The nerdwallet article directly copies their medical bankruptcy numbers from the article McCardle cites. Since they added no value to this, criticizing the original source is adequate.
whereas "when asked about problems that contributed very much or somewhat to their bankruptcy [...] 54.9% cited medical or drug costs". But while 54.9% is lower, it's...not a whole lot lower.
So what? This number is again not the true figure. The true figure is #bankruptcies in real life - #bankruptcies there would be absent medical causes. The study doesn't compute this.
Nearly 100% of people who went bankrupt could cite that they paid at least $1001 in taxes and could attribute their bankruptcy to that in a subjective survey if they wanted. Does this mean that it's a "damning statistic" and "disgraceful" that most people pay $1001 in taxes?
Furthermore, bankruptcy for medical reasons (like being unable to work - which the study does include) does happen in countries with socialized medicine. These numbers - and the implications innumerate reporters drew from them - are simply indefensible.
Yes, the bankruptcy statistics are from the PNHS study. What about the other numbers from the CDC and the Commonwealth Fund? They also damn the US private healthcare system, and so far you've been ignoring them.
It's impossible to determine "#bankruptcies there would be absent medical causes", because it's impossible to determine a number that only exists in a counterfactual. Absent this, subjective surveys give us an approximation that's broadly useful; literally anyone can lie or misattribute just about anything on any subjective survey, but that hardly makes them useless. There's no sense in being interested in "the true figure" exactly unless we have reason to believe that it varies dramatically (say, by an order of magnitude) from our best approximations, and outliers like a criminal millionaire football player are hardly that; what matters is an idea of the impact of medical costs on people's financial security, and the study absolutely provides that.
Exactly what realistically obtainable data could persuade you that medical bills contribute to financial instability and bankruptcy in the US?
The PNHS study showed that among medical bankruptcies, people on average paid ~$17k out-of-pocket on medical bills. Would those people have gone bankrupt even without having to drop that much money on bills? Maybe! It's impossible to know for sure. But here's a study that says 76% of Americans live paycheque to paycheque [0]; what happens when you drop an unexpected $17000 bill on them? You're fighting an uphill battle against common sense, here.
And from the other direction: a blog post with some numbers showing that people do indeed go bankrupt in countries with single-payer or socialized medicine [1]. Based on the blog title and the writing, this is, I suppose, is supposed to be a rebuttal against arguments for the public system, but the actual numbers - exactly as imprecise and subjective as the American PNHS numbers, mind - are 5%-15% instead of 30%-60%. That's still too high and still disgraceful, but a dramatic improvement nevertheless.
I'm disputing only your claim of causality: No one in Canada goes bankrupt due to medical bills; in the US, roughly 2 million people do a year
It's impossible to determine "#bankruptcies there would be absent medical causes", because it's impossible to determine a number that only exists in a counterfactual.
If you were correct that calculating counterfactuals is impossible, then the study in question would be trivially wrong. So would all claims of global warming (earth warmed relative to a counterfactual), all macroeconomic claims about alternate policy proposals (bigger stimulus would have been better), VAM for teacher evaluation, pollution impact studies, etc.
Exactly what realistically obtainable data could persuade you that medical bills contribute to financial instability and bankruptcy in the US?
I'd like a model that accurately predicts bankruptcy probabilities in people who had no "major medical cause" (i.e. medical expenses under $1001). Then I'd apply that model to people with major medical cause and compute #actual bankruptcies - #predicted bankruptcies for the group that did have medical expenses in excess of $1001. This is basic science.
You are right that causality is hard to measure. That doesn't mean we take a totally wrong quantity and pretend it's the right thing. We just admit ignorance.
Now your turn. What evidence (if any) would cause you to believe that taxes in excess of $1001 cause at least 90% of bankruptcies and that this is "too high" and "disgraceful"?
It's impossible to precisely calculate "the true figure" of a counterfactual, which is what you appeared to demand. It's obviously not impossible to estimate it or approximate it, particularly when we have things like physical laws, historical correlations, basic reasoning, or even self-reported data to guide us. None of these are "the true figure", although physical laws tend to work pretty well, and despite that are not necessarily totally wrong, within some margin of error. (I'm not sure if macroeconomic claims are the best way of demonstrating the possibility of calculating counterfactuals, at any rate!)
Anyway: if you showed me a study that interviewed a statistically appropriate number and distribution of bankrupt debtors and found that over 50% claimed that a high tax bill was the cause of or contributed to their bankruptcy, I'd agree that taxes probably needed to come down.
Still, a tax bill is fundamentally different from a medical bill, in that your tax bill is ultimately a fact of life: it's something you're aware of ahead of time, and the assumption that you have to pay it is baked into the salary you take, and, in principle, into the rate chosen by legislators. You can plan for it and account for it in a way that you can't catastrophe, and outside of extenuating factors, failure to do so likely indicates pretty severe financial irresponsibility if tax rates are at all reasonable. That's probably why people wouldn't be too likely to claim that tax (or groceries, or rent...) caused their bankruptcy - even if a person is living paycheque to paycheque, they might be scraping by, and then wham: suddenly they get diagnosed with cancer or get struck by lightning and half their annual salary goes to the hospital in one moment, they're going to say that those medical bills caused the bankruptcy, not the expenses that they'd already accounted and planned for. Which I don't think is necessarily wrong: if I knock a glass off a table, in terms of blame, my action is what caused it to fall and drop, and chalking it up to gravity or the glass being in the way is somehow wrong, in terms of our understanding of the idea of fault.
A better comparison might be a tax hike causing bankruptcy. And yeah, if the federal government declared that a person with an annual income of 45k (the average of the people in the PNHS study) suddenly owed 17k more in taxes and people went bankrupt trying to pay it and blamed it on the hike, I would 100% be on their side (and yours, I'm guessing). You wouldn't even need to show me a study, to be honest. I would probably also say that instead of taxing these people just scraping by, they should tax the rich instead, who can easily afford it, and use that to subsidize for the poor, which is incidentally how I think health care should work.
No, but they may be a good approximation. P(B|A) is not a good approximation to P(A|B) - P(A|!B), no matter how much you wish it were.
Anyway: if you showed me a study that interviewed a statistically appropriate number and distribution of bankrupt debtors and found that over 50% claimed that a high tax bill was the cause of or contributed to their bankruptcy, I'd agree that taxes probably needed to come down.
So subjective preferences matter more than objective figures (like costs in excess of $1001)? Interesting.
That's probably why people wouldn't be too likely to claim that tax (or groceries, or rent...) caused their bankruptcy - even if a person is living paycheque to paycheque,...
Yes. The person doesn't want to admit that their spendthrift ways are cause of their problems. They instead choose something that they can nominally pretend is not their fault.
I've seen this in action. I know a guy with a $100-200k/year income, gigantic home, second home, third investment property, spendthrift wife, 2 cars, and living "paycheck to paycheck". He's in serious financial trouble, hundreds of thousands in debt. He also blames unexpected medical expenses (probably under $20k) for his troubles - certainly easier than blaming himself.
You seem to be defending this claim, by saying that Warren's criteria are reasonable.
The fact an expense of 40% of your annual compensation should be easy to handle - a 10% savings rate will get you there in 4 years. Americans prefer a risky financial position in order to have high consumption. That's a choice.
I suppose it is disgraceful that so many Americans behave irresponsibly and then expect others to pick up the tab.
whereas "when asked about problems that contributed very much or somewhat to their bankruptcy [...] 54.9% cited medical or drug costs". But while 54.9% is lower, it's...not a whole lot lower.
So what? This number is again not the true figure. The true figure is #bankruptcies in real life - #bankruptcies there would be absent medical causes. The study doesn't compute this.
Nearly 100% of people who went bankrupt could cite that they paid at least $1001 in taxes and could attribute their bankruptcy to that in a subjective survey if they wanted. Does this mean that it's a "damning statistic" and "disgraceful" that most people pay $1001 in taxes?
Furthermore, bankruptcy for medical reasons (like being unable to work - which the study does include) does happen in countries with socialized medicine. These numbers - and the implications innumerate reporters drew from them - are simply indefensible.