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Chairman Cohen and members of the subcommittee, thank you for inviting me here today to discuss the problems individuals face when they cannot afford health insurance or health care. We are in the middle of a great national debate on health care. For the first time in more than 15 years, we are truly trying to fix the broken health care system—and deal with the twin problems of the status quo, skyrocketing health care costs and the millions of Americans living without health coverage. As Congress and the administration wrestle with the big picture and the very important details, it will be critically important to ensure that health reform guarantees that coverage and care will be affordable for Americans of all incomes.
I know that the committee is particularly interested in the financial hardships that many Americans experience due to health care costs. As Dr. Woolhandler will note, medical expenses are a major factor in a majority of bankruptcy filings. People with poor or no health insurance coverage and a significant health problem are particularly likely to accrue considerable medical debt—and thus are particularly vulnerable to bankruptcy. Yet when they reach bankruptcy court, the bankruptcy trustee has little ability and little incentive to address the underlying factors that have led to medical debt and medical bankruptcy, including insurance company denials and aggressive collection efforts by medical debt collectors. Medical debt is, of course, a symptom of larger problems in our health care system—and the solution to medical debt and medical bankruptcy is real health reform that results in affordable, reliable health coverage and affordable health care for all Americans.
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