Millions staggered by medical bills, with or without insurance

They exhaust savings and retirement accounts, take on extra work or jobs, share housing, and seek charitable assistance. Some have lost homes, others forego needed therapies or medications. Some take on credit card or loan debt, or borrow from friends and families. They say they can’t pay for necessities, such as food, heat, and housing. They live with incredible stress that affects their family life, work, personal credit, and self-respect. All this to pay medical bills in 21st century America.

Millions more Americans have health insurance because of the Affordable Care Act, aka Obamacare. But for millions of Americans, particularly those with already wobbly finances, soaring medical costs persist in creating staggering debt problems for those with and without insurance, a large new poll by the New York Times and the Henry J. Kaiser Foundation finds.  The paper reported that 1 in 5 Americans younger than 65, with insurance, struggled in the last year to pay medical bills, while more than half of the uninsured grappled with the same woes.

The survey puts a stark, human face on Americans’ struggles with health care bills.

Those who earned less than $50,000 annually reported the greatest vulnerability. Those with poor health and great needs for care also were hard hit.

The newspaper and the foundation, which separately analyzed their national survey of more than 2,500 English and Spanish speakers by phone and online, both emphasized that insurance practices worsen the problem. Respondents said they were blind-sided by debts incurred under high-deductible coverage, often provided by their employers. They found themselves saddled with big bills for out of network care — services that typically come at significantly higher and often unexpected cost. This is especially true as insurers, seeking to keep their costs down, narrow provider networks for which they will pay and force consumers to bear more expense.

Based on additional research among more than 1,200 adults younger than 65 who said they had problems paying medical bills in the last year, the Kaiser foundation reported that respondents blamed one-time events rather than chronic conditions for their big medical bills. Single episodes of major care for cancer, broken bones, heart conditions, surgeries, severe pain, and infections (pneumonia and viral) were the leading culprits.

The foundation delves into some major health care cost issues, including the difficulties in consumers’ educating themselves, shopping around for coverage and care, and the lack of transparency in the provision and costs of medical services.

Suffice it to say that health care economics are complex and daunting for experts, much less lay people. But for those who champion the Affordable Care Act, the work isn’t done. More insurance to cover more Americans has been a huge help. Clearly, insurance can’t be the nation’s only health safety net. More needs to happen to curb medical costs and to expand care.

As for those who oppose the Affordable Care Act, ideological opposition accomplishes nothing. It doesn’t pay bills that crush 1 in 4 Americans younger than 65. We’re paying some of the highest prices for health care in the world, and we all deserve more than sleepless nights worrying about the bills for it. It’s simply shameful that medical care is the reported No. 1 cause of personal bankruptcy. That’s true only in America, and it shouldn’t be.