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More Americans Struggling With Medical Debt

Survey finds two-thirds of those polled unable to pay medical bills, even when insured

FRIDAY, Feb. 3, 2006 (HealthDay News) -- Cheryl Smith's life as she knew it ended abruptly one day in 1997.

"I went from being an employed, normal person to being unemployed," she recounted. "I lost my health insurance. I couldn't afford the COBRA, and there was no other income."

Now Smith lives in subsidized housing and subsists on a patchwork of government health coverage, unsure from one day to the next if she will have to choose between drugs and food.

Smith, 51, traces her current problems to inadvertent exposure to a chemical floor stripper at the hospital in Newport News, Va., where she worked as a critical care nurse. Almost immediately, she experienced trouble breathing and ended up in the emergency room.

Within months, she was told she had permanent lung damage, had to be on oxygen and confined to a wheelchair. Even taking out the trash took too much of a toll on her body.

"I'd been a single mom for many, many years. I did everything. I was 'supermom,'" she said. "I was strong and able. I could not believe this was happening."

But this, and more, was happening.

Smith was later diagnosed with multiple sclerosis and was forced to move to Missouri to be near her eldest daughter, to accept help from her church and from the Salvation Army to pay the rent, and to contend with more than $5,000 in medical debt. It was as if "all my warranties expired on my body," she said.

Even now, with the help of Medicaid and Medicare, she can't afford all her medications (one inhaler costs $200) and is fighting to replace her wheelchair, which was broken in the move.

Smith's medical debt is now over $5,000, and she said she's lost hope of paying it off.

Unfortunately, Smith's story is just one of many playing out across the nation as millions of Americans stagger under the burden of medical debt.

Dorothy Mesa, a single mother of three in Kansas, found herself saddled with $200,000 in debt after one of her sons was injured in a car accident. At the time, her son was covered both by her insurance and his father's insurance. Mesa has since lost her job and her health insurance. Both son and mother are working multiple jobs to keep paying the medical bills.

Across the country, people report being denied loans and even scrimping on school lunches for their kids because of crushing medical debt.

The crisis is detailed in a new study, Playing by the Rules but Losing, published by the Boston-based nonprofit advocacy group The Access Project.

In their survey of more than 1,000 Kansans, the researchers found that nearly two-thirds (63 percent) reported having medical debt. Those in debt included people from every racial and ethnic group, and the uninsured as well as the insured.

Rates of medical debt ranged from 66 percent to 72 percent for individuals in families where all or some members were uninsured. Slightly more than one-half of individuals in insured families had medical debt.

"The findings are shocking and disappointing," said Lougene Marsh, director of the Flint Hills Community Health Center-Lyon County Health Department in Kansas, at a news conference held Thursday. "The magnitude of the problem and additional problems to medical care because of medical debt are overwhelming."

Other studies have reported that, nationally, 25 percent to 40 percent of Americans have problems paying their medical bills.

One of the main burdens of medical debt is patient difficulty in getting access to care. In the Kansas survey, 48 percent of those with medical debt reported having delayed a doctor's visit because of debt. One out of six respondents who delayed care said they had been refused an appointment because they carried some medical debt.

People with medical debt also struggle to pay off bills, borrowing from family, savings and credit cards, and even taking out loans and borrowing against their home, said Carol Pryor, senior policy analyst at The Access Project. She spoke at the same news conference.

Over half of those surveyed said having these debts made it harder to get loans, and that they had housing and employment problems as a result.

The problem typically starts with relatively small amounts of debt, under $800. "And small increments increased the likelihood of problems," Pryor said.

Some of those interviewed did have hope they would pay off the debt and resume a normal life. Others, like Smith, may never have that option.

"It left me devastated," she said. "I have to choose every single month between 'Am I going to get the bills paid, or am I going to get food in the house?'"

More information

For more on the new survey, visit The Access Project.

SOURCES: Cheryl Smith, Joplin, Mo; Feb. 2, 2006 news conference with Carol Pryor, senior policy analyst, The Access Project, Boston, and Lougene Marsh, director, Flint Hills Community Health Center - Lyon County Health Department, Kansas; Feb. 2, 2006, Playing by the Rules but Losing, The Access Project
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