One of the fundamentals of healthcare reform is applying the cost of receiving care to the true quality of actual care that is received, creating a perception of quality in the process. Oftentimes, this is where the myriad criticisms and critiques of the reform model begin to diverge. One key quality aspect of reform is the promise of care delivered in a cost-effective manner — something Insurance obviously has a stake in, but healthcare consumers as well. Is the axiomatic “you get what you pay for” applicable to reform? With respect to the number of personal bankruptcies due to medical costs for consumers in the nation’s bellwether of reform — Massachusetts — one study fails to show a benefit to consumers’ wallets. Researchers took a random sample of Massachusetts’ bankruptcy filers in July 2009 and sent surveys to 500 households. The Massachusetts healthcare reform was implemented in 2008 — they compared their data to 2007 information. Medical bills were still 52.9 percent of all bankruptcies in the state. One of the study’s authors cited the still too prohibitive cost of insurance for some of the insured, creating offsets that still levied higher expenses for the delivery of care to the uninsured in the state.