Trapped in America's Safety Net

Bankruptcies tend to have multiple causes, so it is difficult to measure precisely the effect of medical debt. 34 But we do know that this pattern of events—illness, job loss, insurance loss, bankruptcy—is uniquely American. 35 In virtually all other economically advanced nations, citizens have health insurance regardless of their employment situation. The Obama administration health reform, the Affordable Care Act, will cut the number of uninsured and underinsured and will reduce some—but not all—disparities in health insurance coverage by age, income, and education, as chapter 6 explains. In other countries, however, these differences in insurance coverage across subgroups do not exist. People have health coverage by virtue of their citizenship.