You might be surprised to know that a large number of families driven into medical bill debt are the so-called middle-class. These are families who can afford to pay insurance and more than likely, own insurance. But they are caught in a rock-and-a-hard-place situation: too moneyed to avail of the government assistance program but not nearly rich enough to settle their bills,without necessarily finding themselves buried in debt.

These are the country's underinsured and, for all intents purposes, the country's overlooked. Statistics from ten years ago revealed that as much as 70% of the underinsured were pushed to brink of bankruptcy because of medical bill debt. The figures today aren't much better because the broken health system remains. The numbers could even have ballooned when the financial crisis of 2008 and the ensuing US recession left millions of families struggling to stretch their monthly household budgets.

In America today, more than ever, nobody is allowed to get sick. Moreso the underinsured.

To be sure, the reforms will not be easy because the problems cuts across the supply and service chain. From loopholes in health laws, insurance companies that take advantage of these gaps to decline claims, to doctors saddled with non-payments of services and high malpractice lawsuits and finally, to employers who are forced to pass on to their employees the burden of paying for their insurances in order to cut costs. (We are not even mentioning those employers who take advantage of the economic crunch to eschew paying for insurance.)

Creating a perfect storm is the lack of extra money as families realign savings to pay for the mortgages, utility bills, education and day-to-day expenses. Without savings of their own, it goes without saying that they couldn't afford to pay the co-pays or co-insurance requirements as well as the deductibles, or if their insurance policies do not cover the medical procedure they are seeking.

More often than not, it's not the catastrophic disease that contributes to a medical bill debt when you have no more savings. It's the little things. Consultations that you postponed because you couldn't pay the doctor's fee, procedures you deferred due to lack of money, and the medicines you failed to purchase. These variables add up over time, either your condition worsens or your savings deplete.