jun 4, 2009 10:26:03 PM
Healthcare and health insurance costs in America are driving us to the poor house ... God forbid if you have to enter the "sick care" system!
Denise
Posted by: Denise | Jun 5, 2009 12:10:30 PM
The obvious REAL question is:
how many Companies, Small Businesses, Corporations, and even- at this point- municipalites (or even States) have to declare bankruptcy due to medical costs, especially due to former employees, pension holders, and lawsuits?
And how many nurses, doctors, charities, hospitals, etc need to file, or at least restructure due to financial concerns?
Take the burden away from productive/beneficial sectors (doctors, businesses, small businessmen, charities, hospitals, etc). And get a single-payer, universal system. And take way the money paid to the unproductive enterprises (lawyers, insurance companies, bureacracy, etc.)
Posted by: Ed | Jun 6, 2009 12:15:40 AM
The Big 3 chartered a jet to DC to tell Congress how much taxpayer money they needed - Now it's time for at least 3 chartered planes! Load all of our very well insured/pensioned ELECTED Congressmen aboard - fly them to Canada, France, England etc... For first hand knowledge as to exactly how a well run State Health program works. I don't believe Insurance Companies or the Drug Industries either lobby or control their health care. They are healthier and live longer than we do - I wonder why? Their taxes, including their health care tax, allow companies to have healthier employees at a fraction of the cost of employer's here.
Posted by: kitchendoc | Jun 6, 2009 2:13:30 PM
For decades the AMA has opposed a comprehesive national health care plan at the cost of thousands of American lives in violation of the credo to "do no harm". We need to take control of health care out of the AMA's destructive hands, expand the number of medical schools; and end the age of the AMA's position as gate keeper to entrance into this profession.
Posted by: charlesRN | Jun 11, 2009 8:46:04 AM
I keep asking this - Who pays??? Current basic medical insurance is approximately $450/person/month. Family of four $1800/month. Average take-home wage $2350/month. You finish the math. No matter how much you manipulate the numbers the cost per person is still enormous. Current proposals will require all Americans buy coverage, either personally or through their employer. Can we say "never ending recession." Can we not see small business closing or scaling back to absolute minimum to cover owners. Just where does this "Right to Medical Coverage" come from - not the Constitution. Where is the call for a Consitutional Ammendment to justify this political push for universal coverage? This is a steep slope covered with shale we are about to step onto.
Posted by: FHeuy | Jun 15, 2009 2:19:48 PM
Good review. ABC doesn't do enough of this type of reporting.
We have to ask ourselves, at what price will we support paying. While AIDS, Cancer and other diseases are bad, just think if we spent the money elsewhere. It would be a lot more efficient and logical to spend 200K on children through vitamins, inoculations, etc than for a cancer patient.
While sounding cruel, it comes down to a number game. We can't afford it all.
Posted by: CPO | Jun 18, 2009 6:24:03 PM
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