Care Crisis: The Relationship Between Medical Treatment And Debt


According to the Human Development Index — which categorizes nations based on their life expectancy, education, and gross national income (GNI) — the United States is considered “very highly developed.” Despite our achievements, we are the only nation in that category out of 58 that does not offer universal healthcare for its citizens. As a result, medical treatment in America is often delayed because patients can’t afford its costs; those that do finally seek help are often left buried under debt.

A Sad State Of Affairs

Out of the approximately 80% of Americans struggling with debt, two million are in such a position due to medical bills. With medical bankruptcy being such a high risk for so many people, and with the fallout of declaring bankruptcy so severe, many people — especially younger adults — will neglect their health in favor of their money.

Those suffering from chronic illnesses are the most at risk. From rare diseases to weekly treatments, medical bills can add up very quickly. Take nontuberculous mycobacterial (NTM) lung disease: an estimated 180,000 people are diagnosed with the disorder in the U.S., and that number is increasing 8.2% every year in people 65 years of age and older. There are two primary presentations of the disease.

  • Nodular bronchiectasis: This form causes the airways of the lungs to become damaged and subsequently dilate and become scarred. As a result, they lose their ability to clear mucus, which then builds up and serves as a nutrient source and home for the mycobacteria. Infiltrates (such as pus, blood, or protein-rich fluid) can then accumulate within the lungs. Though it may not sound like it, this is the less severe form of NTM.
  • Cavitary disease: With cavitary disease, scarring (fibrosis) or cavities form in the lungs through a process called cavitation. If left untreated, progressive cavitation and fibrosis can occur and cause respiratory failure.

With symptoms including cough, fatigue, shortness of breath, fever, night sweats, loss of appetite, and unintended weight loss, NTM is a very serious disease. As you can imagine, the costs associated with treating it can be exorbitant. One study performed in 2010 (which estimated 86,244 national cases) was predicted to cost $815 million; that’s an average of nearly $10,000 per patient, although we know that there was probably a mix of both more extreme and less extreme cases.

Regardless, these are costs that would have been fully or nearly-fully covered had the patients been residents of Canada, Germany, Norway, or any of the other 54 countries on the “very highly developed” list. Hopefully, the U.S. will soon realize that money is less important than the health of its citizens.

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