The American Journal study reinforces earlier work showing that most bankruptcies in the U.S. are due to financial consequences of serious illness. A study reported in early June in health policy journal Health Affairs found that employer coverage may not be much of a guarantee against medical poverty. Research showed that sick people with modest incomes are probably underinsured, even with employer-based coverage. Out-of-pocket spending grew more than one-third from 2004 to 2007, the study said. The news was equally worrisome from the actuarial firm, Milliman, which released its fifth annual Milliman Medical Index.
The Index measures the average yearly medical spending for a typical family of four with employer-provided insurance. This year, the total amount this prototypical family spends on medical care will increase by more than $1000 from 2008—the third year in a row that there has been a double-digit percentage increase in the amount employees spend for health care.

There were a number of workmanlike stories explaining the math behind the Milliman index, such as those done by and Reuters. Ditto for stories that reported the bankruptcy study and underinsurance findings. For example, a post by Tara Parker-Pope on her New York Times blog, Well, clearly discussed the key findings of the American Journal study. But there wasn’t much dot connection in this crop of reporting. It’s fine to report studies—but in the middle of a contentious health reform debate, context is super important.

Right now, proposals for taxing benefits, which could ultimately leave more people vulnerable to the kinds of things these studies found, cry out for dot connection. Can’t leave this one up to the economists.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.