Set health costs apart by use of dedicated credit card

Regarding "Giving credit to get what's due: How doctors can help patients pay the bill" (Article, Jan. 21): Many articles about health care state that people have spent their savings, maxed out their credit cards, lost their homes, and even gone bankrupt because of medical bills. To be sure, when in dire straits, the details may not matter, but there is seldom reference to the dollar amounts involved, .i.e, whether those savings, credit limits, and home values were $5,000, $25,000, $100,000 or whatever. When you are losing all that you have, does it matter what you had?

Nonetheless, if your circumstances are part of the story, then it matters.

Many people pay for medical expenses with high-interest-rate credit cards and, no doubt, the credit card debt escalates because of minimum payments, late fees, and penalties, all of which are compounded at that high-interest rate. And so, why not go for broke? Buy that entertainment system, that prom dress, those football tickets. It's just more debt -- that will never be paid off.

Perhaps a health-care-expenses-only credit card would prevent some people from this credit card cycle. Certainly the documenting system is in place, and there is enough business to create a niche credit card that could be used for health care expenses only. This credit card would have an interest rate not much different from prime, as well as defined monthly payment amounts, and low late-penalty fees. It might even have a deferred payment arrangement until things get back to normal for the people involved. Home loans, car loans and student loans have all been treated uniquely. Perhaps it is time for health care expenses to join the group of big ticket items.

A health-care-expenses-only credit card would help people keep this unique expense separate from other expenses, both financially and psychologically. It would give insurance companies, and government agencies, some handle on what the costs of health care are to individuals rather than cluttering the medical bills picture with other expenses. Finally, it would provide a clearly defined need that charitable friends and associates, as well as philanthropists, might respond to when they know the money is going to pay for medical bills and not for other things.

Elizabeth Nolan, MD, Coronado, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/02/18/edlt0218.htm.