Because of an increasingly unstable economy, many Americans are going without medical insurance, simply because they can’t afford it. But if they’re not careful the uninsured may face crushing medical debt from even the smallest illness. Because those without medical insurance depend on the emergency room to handle every type of illness from the flu to an infection, medical debt can quickly pile up. But an article in the Dallas Morning News offers some savvy tips for the uninsured to reduce or avoid medical debt. Here are just a few.

1. Avoid emergency room visits when possible.
   The emergency room should only be used for
   life threatening conditions.
2. Use clinics and free health fairs to diagnosis conditions
   such as diabetes and high blood pressure.
3. Use generic drugs, their cheaper and work just as well.
4. Use free or community clinics for vaccinations.

If you find yourself in an emergency room, ask the staff what procedures and medications are unnecessary (ie. extra tests, brand name drugs etc.) so you can save money and avoid medical debt.

U.S. News has an informative article about how medical expenses are sending fully insured Americans into a financial tailspin.

U.S. News says: " Since 1999, Keith and Deborah Krinsky of Magalia, Calif., have seen their health insurance deductible soar from $1,000 to $10,000. And their health-care costs have put them in a financial hole."

$10,000 is a lot of money to have to shell out as a deductible for medical insurance. That’s in addition to paying monthly healthcare premiums, credit card minimums, a mortgage and other everyday expenses that pop up. This family is literally a financial disaster waiting to happen. As most of us know most people who take out these high deductible healthcare plans don’t actually have $10,000 sitting in a bank account. What happens when a medical emergency occurs? They can’t pay and then the bill collectors start to call, write, file lawsuits and garnish wages which is what happened to another couple with barebones medical insurance.

U.S. News Says: "The Smiths, who raised six children together, consistently had employer-sponsored health insurance. Like the Krinskys, however, they began to notice a drift upwards in the cost of premiums as well as higher co-pays and higher deductibles in the 1990s… By 2004, their health insurance policy had a maximum out-of-pocket exposure of $9,000, and they were sued by a dermatologist for an unpaid bill. The amount? A mere $600. Donna’s wages were garnished, and the couple were forced to declared bankruptcy and sold their house for pennies on the dollar, all while they were technically fully insured."

Being fully insured with outrageous deductibles is risky business to put it mildly. If you notice that your medical bills are pushing you to the brink financially, don’t wait until it’s too late and your wages are being garnished. As soon as you see that medical expenses are jeopardizing your ability to stay afloat financially, that’s when you should begin considering all of your options, including Chapter 7 or Chapter 13 bankruptcy. You are not alone, according to data from the Commonwealth Fund, over 72 million Americans are overwhelmed with medical debt and have difficulty paying their medical bills.

Did you know that over 79 million Americans struggle to pay medical bills? That’s shocking! I was surfing the net today and ran across an article with the headline from statesman.com, "79 Million Americans Struggling To Pay Medical Bills" . The story features a woman who reconnected with her high school sweetheart during middle age; but soon lost him to liver disease. She then went broke trying to pay her spouse’s medical bills. She eventually filed for bankruptcy, but not before she lost her home. Medical bills are a leading cause of financial stress in this country; but most people wait too long before they get help taking a serious inventory of their financial picture. Sometimes you can restructure or even settle medical debt; but you need to move fast. Once your medical bills go to a debt collection agency it will be much more difficult to negotiate a settlement. If you see that your medical bills are causing you to fall behind on payments for the financial essentials such as housing, food and savings for an emergency, it may be time to seek help from a professional debt counselor.

Even those born during the depression are finding this economy’s downturn hard to bear. According to an article in the Associated Press the elderly are succumbing to bankruptcies as they face a rapidly rising cost of living.

The AP says: "Older Americans are hit by a one-two punch of jobs and medical problems and the two are often intertwined," said Elizabeth Warren, a Harvard Law School professor who was one of the authors of the study. "They discover that they must work to keep some form of economic balance and when they can’t, they’re lost."

That’s precisely what happened to Noda. She worked all her life, on a hospital’s housekeeping staff, and later selling boat tickets to tourists. She cut corners when she needed to but always paid the bills she neatly logged in a ledger.

"I was born during the Depression," she said. "I paid the bills whether I ate or didn’t, whether I went to the doctor or not."

It all worked fine for Noda, a widow for 23 years, until she was forced to undergo double-bypass surgery and deal with respiratory problems. She started using two credit cards more frequently for food and bills. Before long, she was $8,000 in debt and behind on car payments.

Noda is not alone. According to Consumer Bankruptcy Project people over 65 years old are more than twice as likely to file for bankruptcy. But unfortunately because of their values and upbringing many seniors attempt to battle mounting debt even after it’s clear that doing so will jeopardize their well being as noted by Noda who would rather not eat than allow a bill to go unpaid. It is so important for us to remind ourselves that bankruptcy is here to help those who need debt relief. And when you must choose between eating and paying your bills, then that debt relief is desperately needed.