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Nearly one-in-three individuals with a serious health problem have been contacted by a collection agency because of an unpaid medical debt, according to a study that was released by the Harvard University School of Health, The New York Times, and The Commonwealth Fund.

Having a serious health issue has caused 37% of those surveyed to use up all of their savings, according to the report, and left 23% unable to pay for basic necessities such as food, heat, or housing.

These statistics are somewhat startling given the fact that 91% of those who were surveyed indicated they had some form of health insurance to cover their medical expenses and prescriptions. While such a large majority of individuals have health insurance, 34% said they have had a serious problem paying hospital bills, 29% have had a problem paying for prescription medication, and 27% have had a problem paying for dental care.

“Taken together, the survey shows that if we are to improve the health care and health insurance systems in the future for those who are seriously ill, we have to look more carefully at a set of less visible issues that really impact the outcome of their life experiences when seriously ill,” the report concludes. “Often the broad discussions about health reform miss these critical issues that importantly impact those with a serious illness.”

The report defined someone who is seriously ill as either those who themselves in the past three years have had a serious illness or medical condition that required multiple hospital visits and visits to multiple physicians, or if the individual participating in the survey has not had such an experience themselves, but has had a close family member not available to be interviewed who have had such an experience in the past three years.

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