Filler: Picking the health care winners and losers

In the wake of the massacre that unfolded at a midnight showing of "The Dark Knight Rises" in Aurora, Colo., a lot of people realized that letting wounded survivors be bankrupted by medical bills would be cruel. People came to see this because they could attach faces to the tragedy, and thus feel sorrow, which led to empathy, and then action.

At least three of the five Aurora-area hospitals treating these victims have said they will not be billing the injured for their care. The uninsured will receive no bills. Those with insurance will not be held responsible for co-pays. The other two facilities are the state's top safety-net hospitals, dispensing over $750 million annually in free treatment, and likely won't be hounding the injured for cash either.

Instinctively, that feels right. Handing huge tabs to victims of a bloodbath would be the perfect example of the phrase "adding insult to injury."

Once out of the hospital, many of the injured will face expensive rehabilitation. The producers of "The Dark Knight Rises," a fabulously successful movie, say they will donate millions to defray these costs. And family members have begun raising money toward the rest of the expenses, apparently with some success.

So we have agreed, as a civilized society, that we don't want these victims bankrupted by the violence of a madman. But this naturally raises a question: Do we really want the victims of any crazy-bad luck leading to grievous medical issues to be bankrupted?

Until recently, a debate raged over whether 9/11 responders suffering from cancer should be covered by the federally funded Zadroga Act so that their lives would not be destroyed by their staggering medical bills and income loss. The issue was whether it could be proven their cancer came from working the pile.

Does that mean, if it were proven the cancer was unrelated to their sacrifice at the site, we could have said, "Whew, what a relief, now we can be comfortable with these heroes' lives being destroyed because it's not verifiably related to a national disaster big enough to warrant memorials?"

It's not that we believe no one deserves to go bankrupt. People earning $26,000 a year who bought $400,000 houses deserve to go broke. Folks who believe that when black comes up on the roulette wheel the ball will almost certainly land on red next time earn the poverty likely to ensue. And people (me, I mean) who base their retirement plan on purchasing Powerball tickets and searching for previously unknown, fabulously wealthy relatives on Ancestors.com? Whatever horrid things our sunset years bring will be karmically fair.

But studies suggest about 60 percent of Americans who declare bankruptcy do so because of a medical problem, and about three quarters of those have health insurance. They're not imprudent wastrels. They're just sick, then broke.

This isn't a column about how to fix and fund our health care system. Today I'm exploring how we decide which victims deserve care, and love, and solvency -- and which don't.

Every day, all over the country, men and women and children are shot and grievously wounded. Statistics suggest a whole bunch of someones will survive such violence today. Some will have no insurance. Others will be covered, but face co-pays larger than their assets, or bills from treatment and rehabilitation that exceed coverage caps. They'll be twice unlucky: first, to have been injured, and second, to have been injured in a way that did not make them nationally celebrated and beloved.

They shouldn't be bankrupted by the medical bills their horrid luck brings. But I fear they're not going to become famous enough to avoid it.