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Comment by ajuc | Hacker News Reader

Medical bankrupcy would make you homeless and cause you to abuse drugs and commit crimes at higher rate for one example.

Badly controlled medical system with bad incentives caused opioid crisis.

Bad incentives (government and healthcare system earning money on people getting sick instead of losing money on them) also makes it less likely for the system to focus on healthy work-life balance (paid maternity leave, paid vacations, good preventive care, education for healthy lifestyle) and instead focuses on expansive aftercare.

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What a weird comment. Most people who go through bankruptcy don't become homeless. And most people who go through medical treatment don't become bankrupt.

If it happens much more in US than in other countries - it contributes.

There's about 500 000 medical bankrupcies in US per year. That's huge.

Also - medical debt (not even bankrupcy necessarily) contributes significantly to homelessness:

https://publichealthpost.org/health-equity/medical-debt-home...

https://pubmed.ncbi.nlm.nih.gov/32513034/

> two-thirds [of homeless interviewed] reporting current medical debt. Almost half reported trouble paying medical bills for themselves or family members. Almost one-third believed medical debt was in part responsible for their current housing situation. More than half with medical debt incurred this debt while they were covered under insurance. People who had trouble paying medical bills experienced a more recent episode of homelessness 2 years longer than those who did not have such trouble, even after controlling for race, education, age, gender, and health status

Your numbers are way off. Most people who file bankruptcy have some medical debt but medical debt is seldom the primary cause of bankruptcy. When people suffer a loss of income or get overextended then they tend to prioritize their housing and car bills out of necessity, and quit paying medical bills.

The US healthcare financing system is a disaster and needs reform. But if you look deeper into the alarmist reports about medical bankruptcies you'll find that they're lying with statistics to push a political narrative.

https://www.amjmed.com/article/S0002-9343(09)00525-7/fulltex...

> The article by Himmelstein et al1 in this issue of the The American Journal of Medicine documents that health care expenses were the most common cause of bankruptcy in the United States in 2007, accounting for 62% of US bankruptcies compared with 8% in 1981.2

https://pmc.ncbi.nlm.nih.gov/articles/PMC6366487/

> Table 1 displays debtors’ responses regarding the (often multiple) contributors to their bankruptcy. The majority (58.5%) “very much” or “somewhat” agreed that medical expenses contributed, and 44.3% cited illness-related work loss; 66.5% cited at least one of these two medical contributors—equivalent to about 530 000 medical bankruptcies annually.

"Medical expenses contributed" is awfully vague. Doesn't any expense contribute to bankruptcy? I'm more interested in the ~40% who didn't have medical expenses contribute. Are they not seeing doctors at all, or are they on a program that covers all medical expenses?

I find this framing to be extremely misleading. "Medical bankruptcies" suggests something like someone gets cancer and insurance doesn't cover the treatment and they end up a million bucks in debt to the hospital. But the numbers above seem to cover someone who got fired, bet all their savings on black at the roulette table, and also visited the dentist.

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