Healthcare

What if they can't pay?

Then it's up to Jesus to help them and it's not even a problem since Jesus accepts mediocrity.

I already stated earlier: in that case it's the government who is going to pay
 
You can't charge people to use the NHS. It just needs to be funded properly and not cut like the Tories have done for the last 8 years or whatever it has been. Also an extra 1p per £ on your national insurance would be acceptable to any sane and rational working person if it helped keep the NHS going. However that's a cop out really and more Government funding and less cuts is the real answer.
 
Part of the NHS's problem is the capital spending has been abysmal over the years. Its barely had the funding for operational stuff and spending on infrastructure has been completely neglected. When I was at the Bristol hospital many of the buildings really needed knocking down or completely gutting and modernizing.
 
Well technically there are charges in the NHS today. Prescriptions are not free. Many people pay for a specialist visit themselves to reduce the wait time. Hospitals offer upgrades like private wards.
 
As in it‘s legally impossible or you don‘t think it‘s a good idea? Resource efficency could imo be increased that way.

Of course you can charge if you like but that defeats the purpose of a NHS in my opinion. And you can be pedantic and say the NHS already charges as you pay from your tax and pay for prescriptions etc, but that's just being pedantic for the sake of it.

What I meant was it would be unfair as many couldn't pay the charges, it would cause headaches about disputed charges etc. Much easier to look for fairer ways and for the government to stop trying to privatise it. That's half the trouble at the moment and the other half is wastage. It needs a complete overhaul and needs to be streamlined. It's not easy and won't happen overnight but it could be done. It's only broken, not irreparable.
 
Posting this because its a great graphic. Maybe not from a pure statistics standpoint but as a BI chart its great. I presume the original and drill down and drill thru. Gives a good visual of GDP spent on healthcare comparing 2009 and 2013 using a tornado graph and graphics for the movers up and down.

change-in-total-health-spened-as-a-proportion-of-gdp.jpg

https://www.kingsfund.org.uk/blog/2015/10/nhs-spending-squeezed-never
 
I say this with the greatest respect, as I am sure its not easy for you and your grandfather, I get the frustration.
However, whilst true, for the person who doesn't have the £7k to pay, waiting 6 months is better than not being able to get treatment at all.
The NHS is actually a great service, which does need some improvements, but its better to have a waiting time, than to have nothing.

The option isn't between not getting treatment and getting a poor, delayed and inadequate treatment.

In no other part of our life do we accept mediocrity because it's better than nothing at all. Can you imagine in a restaurant getting a completely burned steak and proclaiming "well it's better than no food at all". Of course not - you'd expect better.

The problem is people have been duped into believing it's free so it being poor is just accepted. The fact that it's actually exceptionally costly is hidden.

On a more positive note we visited the private hospital today and it's like visiting a 5* hotel. The consultant visited regularly, there was sky sports on the tv for him to watch the United game tonight. WiFi for him to surf the web. A dozen menu choices for dinner and breakfast. His own private room and one nurse serving half a dozen patients. Probably the best £7k I've spent in years, just a shame not everyone is in a position to pay this.

What I would say to everyone on here is: if you can afford the £50-100 monthly premium get private healthcare insurance. It's absolutely worth every penny and even if you think the NHS is fantastic, see it as relieving pressure on the service!

The NHS saved my life. As is well know on this site I had a brain haemorrhage. I would and should be dead but the NHS saved my life and I had a weeks stay in hospital that I cannot fault whatsoever. Without insurance i have been told my operation and treatment would have cost well over £300,000. My dad had a double heart attack at Christmas and it saved his life too. People want and expect everything straight away with the NHS and that pisses me off tbh. It's free, it should be appreciated and having to wait a short amount of time although uncomfortable as it may be, I think is a price worth paying for top class FREE health care.

It isn't free at all. Every family in the UK pay £8000 per annum towards the health service. We act like the only choices are no healthcare or poor but "free" healthcare.
 
It isn't free at all. Every family in the UK pay £8000 per annum towards the health service. We act like the only choices are no healthcare or poor but "free" healthcare.

Maybe I am missunderstanding.

Surely it isnt every family though? I.E those without income etc and the reason those who can afford to pay the 8k do is to cover the ones that cannot?

I agree the service can be better and if you have the money paying for private cover makes sense.

However if you dont have the income then this is a good service no?
 
It isn't free at all. Every family in the UK pay £8000 per annum towards the health service. We act like the only choices are no healthcare or poor but "free" healthcare.

Sorry I completely disagree with you. I think all the treatment myself, my family and kids have had from the NHS has been absolutely superb. I cannot fault a single thing and would never hear a bad word against the service.
 
Perhaps the Government of the last seven years shouldn't have slashed social care budgets and underfunded the NHS.

Give it the money it needs, we can afford it and we spend less on the NHS as a % of our GDP as many European countries (around 9% versus 11%).

You can’t just keep throwing money at it though. Ageing populations and new technologies means the funding gaps will only get worse each year.

I’m afraid it will take a more radical approach to rectify the problems of the NHS. Short term spending is one thing, but it needs an overhaul if it is to stay alive and by alive I also mean actually allowing Drs and nurses not to be over worked.

My comments on Drs charges were trying to reduce time wasters as opposed to charging people (plastic bags in uk scenario).
 
Maybe I am missunderstanding.

Surely it isnt every family though? I.E those without income etc and the reason those who can afford to pay the 8k do is to cover the ones that cannot?

I agree the service can be better and if you have the money paying for private cover makes sense.

However if you dont have the income then this is a good service no?

Not every family pays £8000, but the average family over the population pays £8000. Healthcare for example costs the same as VAT and fuel duty combined.

I don't believe the service is great even for the poorest, because it still costs £150 billion. I'm not advocating everyone paying for their own healthcare, if I were I'd agree the current system is obviously better for the poor than no cover.

However with the same huge investment in healthcare we could have a much better service whilst still protecting the poorest in my view.
 
One thing I have noticed over here is health premiums seem to have stopped going up at 300% a week. Just been deciding on three job offers and the healthcare was less than we paid last year. That has not happened for about a decade.
 
One thing I have noticed over here is health premiums seem to have stopped going up at 300% a week. Just been deciding on three job offers and the healthcare was less than we paid last year. That has not happened for about a decade.

Private healthcare in the UK is a real bargain in truth, particularly for under 60's. My premium last year was less than my phone contract at around £30 a month. It's just under £60 now that I've added my wife to the policy.

That's as a 30 year old and it increases to around £150 a month for a 50-60 year old and rockets to around £500 a month for a 75-80 year old.

It does make you think when the average family premium in the UK is £8k for the NHS; where I can get private healthcare for under 10% of this.

Typically the biggest increases to health insurance are the government naively increasing IPT from 6 to 10%. This causes less people to take our private health insurance and puts more pressure on the NHS... Bonkers.
 
Private healthcare in the UK is a real bargain in truth, particularly for under 60's. My premium last year was less than my phone contract at around £30 a month. It's just under £60 now that I've added my wife to the policy.

That's as a 30 year old and it increases to around £150 a month for a 50-60 year old and rockets to around £500 a month for a 75-80 year old.

It does make you think when the average family premium in the UK is £8k for the NHS; where I can get private healthcare for under 10% of this.

Unless its changed private healthcare like Bupa only covers a small amount of things. It does not replace the NHS by any means.
 
Unless its changed private healthcare like Bupa only covers a small amount of things. It does not replace the NHS by any means.

It doesn't replace it by any means, but it's certainly more than a small amount and their scope is ever increasing.

For example I can now have a Skype meeting with a private GP and get a referral this way. Meaning I don't need to wait for ages and deal with the hell on Earth that's my local GP practice or A&E.

The biggest thing is you need to get private healthcare before having any long term problems as otherwise they will exclude related illnesses (unless you pay through the teeth for MHD)
 
Private healthcare in the UK is a real bargain in truth, particularly for under 60's. My premium last year was less than my phone contract at around £30 a month. It's just under £60 now that I've added my wife to the policy.

That's as a 30 year old and it increases to around £150 a month for a 50-60 year old and rockets to around £500 a month for a 75-80 year old.

It does make you think when the average family premium in the UK is £8k for the NHS; where I can get private healthcare for under 10% of this.

Typically the biggest increases to health insurance are the government naively increasing IPT from 6 to 10%. This causes less people to take our private health insurance and puts more pressure on the NHS... Bonkers.

You sound like you are proposing the UK go to the U.S. model.
 
You sound like you are proposing the UK go to the U.S. model.

The US is a terrible example of good healthcare (it's better than the UK for the majority, but it's muchm much worse for the minority)

There are many systems worldwide that combine the positives of private competition and incentives which drive efficiencies, with the positives of public healthcare in terms of universal cover. It isn't an either or.

Even if a complete insurance based system were the answer, it would only be so under strict government regulation and with the premiums of the wealthy paying for the insurance of the poorest.

The problem with a governmental body running healthcare is the same as a governmental body running anything - a lack of incentives causing complete apathy in the running of the system, leading to terrible value for money.

To drive efficiency you need incentives, which almost always means more money to managers, doctors, nurses and hospitals innovating and promoting best practices and the closure and unemployment of those doing the opposite.

If my local restaurant served inedible food and had poor customer service, they'd soon close down due to lack of business. When my local hospital has unacceptable waiting times and a poor quality of care... They blame funding but continue to be terrible as the lack of choice means we either like it or lump it.
 
The option isn't between not getting treatment and getting a poor, delayed and inadequate treatment.

In no other part of our life do we accept mediocrity because it's better than nothing at all. Can you imagine in a restaurant getting a completely burned steak and proclaiming "well it's better than no food at all". Of course not - you'd expect better.

The problem is people have been duped into believing it's free so it being poor is just accepted. The fact that it's actually exceptionally costly is hidden.

On a more positive note we visited the private hospital today and it's like visiting a 5* hotel. The consultant visited regularly, there was sky sports on the tv for him to watch the United game tonight. WiFi for him to surf the web. A dozen menu choices for dinner and breakfast. His own private room and one nurse serving half a dozen patients. Probably the best £7k I've spent in years, just a shame not everyone is in a position to pay this.

What I would say to everyone on here is: if you can afford the £50-100 monthly premium get private healthcare insurance. It's absolutely worth every penny and even if you think the NHS is fantastic, see it as relieving pressure on the service!



It isn't free at all. Every family in the UK pay £8000 per annum towards the health service. We act like the only choices are no healthcare or poor but "free" healthcare.


That's a nice price for what you got, but you should know that 7k would barely pay for an ambulance ride here. If the Uk only had private health then prices would skyrocket when they realised how much money could be made.
 
That's a nice price for what you got, but you should know that 7k would barely pay for an ambulance ride here. If the Uk only had private health then prices would skyrocket when they realised how much money could be made.
You wouldn't believe the price tag put on an emergency airlift.
 
I'm just finding it incredible that someone is slagging the NHS off so badly when every single person I know has only positive things to say about it. Aside from a few minor grumbles and a few nurses I know who moan about it from the work side of it, patient wise I have not heard any serious complaints at all.
 
Private healthcare in the UK is a real bargain in truth, particularly for under 60's. My premium last year was less than my phone contract at around £30 a month. It's just under £60 now that I've added my wife to the policy.

That's as a 30 year old and it increases to around £150 a month for a 50-60 year old and rockets to around £500 a month for a 75-80 year old.

It does make you think when the average family premium in the UK is £8k for the NHS; where I can get private healthcare for under 10% of this.

Typically the biggest increases to health insurance are the government naively increasing IPT from 6 to 10%. This causes less people to take our private health insurance and puts more pressure on the NHS... Bonkers.

The premium is cheap because they have the NHS to dump you on if anything goes wrong.

Also almost all staff will have been trained by the NHS and you'll be using NHS facilities half the time
 
I'm just finding it incredible that someone is slagging the NHS off so badly when every single person I know has only positive things to say about it. Aside from a few minor grumbles and a few nurses I know who moan about it from the work side of it, patient wise I have not heard any serious complaints at all.

The NHS is great but it is far from perfect. It often gets a bye because its free at source but don't pretend for a minute there aren't lots of problems. My parents and in-laws are at that age where they utilize healthcare very often. Some of the care they have received has been barely adequate but its hard to complain when its free.
 
That's a nice price for what you got, but you should know that 7k would barely pay for an ambulance ride here. If the Uk only had private health then prices would skyrocket when they realised how much money could be made.

Private healthcare in the UK is comparatively cheap because there is healthy competition. Bupa, Vitality, Aviva, Axa and several smaller decent insurers mean that provided you switch and compare annually you get a good deal.

Prices would not sky rocket just because those insurers insured more people. In fact if there were more business I'd say the opposite would be true: more insurers would enter the market to get a slice ot the action which would increase competition, drive innovation and ultimately benefit the consumer.

I'll reiterate though you absolutely have to switch annually. Every single year my premium renewal is 15% increased and every single year I switch for an inflationary increase only. If I hadn't compared every year for the past 8-9 I'd certainly be paying at least double.
 
The NHS is great but it is far from perfect. It often gets a bye because its free at source but don't pretend for a minute there aren't lots of problems. My parents and in-laws are at that age where they utilize healthcare very often. Some of the care they have received has been barely adequate but its hard to complain when its free.

Yeah but you don't live here anymore. I wouldnt trust second hand information.

I never said it was perfect but it's certainly nowhere near as bad as what people say. And to be honest, everyone I know have no or it.minor complaints.
 
Yeah but you don't live here anymore. I wouldnt trust second hand information.

I never said it was perfect but it's certainly nowhere near as bad as what people say. And to be honest, everyone I know have no or it.minor complaints.

So let's get this straight. The fact I lived in the UK for 35+ years, my wife worked in the NHS for 15+ years, our aging parents and all our extended family and many friends (wife's work in the NHS) are still in the UK, yet my opinion is not valid. However you can comment on every aspect of US society with zero real experience. Makes sense to me. :angel:

Like I said we have aging parents in the UK. They are at that age when they use the NHS a lot. My wife tends to spend a lot of time listening and helping them even to the point of calling doctors in the UK to get information. Of the top of my head in the last year the following have all occurred:

  • My Dad waited a long time for a knee replacement, had the appointment cancelled 3 or 4 times. When they eventually did it he got two preventable infections that set him back months. The physio provided was practically nonexistent.
  • Mother-in-law waiting six plus months for skin cancer treatment. Still waiting no appointment for surgery yet.
  • Mom had a severe chest infection. Got push back from doctor so much she ended up in ER.

I used those three example because I have direct comparison from the US:
  • I have had 3/4 knee surgeries in the US. From calling the specialist to getting surgery was never more than a month. I booked the day that was convenient to me. Didn't have any infections or hiccups. Physio was three times a week for six weeks in a state of the art sports facility.
  • I currently have some dodgy looking skin on my arm. Booked to see my dermatologist last week, and going next Wednesday. Any treatment will be provided that day with follow ups after lab results within a few days.
  • Wife has just had her annual chest infection that turns into bronchitis. Called doctor, seen that day. Chest X Rays and meds all provided and she is on the mend no drama.
  • Adding one more in: I had my annual mans check up yesterday. I have had an ache in my testicle and because of Billy's recent surgery I was slightly concerned. Doctor found no lumps or anything to be concerned about but I am getting a scan. That scan could have been today but I am in work so its next Monday when it is convenient to me. He also wrote me up for full blood work and a colonoscopy which I will book today. <- all of that was free because it's preventative. I also have a small hernia I was unaware of. I could get surgery for that within 2-3 weeks but i am waiting until we move later this month.

The NHS is great for basic healthcare without the worry of bills. Don't fool yourself that it's best in class healthcare or there aren't major problems.

And I am not bashing the NHS here, just being honest. It is a great service that has been underfunded for decades, and right now its dramatically under funded.
 
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Zero experience of the USA? Ok then. Despite having 12 close relatives in 3 States.

That is not experience. Have you worked, paid taxes or used healthcare in the US?

I have dozens of relatives in the UK. Not sure what you are classifying as close relatives, to me that would literally be parents and possibly siblings.

Yeah but you don't live here anymore. I wouldnt trust second hand information.

Expect for when its your second hand information then its fair game. ;) Just busting your chops, it's all good. We all use personal experience, direct or indirect.
 
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Anyone else see this:

Five NI patients 'made 800 emergency ambulance calls
The five most frequent callers to the NI Ambulance Service dialed the service almost 800 times in a year, figures obtained by the BBC show.


The figures show that in 2016-17 the five people called for an ambulance 782 times, but a person was taken to hospital on only 138 occasions.
http://www.bbc.com/news/uk-northern-ireland-43317227
 


643,000 bbbbbb but i thought that nobody went bankrupt from the amazing insurance based healthcare in the USA?

Yes the NHS has flaws but It's nowhere near as bad as the disgusting US system. Latest approval rating is 78% too. So feck the haters and scaremongers. If you want an insurance based system or private care then move to the USA and stop knocking our system.
 


643,000 bbbbbb but i thought that nobody went bankrupt from the amazing insurance based healthcare in the USA?

Yes the NHS has flaws but It's nowhere near as bad as the disgusting US system. Latest approval rating is 78% too. So feck the haters and scaremongers. If you want an insurance based system or private care then move to the USA and stop knocking our system.


That chart was already debunk on snopes I think.

People file bankruptcy much more freely in the US. Someone filing bankruptcy might have $20,000 in total debt and $100 of it is medical. The number above included that sort of bankruptcy in the medical bankruptcies which is misrepresenting the truth to say the least. More accurate studies have used 30% or 50% of the total debt to determine if its a medical debt bankruptcy. Using 30% medical debt ratio accounted for 25% of bankruptcies. There were around 770,000 total bankruptcies in 2017 so do the maths.

That doesn't mean medical bankruptcies are not a problem. They are just not at the level in the chart above. Getting the uninsured coverage would go a long way to reducing the bankruptcy numbers.

No one is saying the NHS is bad or the US system is great. Healthcare is a very emotive subject, and rising costs the world over make it a very challenging issue.
 
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That chart was already debunk on snopes I think.

People file bankruptcy much more freely in the US. Someone filing bankruptcy might have $20,000 in total debt and $100 of it is medical. The number above included that sort of bankruptcy in the medical bankruptcies which is misrepresenting the truth to say the least. More accurate studies have used 30% or 50% of the total debt to determine if its a medical debt bankruptcy. Using 30% medical debt ratio accounted for 25% of bankruptcies. There were around 770,000 total bankruptcies in 2017 so do the maths.

That doesn't mean medical bankruptcies are not a problem. They are just not at the level in the chart above. Getting the uninsured coverage would go a long way to reducing the bankruptcy numbers.

No one is saying the NHS is bad or the US system is great. Healthcare is a very emotive subject, and rising costs the world over make it a very challenging issue.


It wasn't really debunked, it was given a "mixed" review by Snopes:

"Although the “643,000” figure didn’t expressly appear in that article, if we take the number of bankruptcy filings in the U.S. in 2013 (1,032,236) and apply NerdWallet‘s statement that “three in five (60%) bankruptcies will be due to medical bills,” then we arrive at a number of medical bill-related bankruptcies (619,342) reasonably close to the 643,000 figure (although technically a bankruptcy filing can represent more than one person).

Likewise, a 2013 CNBC item based on the 2013 NerdWallet Health Analysis included a chart showing the estimated total number of medical-related bankruptcies in the U.S. in 2013 to be 646,812, which is also quite close to the cited 643,000 figure...

In short, using some very specific analyses, one could make the case that (at least within the last several years) about 643,000 Americans declared bankruptcy annually due to medical bills. But the accuracy of those analyses is open to question, the playing field has changed significantly since they were undertaken (due to the implementation of the ACA), and it’s far from an absolute that the other countries listed in the meme experience zero medical-related bankruptcies."

TBF there does seem to be some support for Obama's ACA reducing medical bankruptcies

image
 
It wasn't really debunked, it was given a "mixed" review by Snopes:

"Although the “643,000” figure didn’t expressly appear in that article, if we take the number of bankruptcy filings in the U.S. in 2013 (1,032,236) and apply NerdWallet‘s statement that “three in five (60%) bankruptcies will be due to medical bills,” then we arrive at a number of medical bill-related bankruptcies (619,342) reasonably close to the 643,000 figure (although technically a bankruptcy filing can represent more than one person).

The problem with the 643,000 figure is it was in a year with record numbers of bankruptcies in general during a major recession. The big question is where you draw the line in medical debt being the cause of a bankruptcy. Using 30-50% as the level of medical debt it suggests the number of medical bankruptcies is around 26% of all bankruptcies. There were a total of 770,000 bankruptcies in 2017 so take 26% of that and it would be more realistic.

Getting the uninsured covered should dramatically reduce the bankruptcy numbers.
 
The problem with the 643,000 figure is it was in a year with record numbers of bankruptcies in general during a major recession. The big question is where you draw the line in medical debt being the cause of a bankruptcy. Using 30-50% as the level of medical debt it suggests the number of medical bankruptcies is around 26% of all bankruptcies. There were a total of 770,000 bankruptcies in 2017 so take 26% of that and it would be more realistic.

Getting the uninsured covered should dramatically reduce the bankruptcy numbers.

Not sure what you mean. The study the original image was based on was from 2007 bankruptcies and the Snopes analysis cited 2013. Neither one of those years was the peak of US bankruptcies which peaked 2009-2011:

image


The studies did show 3/5 (60%) bankruptcies due to medical before the ACA. And the data does show the ACA reduced the amount of medical bankruptcies but I don't see hard evidence enough to make claims about specific percentages, like your heuristic concluding 26% due to medical currently.
 
Not sure what you mean. The study the original image was based on was from 2007 bankruptcies and the Snopes analysis cited 2013. Neither one of those years was the peak of US bankruptcies which peaked 2009-2011:

The studies did show 3/5 (60%) bankruptcies due to medical before the ACA. And the data does show the ACA reduced the amount of medical bankruptcies but I don't see hard evidence enough to make claims about specific percentages, like your heuristic concluding 26% due to medical currently.


No one really knows for sure where the 6430,000 number came from. I think we are splitting hairs on arguing a year. There are plenty of studies suggesting some of the numbers quoted are inflated. Just because a medical bill is part of a bankruptcy filing is not a very reliable way to determine medical debt bankruptcies. The medical portion of the debt should be sufficient to be a major contributing factor.


This study seeks to close that gap by drawing upon medical debt and other data from consumer bankruptcy cases filed in 2013 and responses to a nationwide survey of recent bankruptcy filers. The data adduced in this study shows that medical bills are the single largest causal factor in consumer bankruptcy — but not to the degree found in the study cited by President Obama. My study concludes that medical debt is the predominant casual factor in 18% to 26% of all consumer bankruptcies. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2515321

We conclude with calculations which suggest that out-of-pocket medical costs are pivotal in roughly 26% of personal bankruptcies among low-income households. https://www.scholars.northwestern.e...-the-consumer-bankruptcy-decision-evidence-fr

For the sake of the healthcare discussion the exact number of bankruptcies is irrelevant. No one should ever face financial hardship due to healthcare bills. However its very important that we don't inflate or exaggerate numbers. If that happens it gives the opposing side something to discredit and shifts the discussion. If we don't act with honesty and integrity we are no better than Fox News.
 
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No one really knows for sure where the 6430,000 number came from. I think we are splitting hairs on arguing a year. There are plenty of studies suggesting some of the numbers quoted are inflated. Just because a medical bill is part of a bankruptcy filing is not a very reliable way to determine medical debt bankruptcies. The medical portion of the debt should be sufficient to be a major contributing factor.

Did you read Snopes? It comes from this study from 2007. Fair enough it was before ACA and ACA seems to have cut medical bankruptcies. But even Snopes didn't say it was debunked but "mixed", so if you want accuracy then you can't just say "debunked".

This study seeks to close that gap by drawing upon medical debt and other data from consumer bankruptcy cases filed in 2013 and responses to a nationwide survey of recent bankruptcy filers. The data adduced in this study shows that medical bills are the single largest causal factor in consumer bankruptcy — but not to the degree found in the study cited by President Obama. My study concludes that medical debt is the predominant casual factor in 18% to 26% of all consumer bankruptcies. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2515321

We conclude with calculations which suggest that out-of-pocket medical costs are pivotal in roughly 26% of personal bankruptcies among low-income households. https://www.scholars.northwestern.e...-the-consumer-bankruptcy-decision-evidence-fr

I've seen that study before and even its author acknowledges that study might be too restrictive.
"Austin tried to dispel the murkiness of the definition of "medical bankruptcy" by limiting it to cases in which medical debt came to more than half the debtor's total debt or more than 50% of his or her income, or if the debtors themselves identified it as the primary cause of their filing. Even so, he found, that definition potentially left out hidden medical debts. That's because some was paid by credit card, including special healthcare credit cards or paid out of a second mortgage or home equity line, in which cases it wouldn't appear as a medical liability in a bankruptcy filing."

So its quite possible that 26% is really too low to be representative of all the bankruptcies with medical debt pushing the debtor over the line.
 
I've seen that study before and even its author acknowledges that study might be too restrictive.
"Austin tried to dispel the murkiness of the definition of "medical bankruptcy" by limiting it to cases in which medical debt came to more than half the debtor's total debt or more than 50% of his or her income, or if the debtors themselves identified it as the primary cause of their filing. Even so, he found, that definition potentially left out hidden medical debts. That's because some was paid by credit card, including special healthcare credit cards or paid out of a second mortgage or home equity line, in which cases it wouldn't appear as a medical liability in a bankruptcy filing."

So its quite possible that 26% is really too low to be representative of all the bankruptcies with medical debt pushing the debtor over the line.

Definitely a good point regarding credit card and home equity draws for medical bills. The study did include asking the debtor if medical bills were the primary factor, so I don't think it would move the needle much TBH. Americans tend to file bankruptcy fairly freely. Its just an instrument to discharge debt and reset for a lot of people. Unless the medical bills account for 50% of the debt I really don't think that bankruptcy should count in the medical bankruptcy numbers.