Health issues and health care expenses in Canadian bankruptcies and insolvencies

Int J Health Serv. 2014;44(1):7-23. doi: 10.2190/HS.44.1.b.


Illness can contribute to financial problems directly, through high medical bills, and indirectly, through lost income. No previous in-depth studies have documented the role of medical problems among Canadian bankruptcy filers. We obtained the bankruptcy filings from a random sample of 5,000 debtors across Canada and mailed surveys to them seeking information about the medical antecedents of their bankruptcy. A total of 521 debtors responded (response rate of 10.4%), of whom 40.1 percent reported losing at least two weeks of work-related income because of illness or injury in the two years before their filing; 8.3 percent reported a similar income loss because of caregiving responsibilities for someone else who was ill. Although 60.1 percent of respondents reported being responsible for a medical bill within the previous two years, only 6.9 percent had bills over $5,000 (all amounts in Canadian Dollars). Prescription drugs were cited as the costliest medical expense by two-thirds of debtors reporting bills > $5,000, with dental bills cited by 22.2 percent. Universal health insurance affords Canadians protection against ruinous doctor and hospital bills. Inadequate coverage for prescription drugs and dental care, however, leaves some with unaffordable out-of-pocket costs. In addition, illness is a frequent indirect cause of bankruptcy through loss of work-related income.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bankruptcy* / statistics & numerical data
  • Canada
  • Female
  • Health Expenditures / classification*
  • Health Expenditures / statistics & numerical data
  • Health Status Indicators*
  • Humans
  • Income*
  • Male
  • Surveys and Questionnaires*