Health Insurance and Mortality in US Adults

By Andrew P. Wilper, MD, MPH, Steffie Woolhandler, MD, MPH, Karen E. Lasser, MD, MPH, Danny McCormick, MD, MPH, David H. Bor, MD, and David U. Himmelstein, MD
American Journal of Public Health
September 17, 2009
Conclusions
Lack of health insurance is associated with as many as 44,789 deaths per year in the United States. The increased risk of death attributable to uninsurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance. Despite widespread acknowledgment that enacting universal coverage would be life saving, doing so remains politically thorny. Now that health reform is again on the political agenda, health professionals have the opportunity to advocate universal coverage.
http://www.ajph.org/cgi/content/abstract/AJPH.2008.157685v1

This study analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III) conducted by the National Center for Health Statistics (NCHS). This was a scientifically rigid analysis of a highly credible data source. The study concludes that the deaths of about 45,000 people each year are associated with the lack of health insurance.
A previous, widely-quoted study from the Institute of Medicine concluded that each year the deaths of 18,000 people are related to a lack of health insurance. This number was updated to 22,000 by a study from the Urban Institute. The current study indicates that 45,000 is a highly credible number and can be used as a reasonable estimate of the extent of the problem.
The precise number does matter for those individuals unfortunate enough to become a member of this statistical group. But an exact count is not important for those of us attempting to provide health care justice for all. We know that uninsurance kills people and that it must be eliminated.
Congress and the Obama administration have selected a model of reform that has no hope of insuring everyone. Their model includes hardship waivers that explicitly acknowledge this unacceptable deficiency. It is astonishing that they continue to reject a less expensive and more efficient model that automatically insures everyone: a single payer national health program. You would think that they would show some interest in a model that actually saves lives.

By Andrew P. Wilper, MD, MPH, Steffie Woolhandler, MD, MPH, Karen E. Lasser, MD, MPH, Danny McCormick, MD, MPH, David H. Bor, MD, and David U. Himmelstein, MD
American Journal of Public Health
September 17, 2009

Conclusions

Lack of health insurance is associated with as many as 44,789 deaths per year in the United States. The increased risk of death attributable to uninsurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance. Despite widespread acknowledgment that enacting universal coverage would be life saving, doing so remains politically thorny. Now that health reform is again on the political agenda, health professionals have the opportunity to advocate universal coverage.

http://www.ajph.org/cgi/content/abstract/AJPH.2008.157685v1

Comment:

By Don McCanne, MD

This study analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III) conducted by the National Center for Health Statistics (NCHS). This was a scientifically rigid analysis of a highly credible data source. The study concludes that the deaths of about 45,000 people each year are associated with the lack of health insurance.

A previous, widely-quoted study from the Institute of Medicine concluded that each year the deaths of 18,000 people are related to a lack of health insurance. This number was updated to 22,000 by a study from the Urban Institute. The current study indicates that 45,000 is a highly credible number and can be used as a reasonable estimate of the extent of the problem.

The precise number does matter for those individuals unfortunate enough to become a member of this statistical group. But an exact count is not important for those of us attempting to provide health care justice for all. We know that uninsurance kills people and that it must be eliminated.

Congress and the Obama administration have selected a model of reform that has no hope of insuring everyone. Their model includes hardship waivers that explicitly acknowledge this unacceptable deficiency. It is astonishing that they continue to reject a less expensive and more efficient model that automatically insures everyone: a single payer national health program. You would think that they would show some interest in a model that actually saves lives.