一个single hospital stay can cost a patient tens of thousands of dollars. This is driving many people to crowdfunding in order to pay for their medical bills.
If it weren’t for Medicaid, the parents of a 3-year-old child born with a rare disorder would have owed more than $200,000 for their son’s one-week stay in the hospital.
Last month the child’s mother, Alison Chandra,发表Twitter上医院法案的图像。她跟进了细节的摘要。
“我会为您节省一些数学；如果没有保险，我们将在OR中欠下231,115美元，在CICU中1周，在心脏地板上1周。”她写道。
Chandra’s son was born with杂动综合症, which required him to have four open-chest surgeries before his third birthday.
钱德拉告诉了Philadelphia Inquirer那个医疗补助为她的产前护理和儿子的前两次手术拿起了标签。保险后，他们最终欠了500美元。
Now, the family’s medical expenses are covered by insurance that her husband gets through his new job.
Without Medicaid, though, the parents might have ended up like many other Americans who file for bankruptcy each year due to overwhelming medical bills.
由于需要大量医院护理的复杂健康问题，医疗费can quickly add up.
In the United States, septicemia (blood poisoning) accounted for $23 billion in inpatient hospital costs in 2013, according to areport由医疗保健研究和质量机构撰写。这占当年所有住院住院费用的6％。
其他高成本住院治疗包括新生婴儿的住宿，骨关节炎或医疗装置引起的并发症，植入物或组织移植物以及急性心脏病发作。
然而,当看着每个hosp平均成本ital stay, heart valve disorders topped the list at $41,878.
Heart attack and complications from a medical device, implant or tissue graft comes in at an average of about $20,000 per stay. Septicemia is about $18,000 per stay.
有医疗保险的人可能永远无法支付the full costs, even though they see the hospital charges on their medical bills.
但
上升主要是由于免赔额增加，或者在大多数服务涵盖其保险计划之前必须支付的医疗费用。
人们满足自付额（称为共同保险的过程）后，他们还支付了更大比例的医疗费用。
一个2015studyby the Kaiser Family Foundation also found that insurance premiums rose 4 percent over the past year. People with a plan that included coinsurance paid about 18 percent of the cost of primary care and specialty care visits.
When people lose their insurance coverage, they risk being slammed with medical bills.
当一个人因疾病而离开工作或其他原因（例如必须照顾生病的孩子或配偶）时，这可能会发生这种情况。
一个2009studypublished in The American Journal of Medicine found that almost two-thirds of bankruptcies in the United States had a medical cause.
大约78％的人在疾病开始时就有保险。到破产时，拥有私人保险的人群已经下降，而患有Medicare或Medicaid的人已经有所增加。
On average, uninsured families bankrupted due to medical expenses owed almost $27,000, while those with private insurance owed more than $17,000.
从私人承保范围开始但在破产时丢失的家庭，平均欠下了约22,000美元。
对于申请医疗破产的人，随后是处方药，医生账单和保险费的人来说，医院账单是最大的自付费用。
In almost 40 percent of families, someone had lost or quit a job because of the illness. In one-quarter, a family member was fired as a result of the illness.
In recent years, there are signs that the Affordable Care Act (ACA) has eased some of the burden of medical bankruptcies.
一个study今年早些时候，消费者报告发现，在2010年至2016年之间，美国的破产申请下降了50％，至770,846，这是ACA生效的时期。
Experts pointed out that the improving economy and changes to the bankruptcy laws in 2005 contributed in part to this decline. But expanded healthcare coverage as a result of the ACA also had a major role.
Illness is a slippery financial slope, especially when your health insurance coverage depends on you — or another member of your family — to continue working during the illness.
根据2015年surveyby the Robert Wood Johnson Foundation, more than one-quarter of American adults said that they have major financial problems as a result of healthcare costs.
That’s why some people are turning to crowdfunding sites to raise money to pay for their medical expenses.
Crowdfunding involves seeking donations from family, friends, and others through online campaigns. People use crowdfunding websites to raise money for creative projects, new businesses, and now healthcare costs.
一个2015分析by NerdWallet found that 41 percent of crowdfunding campaigns on four sites were for medical costs.
On crowdfunding site GiveForward, 70 percent of medical campaigns were for people recently diagnosed with cancer.
Out-of-pocket medical expenses account for the bulk of the crowdfunding requests, but people also seek money to cover transportation, child care, and lost wages.
Crowdfunding can work for some people, but it is no cure-all.
Only 11 percent of those campaigns analyzed by NerdWallet met their funding goal.
在2016年study研究人员发表在华盛顿大学（UWB）的《社会科学与医学》杂志上，研究人员在GoFundMe上发现了类似的成功率。平均而言，200个竞选活动仅带来了40％的资金目标。
这意味着有些人可能仍在努力支付医疗费用。
众筹似乎是许多政客吹捧的自由市场体系的缩影。但是UWB的研究人员发现，医疗众筹可能只是美国健康保险范围不平等的症状。
关于54 percent of the medical crowdfunding campaigns they looked at were from people living in states that didn’t expand Medicaid as part of the ACA. These states account for only 39 percent of the country’s population.
The researchers also suggested that people who are successful at crowdfunding campaigns may not be the ones most in need.
取而代之的是，人们在众筹中的成功可能取决于他们对“自我营销的财务生存”以及使用在线众筹网站和社交媒体的舒适程度。
The researchers wrote that this may “increase the likelihood that crowdfunding for healthcare is exacerbating severe population health disparities.”