Recent reports by Families USA, a nonprofit, non-partisan research and advocacy organization, show that Americans in 12 states will spend more than 10 percent of their pre-tax family income on healthcare in 2008.  In isolation, that statistic might be underwhelming.

But in all 12 states, more than three-quarters of those who are expected to exceed the 10 percent threshold are insured; in Iowa—the state with the highest insured rate among the 12 studied—91 percent of those families had coverage.

And while statistically less significant, the reports also show that hundreds of thousands of families in each of the 12 states will spend more than 25 percent of their pre-tax income on healthcare.  Do the math; the results of the equation are less than heartwarming.

As financial pressures from a slumping U.S. economy continue to attenuate household budgets (and without real wage gains to keep pace with rising healthcare expenditures), hospitals and physicians in private practice appear more likely in 2008 to face bad debt risk from a population whose medical care is insured, but whose economic stability is anything but assured.