Despite promises, medical bankruptcy still as high with the ACA

HCProf

Moderator
Sep 2014
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#12
Clearly the ACA approach wasn't ideal. It's what you get when you take the Republican approach to healthcare reform as the best that can be achieved. The minute Obama decided that bipartisanship was so important that we'd commit to the Heritage Foundation/Romney goal of preserving corporate profits for the insurers, the magnitude of the improvement was effectively capped. But, has it been an improvement? Hell yes!

As I've mentioned before, we went from falling down the international rankings of life exectancy --for decades-- to rising up them. And the pace of healthcare inflation since Obamacare passed has been the lowest, by a margin, of any period of that length on record. As for bankruptcies, they're down SHARPLY. In the five years culminating in 2010 (the year Obamacare passed), we had an average of 1,149,370 non-business bankruptcy filings per year, and that was rising by an annualized pace of 7.22% per year. Over the next seven years (my data only runs through 2017), even as the population grew, the average number of non-business bankruptcy filings per year fell to 1,004,104, and the annualized pace of DECLINE was 10.4%!

Just the Facts: Consumer Bankruptcy Filings, 2006-2017

Now, granted, that wasn't all due to the huge drop in medical bankruptcies. But, that huge drop did, in fact, play a part. Using the study you cited, where pre-ACA medical bankruptcies made up 67.5% of bankruptcies, that would suggest that back in 2010 we had something like 1,038,172 medical bankruptcies, or 1 per 298 Americans, whereas by 2017 (using the later 65.5% rate from the study you linked to), we had about 502,857, or 1 per every 648 Americans.

Now, stop and really consider those numbers. Picture if I had a time machine and could go back and talk to the 2010 version of yourself, and I told you that if Obamacare passed, the per capita number of medical bankruptcies would drop by well over half in just seven years, you'd have assumed I was lying. There's no way that we could erase over half our medical bankruptcy problem that quickly, right, much less do so while actually climbing the international rankings for life expectacy.... right?

Yet, isn't that what happened? Isn't it fascinating that, even the face of such a breathtaking success, people are trying to spin it as a failure?
The ACA was a failure for the middle class. Everyone else benefited from it. At this point, from my observation in healthcare, they only people who still support this are people who have good insurance....such as the low income, Medicare beneficiaries along with other government sponsored insurance. It is the old "I got mine, screw you" mentality.
 
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Sep 2017
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#13
A big improvement would lower the ratio of medical bankruptcies, which didn't happen.
What makes you think that? Obviously, there could be multiple factors. For example, you could have high real-estate-related bankruptcies in the first period, driven by very loose lending standards and a sudden shock from a national bear market in real estate, along with high medical bankruptcies. Then you could have medical bankruptcies fall dramatically due to ACA, even as real estate bankruptcies fell dramatically because housing prices have been rising uninterrupted and lending standards tightened.

The methodology here just doesn't make sense.
 
Mar 2012
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New Hampshire
#14
Clearly the ACA approach wasn't ideal. It's what you get when you take the Republican approach to healthcare reform as the best that can be achieved. The minute Obama decided that bipartisanship was so important that we'd commit to the Heritage Foundation/Romney goal of preserving corporate profits for the insurers, the magnitude of the improvement was effectively capped. But, has it been an improvement? Hell yes!

As I've mentioned before, we went from falling down the international rankings of life exectancy --for decades-- to rising up them. And the pace of healthcare inflation since Obamacare passed has been the lowest, by a margin, of any period of that length on record. As for bankruptcies, they're down SHARPLY. In the five years culminating in 2010 (the year Obamacare passed), we had an average of 1,149,370 non-business bankruptcy filings per year, and that was rising by an annualized pace of 7.22% per year. Over the next seven years (my data only runs through 2017), even as the population grew, the average number of non-business bankruptcy filings per year fell to 1,004,104, and the annualized pace of DECLINE was 10.4%!

Just the Facts: Consumer Bankruptcy Filings, 2006-2017

Now, granted, that wasn't all due to the huge drop in medical bankruptcies. But, that huge drop did, in fact, play a part. Using the study you cited, where pre-ACA medical bankruptcies made up 67.5% of bankruptcies, that would suggest that back in 2010 we had something like 1,038,172 medical bankruptcies, or 1 per 298 Americans, whereas by 2017 (using the later 65.5% rate from the study you linked to), we had about 502,857, or 1 per every 648 Americans.

Now, stop and really consider those numbers. Picture if I had a time machine and could go back and talk to the 2010 version of yourself, and I told you that if Obamacare passed, the per capita number of medical bankruptcies would drop by well over half in just seven years, you'd have assumed I was lying. There's no way that we could erase over half our medical bankruptcy problem that quickly, right, much less do so while actually climbing the international rankings for life expectacy.... right?

Yet, isn't that what happened? Isn't it fascinating that, even the face of such a breathtaking success, people are trying to spin it as a failure?
I disagree its being spun as a failure especially since the source was a very far left one. They are just acknowledging that many of the promises didnt pan out. Same thing with ER usage. We saw in Massachusetts that never went down. Because we dont have the medical infrastructure to make it happen. Now of course the source does have an ulterior motive in that they want single payer with no insurers, but they didnt want to make the ACA appear as a failure.

'Romneycare' didn't rein in costs
Emergency room visits grow in Mass.
 
Sep 2017
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Massachusetts
#15
The ACA was a failure for the middle class
By what standards? Granted, the major stats I use to measure success don't break it out by class. The US has been rising up the international rankings of life expectancy since Obamacare passed, but it's possible that's due to relative improvements for the upper and lower classes, while the middle class worsened. The pace of healthcare inflation has been at an all-time historic low, but it's possible that has shown up as big improvements for the upper and lower class and worsening for the middle. And the per capita rate of medical bankruptcies had dropped by over half, but maybe that's mostly just for the poor and there's been an uptick among the middle class. But I'd need data to support the assertion, before I believe it.

In my own case, Obamacare hasn't really mattered, in terms of immediate, personal impact. I'm privately insured and have had the same private insurance throughout. It's effectively been a non-issue for me -- other than the role it played in lowering deficits, which has some long-term impact for me. But it's still nice to know it's there. It's nice to know that if I were to lose my job (and thereby my insurance) I could still find other insurance at an affordable rate.... and that even if it happened at a time when I had a pre-existing condition, I wouldn't end up bankrupted by medical costs thanks to that condition not being covered. It's also nice to know that isn't going to happen to my loved ones , like my brother, for whom I would otherwise deplete my coffers if it were to come down to mortgaging my house to cover an uncovered but necessary medical expense, or let them go without it. It gives me such peace of mind to know Obamacare is there. And that's why it's been so aggravating to me and to millions of Americans that Republicans are bound and determined to cut that safety net out from under us. It's also why the Democrats who are willing to fight for our interests won such an historic victory in November.

At this point, from my observation in healthcare, they only people who still support this are people who have good insurance....such as the low income, Medicare beneficiaries along with other government sponsored insurance. It is the old "I got mine, screw you" mentality.
I'm not low income, a Medicare beneficiary, or on other government-sponsored insurance. But I sure as hell am glad we're not back in the dark ages of our pre-Obamacare system!
 
Last edited:
Jul 2013
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Nashville, TN
#16
I like the good old Republican solution, eliminate personal bankruptcy, and the ACA, bring back work farms and poor houses...get back to the good old days...the ever popular dog eat dog scenario.:rolleyes:
 
Likes: Arkady

HCProf

Moderator
Sep 2014
27,833
17,043
USA
#17
By what standards? Granted, the major stats I use to measure success don't break it out by class. The US has been rising up the international rankings of life expectancy since Obamacare passed, but it's possible that's due to relative improvements for the upper can lower classes, and the middle class worsened. The pace of healthcare inflation has been at an all-time historic low, but it's possible that has shown up as big improvements for the upper and lower class and worsening for the middle. And the per capita rate of medical bankruptcies had dropped by over half, but maybe that's mostly just for the poor and there's been an uptick among the middle class. But I'd need data to support the assertion, before I believe it.

In my own case, Obamacare hasn't really mattered. I'm privately insured and have had the same private insurance throughout. It's effectively been a non-issue for me -- other than the role it played in lowering deficits, which has some long-term impact for me. But it's still nice to know it's there. It's nice to know that if I were to lose my job (and thereby my insurance) I could still find other insurance at an affordable rate.... and that even if it happened at a time when I had a pre-existing condition, I wouldn't end up bankrupted by medical costs thanks to that condition not being covered. It's also nice to know that isn't going to happen to my loved ones , like my brother, for whom I would otherwise deplete my coffers if it were to come down to mortgaging my house to cover an uncovered but necessary medical expense, or let them go without it. It gives me such peace of mind to know Obamacare is there. And that's why it's been so aggravating to me and to millions of Americans that Republicans are bound and determined to cut that safety net out from under us. It's also why the Democrat who are willing to fight for our interests won such an historic victory in November.



I'm not low income, a Medicare beneficiary, or on other government-sponsored insurance. But I sure as hell am glad we're not back in the dark ages of our pre-Obamacare system!
My insurance was much better prior to the ACA. Much better. I am not low income or a Medicare beneficiary either. The Medicaid patients I take care of in the hospital have better insurance than I do currently and my out of pocket and premiums have tripled. The best part of the ACA was the regulation, such as pre-existing conditions. The affordability was the failure...at least for the middle class. Either Democrats had no clue what the average middle class person could afford or they didn't care as long as they got legislation pushed through.
 
Sep 2017
5,469
6,536
Massachusetts
#18
I disagree its being spun as a failure especially since the source was a very far left one.
I don't think there can be any question it's being spun as a failure. Whether or not they're "very far left" is immaterial to it. OBVIOUSLY, a lefty source could want to spin ACA as a failure as part of pitching for more socialized medicine (or just as part of impressing the need for more bankruptcy protections for consumers, in this case).

The fact is, they framed this with the assertion that Obamacare hadn't helped lower medical bankruptcies, despite the fact medical bankruptcies per capita are down by over half since Obamacare passed. I find that astounding. The success here has been so massive that it far exceeds what even optimists like me were picturing back when Obamacare was passed. If someone had told me medical bankruptcies per capita would be down by half in just seven years, I'd have thought it was maybe too high a goal to expect, especially in the face of inevitable Republican efforts to sabotage implementation. Yet, here we are.

They are just acknowledging that many of the promises didnt pan out.
No. What they're doing is ASSERTING that the promises didn't pan out. Again, medical bankruptcies are down by over half! And the ratio of medical bankruptcies to total bankruptcies did, in fact, fall, from 67.5% to 65.5%. They may have asserted there wasn't a fall, but their numbers indicated otherwise. There is a desire on both sides of the political spectrum to frame Obamacare as a failure -- conservatives because they want to go back to a dark-ages system where people are left completely at the mercy of the market, and the liberals because they want to move to Medicare for all. But the numbers say what they say.
 
Mar 2012
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New Hampshire
#19
By what standards? Granted, the major stats I use to measure success don't break it out by class. The US has been rising up the international rankings of life expectancy since Obamacare passed, but it's possible that's due to relative improvements for the upper can lower classes, and the middle class worsened. The pace of healthcare inflation has been at an all-time historic low, but it's possible that has shown up as big improvements for the upper and lower class and worsening for the middle. And the per capita rate of medical bankruptcies had dropped by over half, but maybe that's mostly just for the poor and there's been an uptick among the middle class. But I'd need data to support the assertion, before I believe it.

In my own case, Obamacare hasn't really mattered. I'm privately insured and have had the same private insurance throughout. It's effectively been a non-issue for me -- other than the role it played in lowering deficits, which has some long-term impact for me. But it's still nice to know it's there. It's nice to know that if I were to lose my job (and thereby my insurance) I could still find other insurance at an affordable rate.... and that even if it happened at a time when I had a pre-existing condition, I wouldn't end up bankrupted by medical costs thanks to that condition not being covered. It's also nice to know that isn't going to happen to my loved ones , like my brother, for whom I would otherwise deplete my coffers if it were to come down to mortgaging my house to cover an uncovered but necessary medical expense, or let them go without it. It gives me such peace of mind to know Obamacare is there. And that's why it's been so aggravating to me and to millions of Americans that Republicans are bound and determined to cut that safety net out from under us. It's also why the Democrat who are willing to fight for our interests won such an historic victory in November.



I'm not low income, a Medicare beneficiary, or on other government-sponsored insurance. But I sure as hell am glad we're not back in the dark ages of our pre-Obamacare system!
You live in MA so you are probably pretty secure. But I am on the exchange up here in NH and havent had a doctor since last April. Being a small state we have small insurers and few doctors that are accepting new patients so there are waiting lists. For me if I get sick I have to go to the ER. Our monthly premiums are over $800 a month with a 12K deductible. Thats for a silver plan. So its not always a sure thing depending on where you live. Many of us who commute down daily to Mass used to have doctors there near work but under the ACA thats been made near impossible as one has to go through the home state exchange. So be careful about generalizations, not every state has it as good as Mass.
 
Likes: HCProf
Mar 2012
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New Hampshire
#20
My insurance was much better prior to the ACA. Much better. I am not low income or a Medicare beneficiary either. The Medicaid patients I take care of in the hospital have better insurance than I do currently and my out of pocket and premiums have tripled. The best part of the ACA was the regulation, such as pre-existing conditions. The affordability was the failure...at least for the middle class. Either Democrats had no clue what the average middle class person could afford or they didn't care as long as they got legislation pushed through.
I had great coverage too and then when the ACA passed the employer decided to use contractors instead so we could get headcount under 50 so they didnt have to offer any benefits at all. So it was the exchange. The first year we got a waiver because NH had no insurers offering coverage. Then it just became a game for the doctors. They called it "fake insurance" because the reimbursement was too low and they refused to accept it. So driving an hour when there was a doctor across the street became the norm for the "exchangers" as we were called. You really got made to feel like a second class citizen when they rolled their eyes.