Prometheus 6

If the vaccine is given the go-ahead to enter into human clinical trials, it will be at least four years before Kang expects to have statistically significant analysis, and possibly allow the vaccine to be marketed.

Through Western, Sumagen Canada has secured patents for the vaccine in over 70 countries in the world, including the United States, the European Union and Korea. According to the firm, animal testing has resulted in good antibody reactions in immunology tests, with no adverse effects or safety risks. 

Sumagen says it is prepared to begin the clinical trial in the U.S. as soon as approval is granted.

HIV/AIDS vaccine reaches milestone
By Communications Staff
Thursday, July 2, 2009

An HIV/AIDS vaccine developed by University of Western Ontario professor Chil-Yong Kang has reached "an important milestone" as it pushes towards the first phase of human trials.

Health economists once made the harsh financial calculation that the obese would save money by dying sooner. But more recent research instead suggests that better treatments are keeping them alive nearly as long - but they're much sicker for longer, requiring such costly interventions as knee replacements and diabetes care and dialysis. Medicare spends anywhere from $1,400 to $6,000 more annually on health care for an obese senior than for the non-obese, Levi said.

"There isn't a magic bullet. We don't have a pill for it," said Levi. "It's not going to be solved in the doctor's office but in the community, where we change norms."

Obesity rates rising, Mississippi's still fattest
By LAURAN NEERGAARD
The Associated Press
Wednesday, July 1, 2009 8:44 PM

WASHINGTON -- Mississippi's still king of cellulite, but an ominous tide is rolling toward the Medicare doctors in neighboring Alabama: obese baby boomers.

It's time for the nation's annual obesity rankings and, outside of fairly lean Colorado, there's little good news. In 31 states, more than one in four adults are obese, says a new report from the Trust for America's Health and the Robert Wood Johnson Foundation.

And obesity rates among adults rose in 23 states over the past year, and no state experienced a significant decline.

"The obesity epidemic clearly goes beyond being an individual problem," said Jeff Levi, executive director of the Trust, a nonprofit public health group.

But drug company lobbyists and Senate aides said that none of these savings would accrue to the government, which has no liability for a patient’s drug costs in the coverage gap....In an interview, Mr. Butler said he did not think the latest concessions would have “a material adverse impact” on drug company earnings.

Did you REALLY think Big Pharma was going to suggest something that would cut its profits? Really?

Federal Saving From Lowering of Drug Prices Is Unclear
By ROBERT PEAR

WASHINGTON — The White House on Monday hailed what it described as a “historic agreement to lower drugs costs” for older Americans, but it was not immediately clear how much the government would reap in savings that could be used to pay for coverage of the uninsured.

As part of the agreement, pharmaceutical companies promised to help narrow a gap in Medicare coverage of prescription drugs that is known as the doughnut hole.

As Mr. Obama described the gap, “Medicare covers up to $2,700 in yearly prescription costs and then stops, and the coverage starts back up when the costs exceed $6,100.”

Drug companies said they would give most beneficiaries a 50 percent discount on brand-name medicines bought when they hit the gap in coverage.

This could be a boon to Medicare beneficiaries, and AARP praised the deal. But drug company lobbyists and Senate aides said that none of these savings would accrue to the government, which has no liability for a patient’s drug costs in the coverage gap. Indeed, that is the problem for beneficiaries: they are responsible for the entire cost of drugs in the gap.

In Poll, Wide Support for Government-Run Health
By KEVIN SACK and MARJORIE CONNELLY

The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector.

Yet the survey also revealed considerable unease about the impact of heightened government involvement, on both the economy and the quality of the respondents’ own medical care. While 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, 77 percent said they were very or somewhat satisfied with the quality of their own care....

Across a number of questions, the poll detected substantial support for a greater government role in health care, a position generally identified with the Democratic Party. When asked which party was more likely to improve health care, only 18 percent of respondents said the Republicans, compared with 57 percent who picked the Democrats. Even one of four Republicans said the Democrats would do better.

The national telephone survey, which was conducted from June 12 to 16, found that 72 percent of those questioned supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers. Twenty percent said they were opposed...in the poll, the proposal received broad bipartisan backing, with half of those who call themselves Republicans saying they would support a public plan, along with nearly three-fourths of independents and almost nine in 10 Democrats.

Approximately 973,000 California seniors live alone. Of these, 50 percent do not have enough income to meet basic expenses, as defined by the Elder Index.

Long-term care costs exceed yearly income for many Calif. seniors living alone
Costs are soaring even as state considers further cuts to care programs

In Los Angeles County, being disabled can cost a year's income. That's because the annual cost of in-home care services for seniors living alone is now $319 more than this group's median income of $17,029.

Combine long-term care expenses with other basic expenses, such as food and rent, and a Los Angeles senior living alone will need twice the median income to survive, according to new data released today by the UCLA Center for Health Policy Research and the Insight Center for Community Economic Development.

This success was more about the decisions made than the legal form of the organization. And the cooperatives under consideration by Congress are undefined at this point. They could easily turn out to be composed of doctors which, given the A.M.A's position on health care reform, is not likely to redound to our benefit as patients.

Group Health Cooperative shows investing in more primary care pays for itself
Medical home model leads to less emergency room costs and avoidable hospitalizations

SEATTLE—An evaluation of recent innovations in delivering primary care at a Group Health Cooperative medical center shows significant success and rapid return on investment. The data led to a decision to invest in these best practices in all of Group Health's 26 medical centers by 2010.

"Group Health has for many years focused on delivering quality, coordinated primary care, supported by fully integrated electronic medical records," said Group Health President and CEO Scott Armstrong. "This was an effort to bolster primary care further—and really test what we believe: that excellent, proactive primary care will lead to better health outcomes at lower cost."

"At a time when resources are tight, we are so confident in our findings that we are hiring more primary care doctors, physician assistants, and nurses, because we believe this is the best way to achieve our goal of excellent affordable care," Armstrong said.

In one year, Group Health's Patient-Centered Medical Home pilot, compared to controls:

• Broke even on its primary care staffing investment through reduced downstream utilization costs. Emergency room/urgent care visits were 29 percent less and inpatient hospital stays for patients with conditions including diabetes, chronic obstructive pulmonary disease, congestive heart failure, and asthma were 11 percent less.
• Improved indicators of quality of care. Overall improvements were 1.6 times greater across 22 measures than in controls. In seven out of 22 measures, the proportion of people meeting their target went up by more than 5 percent over one year. One example is cholesterol management (LDL less than 100mg/dl) for people with heart disease.
• Enhanced patients' experience, including better bonding between patients and their physicians and care teams as well as better care coordination.
• Improved care teams' work satisfaction and reduced their emotional burnout.

In economics, it is often common to use the word "rationing" to refer to one of the roles that prices play in markets, while rationing (as the word is usually used) is called "non-price rationing." Using prices to ration means that those with the most money (or other assets) and who want a product the most are first to receive it. Such rationing happens daily in a market economy.

Therefore

The choice isn’t between rationing and not rationing. It’s between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it’s hard to argue that we are now rationing very rationally.

Thank you.

Health Care Rationing Rhetoric Overlooks Reality
By DAVID LEONHARDT

...Today, I want to try to explain why the case against rationing isn’t really a substantive argument. It’s a clever set of buzzwords that tries to hide the fact that societies must make choices.

In truth, rationing is an inescapable part of economic life. It is the process of allocating scarce resources. Even in the United States, the richest society in human history, we are constantly rationing. We ration spots in good public high schools. We ration lakefront homes. We ration the best cuts of steak and wild-caught salmon.

Health care, I realize, seems as if it should be different. But it isn’t. Already, we cannot afford every form of medical care that we might like. So we ration.

We spend billions of dollars on operations, tests and drugs that haven’t been proved to make people healthier. Yet we have not spent the money to install computerized medical records — and we suffer more medical errors than many other countries.

We underpay primary care doctors, relative to specialists, and they keep us stewing in waiting rooms while they try to see as many patients as possible. We don’t reimburse different specialists for time spent collaborating with one another, and many hard-to-diagnose conditions go untreated. We don’t pay nurses to counsel people on how to improve their diets or remember to take their pills, and manageable cases of diabetes and heart disease become fatal.

To view the report titled "The Economic Impact of Uninsured Children on America," click here.

Providing health insurance for US children would be cheaper than expected, study says

Research from Rice University's Baker Institute finds that economic benefits would outweigh costs

Extending health insurance coverage to all children in the U.S. would be relatively inexpensive and would yield economic benefits that are greater than the costs, according to new research conducted at Rice University's Baker Institute for Public Policy.

"Providing health insurance to all children in America will yield substantial economic benefits," wrote Vivian Ho, chair in health economics at the Baker Institute and associate professor of medicine at Baylor College of Medicine. She co-authored the report with Marah Short, senior staff researcher in health economics at the Baker Institute. They based their research on recent studies published in peer-reviewed journals to examine the evidence regarding the economic impact of failing to insure all children in the United States.

The children will receive better health care and enjoy better health, thereby improving their productivity as adults, the researchers said. The cost incurred by providing universal coverage to children "will be offset by the increased value of additional life years and improved health-related quality of life gained from improved health care. From a societal perspective, universal coverage for children appears to be cost-saving."

...is that a good or bad sign?

Clout keeps generics out
Drug companies have long blocked measures that would save N.C. money. The state budget crisis could change that.
By Joseph Neff
joseph.neff@newsobserver.com
Posted: Wednesday, Jun. 10, 2009

RALEIGH There's a simple way for North Carolina to save $28million a year in Medicaid spending, but it has been impossible to get anyone at the legislature to act – until Tuesday.

For years, putting limits on what drugs could be prescribed for Medicaid recipients has been untouchable because it would displease the drug companies and cost them millions. And few at the N.C. General Assembly want to upset the drug companies.

But the severity of the $4.5billion budget shortfall for the next fiscal year may finally push lawmakers to make drug companies share the pain. When the House Appropriations Committee rolled out its 481-page budget Tuesday, it included a plan that would force pharmaceutical companies to lower prices.

New Center of Excellence targets reducing disparities in cancer care and outcomes
University of South Florida-Moffitt Cancer Center joint program supported by $6 million grant from National Institutes of Health

Tampa, FL (June 15, 2009) -- The University of South Florida and Moffitt Cancer Center have been awarded a highly competitive, $6-million federal grant to create a National Center on Minority Health and Health Disparities (NCMHD) Center of Excellence. The five-year program grant from the NCMHD, National Institutes of Health, will focus on research, education and training, and community outreach activities to reduce cancer-related health disparities among minority and underserved communities in Florida.

The new Center of Excellence will be among 50 nationwide, and one of three in Florida. (The other Florida centers are at the University of Miami and Florida International University.)

Co-op Compromise Gives White House a Health Option
By THE ASSOCIATED PRESS
Filed at 11:47 p.m. ET

...''It's far preferable to the government-run plan that has been discussed by the administration,'' said Sen. Susan Collins, R-Maine. ''We need to better understand how it would work. But it's certainly better than a Washington-run plan.''

You don't understand how it would work...you just know it's better than a Washington-controoled plan.

Obama administration officials said Sunday that they are open to a compromise: a cooperative program that would expand coverage with taxpayer money but without direct governmental control.

Give corporations money without any government controls...sounds like the bank bailout...sounds like Republican theology.

some lawmakers are expected to introduce specific plans that run counter to Obama's political promises.

That's right...oppose everything. You know it's safe

''This really isn't, to me, a matter of right or wrong,'' Conrad said. ''This is a matter of: Where are the votes in the United States Senate?''

Why not? It certainly should be.

Okay, let's do the synonym shuffle. Maybe that will make it clear.

''This really isn't, to me, a matter being of right or wrong,'' Conrad said. ''This is a matter of: Where are the votes in the United States Senate?''

''This really isn't, to me, a matter of correct or incorrect,'' Conrad said. ''This is a matter of: Where are the votes in the United States Senate?''

''This really isn't, to me, a matter of whether it works or not,'' Conrad said. ''This is a matter of: Where are the votes in the United States Senate?''

Clear? It's certainly typical...

presidential aides and congressional leaders in both parties have sought a speedy compromise.

See what I mean?

It's not like we haven't known this caps on medical malpractice damages don't work for quite a while now. Not only do they fail to produce better medical results, they don't even produce lower malpractice insurance rates as they should.

Tort Reform and Its Impact on Medical Malpractice Insurance
Will Non-Economic Damage Caps Help?
March 2003

The medical malpractice insurance industry is definitely in crisis, with many insurers refusing to cover hospitals and physicians. This scarcity along with skyrocketing costs are thought to be the result of numerous professional liability claims and lawsuits. Tort reform proponants list non-economic damage caps as the number one medical liability reform measure. However, non-economic damage limitations have their greatest impact on lowering hospital, and other institutions’, rates rather than those rates assessed to physicians.

Breaking news  — October 27, 2004
Nation's Largest Medical Malpractice Insurer Declares Caps on Damages Don't Work, Raises Docs' Premiums;
Douglas Heller, (310) 392-0522 ext. 309
Smoking Gun Document Exposes Insurance Industry Lies

Santa Monica, CA -- The nation's largest medical malpractice insurer, GE Medical Protective, has admitted that medical malpractice caps on damage awards and other limitations on recoveries for injured patients will not lower physicians' premiums.

The insurer's revelation was made to the Texas Department of Insurance (TDI) in a regulatory filing obtained by FTCR. The revelation was contained in a document submitted by GE Medical Protective to explain why the insurer planned to raise physicians' premiums 19% a mere six months after Texas enacted caps on medical malpractice awards. In 2003, Texas lawmakers passed a $250,000 cap on non-economic damage compensation to victims of medical malpractice caps after Medical Protective and other insurers lobbied for the change.

According to the Medical Protective filing: "Non-economic damages are a small percentage of total losses paid. Capping non-economic damages will show loss savings of 1.0%." The company also notes that a provision in the Texas law allowing for periodic payments of awards would provide a savings of only 1.1%. The insurer did not even provide its doctors that relief and eventually imposed a rate hike on its physician policyholders.

Obama Open to Reining in Medical Suits
By SHERYL GAY STOLBERG and ROBERT PEAR

WASHINGTON — The American Medical Association has long battled Democrats who oppose protecting doctors from malpractice lawsuits. But during a private meeting at the White House last month, association officials said, they found one Democrat willing to entertain the idea: President Obama.

In closed-door talks, Mr. Obama has been making the case that reducing malpractice lawsuits — a goal of many doctors and Republicans — can help drive down health care costs, and should be considered as part of any health care overhaul, according to lawmakers of both parties, as well as A.M.A. officials.

It is a position that could hurt Mr. Obama with the left wing of his party and with trial lawyers who are major donors to Democratic campaigns. But one Democrat close to the president said Mr. Obama, who wants health legislation to have broad support, views addressing medical liability issues as a “credibility builder” — in effect, a bargaining chip that might keep doctors and, more important, Republicans, at the negotiating table.

Seriously, though...this should have come out of Friday, the traditional day for releasing avoidable stupidity. Because I HATE having to pull all this together at 6 AM.

Yes, I could have picked a better version to embed

Many in Congress Hold Stakes in Health Industry
By JACKIE CALMES

WASHINGTON — As President Obama and Congress intensify the push to overhaul health care in the coming week, the political and economic force of that industry is well represented in the financial holdings of many lawmakers and others with a say on the legislation, according to new disclosure forms.

The personal financial reports, due late last week from members of Congress, show that many lawmakers hold investments in insurance, pharmaceutical and prescription-benefit companies and in hospital interests, all of which would be affected by the administration’s overhaul of health care.

The lawmakers’ stakes are impossible to quantify because the reports ask for ranges of value for each asset, and because many officials’ holdings are in stock index and mutual funds. The Senate majority leader, Harry Reid of Nevada, for example, has interests in a stock index fund for the health care sector of more than $50,000 and up to $100,000.

Representative Dave Camp of Michigan, the senior Republican on the Ways and Means Committee, one of three panels in the House with jurisdiction over health care, reported at least tens of thousands of dollars in health-related interests, including the medical technology giant Medtronic, the drug maker Wyeth and the insurance company Aetna.

You can get the PDF on the othe side of the link if you're so inclined.

Epigenetics and the embodiment of race: Developmental origins of US racial disparities in cardiovascular health
Christopher W. Kuzawa *, Elizabeth Sweet
Department of Anthropology, Northwestern University, Evanston, Illinois 60208
email: Christopher W. Kuzawa (kuzawa@northwestern.edu)

*Correspondence to Christopher W. Kuzawa, Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA

Abstract
The relative contribution of genetic and environmental influences to the US black-white disparity in cardiovascular disease (CVD) is hotly debated within the public health, anthropology, and medical communities. In this article, we review evidence for developmental and epigenetic pathways linking early life environments with CVD, and critically evaluate their possible role in the origins of these racial health disparities. African Americans not only suffer from a disproportionate burden of CVD relative to whites, but also have higher rates of the perinatal health disparities now known to be the antecedents of these conditions. There is extensive evidence for a social origin to prematurity and low birth weight in African Americans, reflecting pathways such as the effects of discrimination on maternal stress physiology. In light of the inverse relationship between birth weight and adult CVD, there is now a strong rationale to consider developmental and epigenetic mechanisms as links between early life environmental factors like maternal stress during pregnancy and adult race-based health disparities in diseases like hypertension, diabetes, stroke, and coronary heart disease. The model outlined here builds upon social constructivist perspectives to highlight an important set of mechanisms by which social influences can become embodied, having durable and even transgenerational influences on the most pressing US health disparities. We conclude that environmentally responsive phenotypic plasticity, in combination with the better-studied acute and chronic effects of social-environmental exposures, provides a more parsimonious explanation than genetics for the persistence of CVD disparities between members of socially imposed racial categories. Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc.

Racial Disparities in Illness Highlighted
Study Finds Alarmingly High Rates Among Black Women
By Darryl Fears
Washington Post Staff Writer
Wednesday, June 10, 2009

Black women in the District suffer from obesity, diabetes, heart disease and generally poor health in alarmingly high numbers, and white women do not.

That is the finding of a study released early today by the Kaiser Family Foundation. The study said there is a large disparity in the incidence of certain chronic diseases between black and white women.

Kaiser's study was based on data compiled by the Centers for Disease Control and Prevention and the federal Current Population Survey from 2004 to 2006. The study reflected health statistics in the states and the District.

I now proceed to point out the absurdities in the A.M.A.'s comments to the Senate Finance Committee.

While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be “provided through private markets, as they are currently.”

I believe the provision of health care through the private markets, as they are currently, is the very definition of the problem.

The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.

Is your intelligence feeling insulted yet? They assert that adding another choice reduces choice.

And let's say the private insurers won't compete with affordable prices for complete coverage. Would not their failure be a market reaction?

If private insurers are pushed out of the market, the group said, “the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”

"Likely"? Why? Whose costs?

The medical association said it “cannot support any plan design that mandates physician participation.” For one thing, it said, “many physicians and providers may not have the capability to accept the influx of new patients that could result from such a mandate.”

Doctors refuse new patients now when they reach their capacity. This is just stupid.

“In addition,” the A.M.A. said, “federal programs traditionally have never required physician or other provider participation, but rather such participation has been on a voluntary basis.”

The A.M.A., however, has no problem with insurance companies mandates...as long as they get paid.

The tradition argument holds no water when the need is to change traditional practices.

The A.M.A is opposing the creation of a government-sponsored insurance plan for the general public in comments submitted to Senate Finance Committee, and I started to whack at some of it, but I immediately hit an obstacle.

While committed to the goal of affordable health insurance for all, the association had said in a general statement of principles that health services should be “provided through private markets, as they are currently.”

You cannot be committed to change AND the status quo simultaneously. That's obvious to me. So I wrote that...and got stuck. My heurisic subroutines lit up in recognition of a problem, which is that people do not apply this rule when they consider public policy suggestions and decisions.

The group, which represents the hard-liners of organized medicine, has been as instrumental as insurers in blocking serious health reform over the decades—not only with their campaign contributions (the AMA ranks second only to the U.S. Chamber of Commerce over the last ten years in the amount it has spent to influence Congress) but also with other forms of public pressure. Like insurers, they started out by being oh-so-agreeable. Early this year, the AMA even tried to position itself as the “Voice for the Uninsured.” But look what it stands for now. Some of its proposals look like they were cloned from those of AHIP, the insurers’ trade group.

Who Will Be at the Table?
PhRMA and the AMA join forces with insurers
By Trudy Lieberman

During the campaign, Barack Obama promised his cheering crowds that, when he rolled up his sleeves to work on health care, he would “have insurance company representatives and drug company representatives at the table. They just won’t be able to buy every chair.” Now is a good time to look at just what kind of seats special interest groups are having at Obama’s table and what they’re doing to bring the public around to their ways of thinking. This is the ninth of an occasional series of posts that will analyze their activities and how the media are covering them. The entire series is archived here.

Advocates fixated on a public option health plan as a step toward national health insurance have spent months casting the insurance companies as bad guys—fat cats who make too much profit, choke the current health care system, and shower legislators with big bucks for their campaign chests. Most stories emphasize that insurers are fighting such a plan because it could put them out of business by offering lower premiums, controlling costs, and being more efficient. For awhile, I was beginning to think that other stakeholders—who oppose a public plan just as fiercely—were getting a free pass.

Health Care Spending Disparities Stir a Fight
By ROBERT PEAR

Nationally, according to the Dartmouth Atlas of Health Care, Medicare spent an average of $8,304 per beneficiary in 2006. Among states, New York was tops, at $9,564, and Hawaii was lowest, at $5,311.

Researchers at Dartmouth Medical School have also found wide variations within states and among cities. Medicare spent $16,351 per beneficiary in Miami in 2006, almost twice the average of $8,331 in San Francisco, they said....

In his blog last month, Mr. Orszag wrote, “The higher-cost areas and hospitals don’t generate better outcomes than the lower-cost ones.”

But other researchers and politicians are not so sure. They say it would be a mistake to cut or cap Medicare payments without knowing why spending in some places far exceeds the national average.

I wonder if they plan to use guns...

Suspect in abortion doctor death warns of violence
By ROXANA HEGEMAN
The Associated Press
Sunday, June 7, 2009 5:33 PM

WICHITA, Kan. -- The man charged with murdering a high-profile abortion doctor claimed from his jail cell Sunday that similar violence was planned around the nation for as long as the procedure remained legal, a threat that comes days after a federal investigation launched into his possible accomplices.

A Justice Department spokesman said the threat was being taken seriously and additional protection had been ordered for abortion clinics last week. But a leader of the anti-abortion movement derided the accused shooter as "a fruit and a lunatic."

Scott Roeder called The Associated Press from the Sedgwick County jail, where he's being held on charges of first-degree murder and aggravated assault in the shooting of Dr. George Tiller one week ago.

"I know there are many other similar events planned around the country as long as abortion remains legal," Roeder said. He would not elaborate.

Anti-Abortion Activists Worry That a New City Law Will Make Their Task Harder
By JULIE BOSMAN

About 80,000 abortions are done annually in New York City, according to state health statistics, but these days it is far from the center of the national abortion debate. The city is not known for abortion-related violence, and when an abortion provider is shot dead, as was Dr. George R. Tiller in Wichita, Kan., last Sunday, it can feel like it happened in another country.

But 36 years after Roe v. Wade, the abortion war goes on, even in a small way in New York, where next month, a new city law will take effect that could make it easier for anti-abortion demonstrators to be arrested if they restrict access to a clinic or harass people attempting to enter.

Over 60 percent of all US bankruptcies attributable to medical problems
Most victims are middle class, well-educated and have health insurance

New York, NY, June 4, 2009 – In 2007, before the current economic downturn, an American family filed for bankruptcy in the aftermath of illness every 90 seconds; three-quarters of them were insured. Over 60% of all bankruptcies in the United States in 2007 were driven by medical incidents. In an article published in the August 2009 issue of the American Journal of Medicine, the results of the first-ever national random-sample survey of bankruptcy filers shows that illnesses and medical bills contribute to a large and increasing share of bankruptcies. The share of bankruptcies attributable to medical problems rose by 50% between 2001 and 2007.

Following up on a 2001 study in 5 states, where medical problems contributed to at least 46.2% of all bankruptcies, researchers from Cambridge Hospital/Harvard Medical School, Harvard Law School and Ohio University surveyed a random national sample of 2,314 bankruptcy filers in 2007, abstracted their court records, and interviewed 1,032 of them. They designated bankruptcies as "medical" based on debtors' stated reasons for filing, income loss due to illness and the magnitude of their medical debts.

Using identical definitions in 2001 and 2007, the share of bankruptcies attributable to medical problems rose by 49.6%. The odds that a bankruptcy had a medical cause were 2.38 fold higher in 2007 than in 2001.