Medical debt is a uniquely American phenomenon, a burden that would be unfathomable in many other developed countries. According to a survey published this month in the American Journal of Public Health, nearly 60 percent of people who have filed for bankruptcy said a medical expense “very much” or “somewhat” contributed to their bankruptcy.
医疗债务是美国独有的现象，也是很多其他发达国家难以理解的负担。本月发表在《美国公共卫生杂志》上的一项调查显示，近 60% 申请破产的人都曾表示，医疗费用或多或少导致了他们的破产。
Emergency-room visits and planned surgical procedures are the most common causes of large medical bills that patients simply can’t afford to pay. Often, a hospital might be covered by a person’s insurance network, but the individual doctors who work there and the ambulance company that services it aren’t, a situation that can lead to something called balance billing.
急诊就医和计划之中的外科手术是造成巨额医疗费最常见的两个原因，所产生的费用病人们根本负担不起。通常，一所医院可能在个人保险的保障范围内，但是在该医院工作的个别医生和提供服务的救护车公司并不在理赔范围中，这种情况导致了所谓的“差额账单”。
Sometimes, bizarre loopholes kick in at the darkest moments, like the fact that a baby would be covered upon birth under Medicaid or the Children’s Health Insurance Program, the government insurance program for children, but a stillbirth might not be covered, says Simon Sandoval-Moshenberg, a legal director at the Legal Aid Justice Center.
西蒙·桑多瓦尔-摩森伯格是法律援助司法中心的法务总监，他表示，有时候，人们会在最绝望的时刻遭遇匪夷所思的漏洞，例如，婴儿出生伊始，就受到医疗救助计划或儿童健康保计划（后者是政府为儿童提供的保险方案）的保障，但是死胎却可能不在保险范围内。
In a statement, an American Hospital Association spokesperson told me that in 2017, hospitals provided more than $38 billion worth of care to patients who could not afford it otherwise.
在一份声明中，一位美国医院协会的发言人告诉笔者，在 2017 年，美国的医院为那些负担不起医疗费用的病人提供了价值超过 380 亿美元的医疗服务。
Still, some patients do wind up with medical debt, which discourages them from seeking medical care, because they fear they will incur even more debt if they go to the doctor again. In the end, they get sicker, and risk plunging even further into debt.
就算如此，一些病人最后还是欠下了医疗债务，这让他们不愿寻求医疗服务，因为他们担心如果再去看病的话会背负更多债务。到头来，他们病得更严重，可能会陷入更深的债务危机。
When everything fails, and the person is at imminent risk of having wages garnished because they’ve been sued for medical debt, it might be time to file for bankruptcy, says Sandoval-Moshenberg. The people who do become the tip of a very big debt iceberg.
桑多瓦尔-摩森伯格说，当一切都分崩离析，病人因医疗债务被起诉，其工资面临着被抵押还债的风险时，也许就该申请破产了。这些宣告破产的人成为了美国巨大债务的冰山一角。
————— 文章来源 / 大西洋
bankrupt/ˈbæŋkrʌpt/
adj. 倒闭的，破产的
e.g.
词根词缀：-rupt（打破）
搭配短语：go bankrupt
unfathomable/ʌnˈfæðəməbl/
adj. 高深莫测的；不可理解的
e.g.
相关词汇：fathom（v. 弄明白，搞清楚）
英文释义：difficult or impossible to understand
搭配短语：an unfathomable theory
file/faɪl/
v. 正式提出（申请），送交（备案）
balance billing
差额账单
bizarre/bɪˈzɑːr/
adj. 怪诞的，异乎寻常的
e.g.
英文释义：very strange or unusual
搭配短语：a person in a bizarre outfit
loophole/ˈluːphoʊl/
n.（法律、合同等的）漏洞，空子
e.g.
相关词汇：loop（n. 圆圈）; hole（n. 洞，孔）
搭配短语：a legal loophole
搭配短语：to close/address a loophole
kick in
开始生效，起作用
e.g.
英文释义：to start to have an effect or to happen
例句：The painkiller kicked in.
upon/əˈpɑːn/
prep. 一...就...
e.g.
Upon arrival, they went in search of a hotel.
stillbirth/ˈstɪlbɜːrθ/
n. 死胎，（婴儿）死产
e.g.
相关词汇：stillborn （adj. 胎死腹中的）
搭配短语：a stillborn plot
spokesperson/ˈspoʊkspɜːrsn/
n. 发言人
e.g.
相关词汇：spokesman（n. 男性发言人）
相关词汇：spokeswoman（n. 女性发言人）
wind up
以…告终，最终沦落到
e.g.
同义词：end up
例句：He wound up as a millionaire.
incur/ɪnˈkɜːr/
v. 招致；遭受
e.g.
英文释义： to experience something, usually something unpleasant, as a result of actions you have taken
搭配短语：incur substantial losses
搭配短语：incur fines
搭配短语：incur the wrath of a friend
plunge into
负债；使陷入
e.g.
例句：America is plunging into recession.
imminent/ˈɪmɪnənt/
adj. （尤指令人不快的事）即将发生的，逼近的
e.g.
搭配短语：an imminent disaster
例句：Many species of animal are in imminent danger of extinction.
garnish/ˈɡɑːrnɪʃ/
v. 为偿付债务（或理赔）而扣押（钱财, 尤指个人薪资）
tip of an/the iceberg
冰山一角；问题的一小部分
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