03 May

Yes Virginia, It’s Highly Probably ACA Cut Bankruptcies in Half. Possibly, actually, even more!

Yesterday I posted a link to a Consumer Reports article that suggested that the implementation of ACA likely cut US bankruptcies half.

I posted the following tweet:

That leads to a Consumer Reports article that has this chart of consumer bankruptcies:

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And the internet blew up for me. At first I was impressed with the clip of retweets, over a couple hours the tweet hit a few hundred retweets. Which is about as far as a tweet of mine has ever gone.

Logged back in after dinner and I’d crossed a thousand retweets and climbing rapidly.

That was when I realized the damn tweet had gone viral. Right now it’s near 7,500 retweets and I’ve lost a lot of time trying to filter through angry responses and have read a lot of truly devastating stories of people summarizing their own bankruptcies due to medical debt.

People that I watch on TV or follow online have retweeted me, which is a surreal experience (geek squee when Adam Savage retweets you, right?), and I’ve had the opportunity to mute all sorts of new and exciting people who are really ANGRY with me. Not angry, but ANGRY. That special kind of online anger that REQUIRES ALL CAPS.

There have been basically two ANGRY replies to my tweet. They break down to positions:

1) You’re cheating by showing a shorter date range of 2010-2017, try 2007-2017 instead, it totally proves you’re wrong!

Here’s it is more politely expressed by Twitter user @weel than by the many, many, MANY folk after him:

To be utterly honest, when I read Consumer Reports articles, I didn’t spot the 2010-2017 framing, and I can see why that would look like axis manipulation. I’ll give the opposition that. And the first thing you find if you hunt for a larger bankruptcy date range, are graphics from the American Bankruptcy Institute that seem to disagree. Take a look:

Weel 2017 May 02

What a look at bankruptcies from 2007 looks like is that bankruptcies climbed up because of a big event. We know that 2008 and onward was the financial crisis, so it wouldn’t seem a big leap to pair those up. Then the rate fell down. That seems like a very different story than CR reported.

I was accused of manipulating data and being a liberal stooge.

Okay.

But if starting the axis from 2010 is manipulating data, then why does the ABI start its data at 2007?

See, because I considered personal bankruptcy in the eye due to overwhelming medical bills in 2008 and I did some research back then. I found out that the bankruptcy laws changed dramatically for 2006 onward due to legal changes championed by Republicans who saw consumers as skipping out on too many of their debts and hurting debtors.

The 2005 changes in the bankruptcy law had a dramatic impact on bankruptcy, and were major headlines back then. How soon we forget.

Q: What is the new bankruptcy law, and when did it take effect?

A: The Bankruptcy Abuse Prevention and Consumer Protection Act of 2005, a major reform of the bankruptcy system, was passed by Congress and signed into law by President Bush in April 2005. Bankruptcy was reformed in a number of ways, including tighter eligibility requirements. The majority of changes instituted by this new law took effect on October 17, 2005 (180 days after the law was signed), although a few changes took effect immediately after the legislation was signed by the President.

So, let’s look at bankruptcy before 2007 and see what our chart looks like:

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Oh dear.

2006 and 2007 were the lowest years of bankruptcy on record because the Bush Administration sided with debtors complaining about the fact that bankruptcies reached a high of 2.1 million bankruptcies. The Bush administration was able to artificially reduce bankruptcies quickly, but they didn’t go after the root cause, but merely made it harder to declare bankruptcy. With a stroke of a pen, they cut bankruptcies. But after that they pop right back up again.

But it’s quite clear that throughout the 90s bankruptcies were rising steadily as well. And after a couple years of the new bankruptcy laws, the rate of bankruptcies began to return to right where they were prior to the late 2005 law to make it harder.

Then, in 2010, it abruptly and dramatically reverses.

The question is why the inexorable march upward?

Well, as many angry GOP twitter folk noted, ‘how can we ever know how many of those bankruptcies are medical?’

We don’t know for sure, but there is research and data. A commonly accepted amount among many folk in the industry is simply ‘more than half.’ Consumer Reports, who are well known for their digging around to focus on just data, also had a rate of roughly half.

Snopes dug into it and found some studies that went as low as 18-25% of bankruptcies being medical in 2015 (after ACA went into affect).

So, there are studies that show somewhere between 62% prior to ACA and as little as 25% post ACA are US bankruptcies related to medical debt pressure.

2) Correlation doesn’t imply causation!

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Well sure, aren’t you clever. This, after complaints about the axis, was the next ‘zinger’ that everyone deployed to make my uncomfortable retweet go away.

So, just as the same time, The Oatmeal posted this awesome comic called “You’re Not Going to Believe What I’m About to Tell You:”

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It’s about the BackFire Effect, where people who believe something deeply will see someone like me posting charts and data and that makes them twice (!) as likely to insist on believing what they believe and dismissing evidence. It’s why facts don’t win arguments.

So, sure. I can point to that chart that shows the inexorable march of bankruptcies up to 2.1 million, the temporary dip down to 600,000 bankruptcies due to a GOP rules change to make them harder, and then the fact that the line pops right back up. Then, in 2010, it reverses.

I can point out that the dip in 2006 was only for two years, but the dip since 2010 has show a 7 year strength in it.

All of those indicate a stronger case for my narrative: that what we’ve been doing for the past 7 years is dramatically reducing bankruptcies.

In fact, I’d argue the bankruptcy rate was climbing to get right back to its natural 2.1 million a year that it hit in 2005 and ACA didn’t just likely halve it, but prevented a shit ton of oncoming bankruptcies.

But, sarcastically, sure, dismiss it all out of hand because it makes you angry.

It doesn’t make that chart go away though. In fact, having looked into the data deeper, worried that I would have to issue a mea culpa, it looks rather likely that bankruptcies on that chart from 2006 to 2010 were rising faster than they had been previously. They freaking tripled in 4 years!

And if most bankruptcy is medical, than rather than saying ‘correlation isn’t causation’ please, one of you, for the love of anything, please explain what halted a 100% a year runaway bankruptcy growth and reversed almost as dramatically? Because so far everyone tossing that phrase out there just runs away and doesn’t offer up a counter-theory.

3) I shouldn’t have to pay for other’s medical expenses

Though a lot of people have explained that they shouldn’t ‘have to pay for other’s medical expenses.’

Now we’re at least being honest, because that isn’t arguing about whether bankruptcies are being dramatically cut. The idea of socially pooling costs upsets you. Never mind that we do that for fire, police, etc, it’s a fundamental issue.

Buddy, welcome to being part of a civilization. I pay for your military defense out of my taxes. We pay for other people’s house fires to get put out. Ever been in a car accident? I haven’t, but my money pools in to pay. That’s how insurance works. We all pool in.

And you don’t have a choice in that. You haven’t since Ronald Regan passed EMTALA, a law that made it illegal for emergency rooms to turn down medical care. That socialized US medicine. What we’re arguing about since then is how to pay for it as a society because people refuse to approach it like any other society with good health and riches has.

And yes, ACA still cut bankruptcies.

05 Sep

New drug mimics the beneficial effects of exercise

Okay, as someone prohibited from intense exercise due to my heart defect, color me intrigued:

“A drug known as SR9009, which is currently under development at The Scripps Research Institute (TSRI), increases the level of metabolic activity in skeletal muscles of mice. Treated mice become lean, develop larger muscles and can run much longer distances simply by taking SR9009, which mimics the effects of aerobic exercise. If similar effects can be obtained in people, the reversal of obesity, metabolic syndrome, and perhaps Type-II diabetes might be the very welcome result.”

(Via New drug mimics the beneficial effects of exercise.)

06 Aug

700K in the US file for medical bankruptcy every year. In Japan 0. Germany: 0. This.

This:

“‘Without insurance, we would have lost our house, decimated the college funds, spent every bit of savings we had, and, six years later, I’m sure we’d still be paying off those bills. Or we would have gone bankrupt. Some 700,000 Americans every year declare bankruptcy because of medical bills. The number in Japan? Zero. The number in Germany? Zero.'”

(Via Cory Doctorow: Without insurance, we would have lost our house,….)

19 May

Does Prozac help authors?

Interesting article takes a look at the effects of creativity while on antidepressants. I tend to have two reactions to this back and forth.

1) I hate seeing antidepressants derided as a ‘crutch’ as no medical doctor has ever said to someone with a broken ankle ‘hey, that’s just a crutch you’re using to keep the weight off your ankle.’ And no one in public would say ‘you should quit using crutches.’ Crutches, by definition, allow the break to heal. I think society is a bit hard on people with mental health fractures. We are ourselves as well. It may be that an artist needs to stop creating while they let themselves heal on something like this (much like you can’t play football if you broke a leg, but no one would mock you for being out for a while on crutches while waiting for it to heal. Not so in brain health. Also, I think it’s at least feasible that some mental health breaks could be career ending, much like an athlete who’s so beaten up they need to retire. A though).

2) I’ve seen many creative friends experience both the ability to write and who have lost it. Most of my friends, anecdotally, seem to find it helpful (and continue being creative) after dropping the fear that antidepressants would kill their creativity. It’s a big fear, articles like this, which don’t use double blind tests and scientific data, but collect a bunch of anecdotes, don’t exactly help. That being said, it at least talks about those who are able to write again thanks to antidepressants. But I do know some who get hit with the fog effect. Hey, people are varied, and it’s not surprising medicines have varied affects. But if you’re super depressed, or suicidal, I submit that taking care of yourself is the most important.

“Within three weeks of my own Prozac fog lifting, I was writing again. Yes, I still felt down, so down some days that I couldn’t work and buried my head under the duvet, but the trade-off was days when my fingers couldn’t move fast enough over the keyboard, my pen struck sparks from the page. In Deborah Levy’s Swimming Home, the heroine, Kitty Finch, has just quit Seroxat. ‘It’s quite a relief to feel miserable again,’ she says. ‘I don’t feel anything when I take my pills.'”

(Via Does Prozac help artists be creative? | Culture | The Observer.)

After my heart defect and the pulmonary embolism almost dropped me in 2009 I tried SSRIs, but they had side effects with the other meds I needed at the time to treat those things. I’ve used xanax off and on to treat physical side effects of stress (my face goes numb, I get disembodied) that came from the change in life in 2009. Stayed off them most of 2010, 2011, and most of 2012.

Early this year I had to reup my prescription due to the stroke-like symptoms of stress I got after a doctor’s visit (and I’ve always used Xanax to help me get on a plane, because flying terrifies the fuck out of me).

As far as I can tell, the main effect has been to let me write because I’m not sitting in a corner obsessing about what’s stressing me out. I’m getting better about not needing it (am off it again after that period early this year) over time, but apparently in 2009 the fall out from almost dying fractured my mind a bit, and I’m still getting over it.

I don’t in the least bit feel ashamed or worried about talking about it. You try almost dying a few times in a short span of time and then move forward with a heart that somedays feels like a landmine in your chest that could go off from too much moving about, and you get a sense for how my brain interprets my daily life some times. Most of the time that doesn’t hit me, but laying stuff down on top of that tends to burst through the energy I spend managing that stuff.

I’m grateful I only occasionally have to resort to Xanax. Hopefully in another few years, I won’t even need that except for on flights (and I’ve always had to use Xanax or copious amounts of scotch to fly happily. My old routine used to be three rum-n-cokes, pour self aboard flight, fly happy!).

17 May

Interesting interview with Bill Gates about worldwide health

This new incarnation of Bill Gates as the richest man in the world who jets around trying to solve world problems is my favorite, and this interview with him is pretty fascinating:

“‘I always use this chart of childhood death,’ Bill Gates says. ‘In 1960, 25% of kids died before the age of 5. And now we’re down below 6% of kids dying before the age of 5.’”

(Via Bill Gates: ‘Death is something we really understand extremely well’.)

29 Apr

An ounce of prevention…

One of the most dramatic impacts in medicare seems to be a program that tested sending nurses around to see how people are doing and focusing on the human care side of things, not the ‘treat them once they’re in trouble’ side:

“If there is a secret to the success of Health Quality Partners at preventing hospitalizations, it’s this: No one else is checking in with the Bradfields or the Allens every week. Medical technology — from pills to devices to surgical procedures — is so advanced and so competitive that making further gains requires enormous investment and rarely brings high returns. But the exciting field of knocking-on-the-Bradfield’s-farmhouse-door is almost totally empty. Medicine has been so focused on what doctors can do in the hospital that it has barely even begun to figure out what can be done in the home. But the home is where elderly patients spend most of their time. It’s where they take their medicine and eat their meals, and it’s where they fall into funks and trip over the corner of the carpet. It’s where a trained medical professional can see a bad turn before it turns into a catastrophe. Medicine, however, has been reluctant to intrude into homes.
For the most part, the medical system treats the old very much like it treats the young. It cares for them when they’re sick and ignores them when they’re well. Coburn’s basic insight is a discomfiting one. He doesn’t really believe in ‘better,’ at least not for elderly, chronically ill patients. He wants someone going over frequently to see if they’re depressed, if their color is good, if they understand their medications, if there’s anything they need. This isn’t medicine so much as it’s supervision.”

(Via If this was a pill, you’d do anything to get it.)

Of course, this may save money in the big picture, but you can imagine that bean counters who focus on short term savings thinking about that. They’re about to shut it down.

12 Apr

David Farland’s lack of insurance due to refusal of insurers to let him sign up for a plan

By 2050 40% or so of the US workforce is expected to be flexible or freelance. Despite the legions of vitriol against health care reform of any kind, right now things like this happen, when freelancers with preexisting conditions can be denied healthcare by companies and thus put their families at risk:

“Through no fault of his own, Farland cannot obtain medical coverage due to pre-existing health conditions. His wife did have a job that allowed them to carry group health insurance, but got laid off during the worst of the recession. When asked how authors survive these kinds of disasters, Farland answered, ‘It’s only through people working together. People are amazingly kind in times like this.'”

(Via Army of Friends Rally Around Best-Selling Author David Farland.)

The current system is due to change next year, due to the reforms that are coming down the pipe. Alas, this happened a year too early for Farland’s family.

This wasn’t a case of someone just not getting health insurance and gambling his family’s life, according to the story above, but a horrible and unique creation of the existing system that conservatives are fighting hard to keep in place, one that forces us to depend on employers and fear being laid off lest things just like this happen.

Consider helping however you can.

By the way, this could have been me. My genetic heart defect means American companies can, until 2014, refuse to even take my offered money if I wanted to get healthcare. Current we’re insured via my wife, but even if I made enough for her to leave her job, I couldn’t get covered due to the same issue.

Outraged?

You should be.

03 Apr

FDA Clears Ingestible Sensor

A swallowable sensor. Take two and the computer will diagnose you in the morning…

“Proteus Digital Health, Inc. announced today that the U.S. Food and Drug Administration (FDA) has cleared its ingestible sensor for marketing as a medical device. The ingestible sensor (formally referred to as the Ingestion Event Marker or IEM) is part of the Proteus digital health feedback system, an integrated, end-to-end personal health management system that is designed to help improve patients’ health habits and connections to caregivers.”

(Via Proteus Digital Health Announces FDA Clearance of Ingestible Sensor – Proteus Digital Health.)

27 Mar

Veti-Gel covers any wound and stops bleeding

Or, for those of you who have played Halo: Biofoam!

“Veti-Gel is said to dramatically speed the body’s natural clotting, closing wounds in seconds. It instantly tells the body, ‘OK, stop the bleeding,’ but also it starts the healing process.

‘I have seen (Veti-Gel) close any size wound that it is applied to,’ said Landolina. ‘As long as you can cover it, it can close it,’ he added.”

(Via Veti-Gel Instantly Stops Bleeding and Closes Wounds of Any Size it Can Cover.)

26 Mar

Trawling social media to find a better picture of drug side effects

This is interesting to me: a group of people mining twitter to look at the lesser reported side effects of drugs that might not get reported on up to the FDA due to them being not as dramatic.

I recently trawled newsgroups to find out that I wasn’t alone in having a reaction to a drug I’m on that gives me the munchies something awful. After noodling around the medical sites and not seeing much about it, I found a ton of anecdotes online from people who’d managed to isolate that same drug.

It was nice to know I wasn’t crazy.

“We found 295 instances of adverse events in the top 10 categories on Twitter – a number higher than is reported to the FDA. In the last 12 months for which data is reported (Jul2012-Jun2012, data is only available through June 2012 at time of writing), there has been an average of 8 adverse events where Claritin was the primary suspect in reports to the FDA, and 265 total adverse events per month where Claritin was mentioned to the FDA in conjunction with other drugs. Almost all of the cases we found on Twitter were primarily due to Claritin, over 30X the number of primary events that are reported to the FDA”

(Via Discovering Drug Side Effects with Crowdsourcing | The CrowdFlower Blog.)