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Crippling Medical Bills--coming To A Person Near You

One reason this country has never mustered the will to enact universal health care is that most Americans have felt their own insurance arrangements were adequate. They sympathized with the plight of people who couldn't pay their medical bills, but couldn't imagine themselves in that situation.

A new report released Wednesday suggests that may be changing. The report, called "Losing Ground," comes from the Commonwealth Fund (which has underwritten some of my own research) and is based upon survey data the Fund has collected over the last few years. Its conclusion: More and more Americans are having trouble paying for health care. That's true of people without insurance and, increasingly, it's true of people with insurance, as well.

Among the specific findings:

Forty-one percent of working-age adults, or 72 million people, reported a problem paying their medical bills or had accrued medical debt, up from 34 percent, or 58 million, in 2005. ...

The share of U.S. adults reporting that the costs of health care prevented them from getting needed care increased from 29 percent in 2001 to 45 percent in 2007. Reports of cost-related access problems rose across all income groups and among both insured and uninsured adults. ...

All told, in 2007 nearly two-thirds of adults, or 116 million people, were either uninsured for a time during the year, were underinsured, reported a problem paying medical bills, and/or said they did not get needed health care because of cost.

The essential caveat here is that this type of survey information is notoriously imprecise: People have fuzzy memories, they interpret questions differently, and so on. But given the rising costs of medical care, it makes sense that more people would be struggling with their bills, even if the survey results overstate the problem. In other words, there are an awful lot of people out there for whom the price of heatlh care is a major problem.

Oh, and in case I haven't mentioned it lately, Barack Obama supports universal health insurance. That is, he wants the government to guarantee that all Americans can get affordable coverage, thereby shielding them from cripping medical bills. John McCain doesn't. In fact, he's proposed reforms that might actually leave more people in trouble. (Check the links if you want to see why.)

--Jonathan Cohn