Illness And Injury As Contributors To Bankruptcy

Himmelstein, David U.; Warren, Elizabeth; Thorne, Deborah; Woolhandler, Steffie

doi:10.1377/hlthaff.w5.63

Cited by 361 publications

(225 citation statements)

References 4 publications

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“…Similarly, large health care payments can lead to financial catastrophe and bankruptcy even for rich households. 5 Although there is not complete consensus regarding the specific threshold for defining financial catastrophe, most agree that it should be measured in relation to a household's capacity to pay. 6 We used the threshold proposed by Ke Xu and colleagues that financial catastrophe occurs with health care payments at or exceeding 40 percent of a household's capacity to pay in any year.…”

Section: Study Methodsmentioning

confidence: 99%

Protecting Households From Catastrophic Health Spending

Xu¹,

Evans²,

Carrin³

et al. 2007

Health Affairs

778

768

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Many countries rely heavily on patients' out-of-pocket payments to providers to finance their health care systems. This prevents some people from seeking care and results in financial catastrophe and impoverishment for others who do obtain care. Surveys in eightynine countries covering 89 percent of the world's population suggest that 150 million people globally suffer financial catastrophe annually because they pay for health services. Prepayment mechanisms protect people from financial catastrophe, but there is no strong evidence that social health insurance systems offer better or worse protection than tax-based systems do. 1 This can lead to financial hardship and even impoverishment because people are too ill to work. The other side of the coin, less well understood, is that many of those who do seek care suffer financial catastrophe and impoverishment as a result of meeting these costs.2 This occurs in both rich and poor countries. 3This paper focuses on the second effect-the financial consequences of paying for care. It begins by presenting new data from a large data set-116 surveys covering 89 countries-allowing the first global estimates of the extent of catastrophic spending and impoverishment associated with out-of-pocket payments for health services to be made. It then explores health system and population characteristics associated with high levels of catastrophic spending across countries, as the basis for assessing the policy options available to reduce the incidence of financial catastrophe. 4 Discussion and conclusions follow.9 7 2 J u l y /A u g u s t 2 0 0 7 O u t -O f -P o c k e t S p e n d i n g

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Section: Study Methodsmentioning

confidence: 99%

Protecting Households From Catastrophic Health Spending

Xu¹,

Evans²,

Carrin³

et al. 2007

Health Affairs

778

768

View full text Add to dashboard Cite

show abstract

“…Cancer is already the highest-cost diagnosis in terms of out-of-pocket spending. 44 And pharmaceutical companies have hundreds of new cancer drugs in development, many of which are likely to have high prices. 45 Therapies recently approved by the Food and Drug Administration and covered under the Medicare program include sipuleucel-T (Provenge), which costs $93,000 per year; ipilimumab (Yervoy), $120,000 per year; abiraterone acetate (Zytiga), $5,000 a month; and cabazitaxel (Jevtana), $8,000 every three weeks.…”

Section: Value Of Cancer Spendingmentioning

confidence: 99%

Therapies For Advanced CancersPose A Special Challenge For Health Technology Assessment Organizations In Many Countries

Neumann

Bliss²,

Chambers³

2012

Health Affairs

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“…Although this percentage cannot be further analyzed to quantify how often such a description referred to a job-related injury or illness, the qualitative evidence collected in the same study suggested that work-related health problems were the events most of those debtors were citing. A more recent 2001 survey by Himmelstein et al (2005) shows that 35.3% of families bankrupted by medical problems indicated at least one member had decreased their employment because of illness or injury. The impact of an injury or illness often extends throughout the family.…”

Section: Literature Reviewmentioning

confidence: 99%