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Sep 17, 2009 05:24 PM | 47
Going without health insurance can delay when people obtain primary and preventative care, potentially resulting in poorer health. Even more gravely, a lack of private health insurance brings an increased risk of death; uninsurance is to blame for some 44,789 adult deaths across the U.S. every year, according to a new study published online today in the American Journal of Public Health.
The findings show that uninsured Americans—between the ages of 17 and 64—have a 40 percent higher risk of death than those who have private insurance. (Those enrolled in government insurance programs, such as Medicaid and Department of Veterans Affairs insurance, were excluded from the study.) About 46.3 million Americans didn't have health insurance as of 2008, according to the U.S. Census Bureau, and the number is estimated to be higher now since the recession has forced many off of employer health plans.
Previous research by the Institute of Medicine (IOM) employing older data had put the risk of death due to uninsurance closer to 25 percent.
The authors analyzed information from surveys and health examinations of more than 9,000 people that was collected by the Centers for Disease Control and Prevention (CDC) between 1986 and 2000 and checked against death records. Even after controlling for age, gender, race, income, education, employment, smoking, alcohol use, assessed health and BMI, the researchers found "lack of health insurance significantly increased the risk of mortality," they wrote in the paper.
"We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease—but only if patients can get into our offices and afford their medications," Andrew Wilper, of the University of Washington Medical School in Seattle, and lead study author, said in a prepared statement.
Indeed, the authors concluded that their findings show 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."
Intermittent insurance also appeared to take a toll on health, the authors wrote, although the survey provided no information on the effects of losing or gaining insurance, as it only recorded reported insurance status at the time the survey was taken.
"The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance," David Himmelstein, a study co-author and associate professor of medicine at Harvard, said in a prepared statement. "Even this grim figure is an underestimate—now one dies every 12 minutes."
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47 Comments
Add CommentI would sure be interested in comparing private insurance to the VA. I would also like to know what job the bureauacrats in the VA my dad's VA physician was appealing her request for care to held. All her appeals were denied (I think she said she got 3) and unfortunately, she was right and they were wrong (regarding whether his problem was "life threatening"). I don't want to call the panel a "death panel" but the outcome was he was denied care and died because of that.
Reply | Report Abuse | Link to thisNow, how many deaths due to car accidents and plain stupidity and how many trillions will we pay to eliminate them?
Murdered by the Republican Party.
Reply | Report Abuse | Link to thisDolmance you are totaly ignorant, the Dems have been running the congress for years, wake up and smell the roses. There is no way of deciding how many deaths can be attributed to insurance. Its all about lies, socialism and propoganda and a media hiding under the table. SA should be ashamed taking a position like this.
Reply | Report Abuse | Link to thisThe study says nothing about whether people were actually insured or not at the time of death. Quote: "We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey.... to determine whether uninsurance at the time of interview predicted death." So how does one draw the conclusion that lack of insurance caused death. Their conclusion was "Uninsurance is associated with mortality" whereas SA declared there was causality. VERY POOR logic. Shame on SA.
Reply | Report Abuse | Link to thisrougarou, the ignorant seem to always claim others.
Reply | Report Abuse | Link to thisThere is sufficient data to suggest that "not having insurance" increases your risk of untreated or under-treated life threatening illness by 1.4 times that of an average american. There is no claim of a direct relationship between not having insurance and deaths. Not having insurance wont kill a diabetic, but not being able to afford the insulin they require will.
If you actually understood the article you would know that. Quit automatically dismissing valid information simply because nuts like Glenn Beck tell you to; think for yourself, it's easy and fun!
The study says nothing about whether people were actually insured or not at the time of death. Quote: "We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey.... to determine whether uninsurance at the time of interview predicted death." So how does one draw the conclusion that lack of insurance caused death. Their published conclusion was "Uninsurance [AT SOME POINT PRIOR TO DEATH] is associated with mortality" whereas someone declared there was causality. VERY POOR logic. Go look at causes of death to convince me. Rubbish.
Reply | Report Abuse | Link to thissciam. we respectfully request you not allow the submission of articles with intellectually dishonest headlines. if or when lack of health insurance is classified as a disease like scurvy that is caused by a vitamin deficiency, then it can be a cod. but that day is not today, thank you and good night.
Reply | Report Abuse | Link to thissciam. we respectfully request you not allow the submission of articles with intellectually dishonest headlines. if or when lack of health insurance is classified as a disease like scurvy, that is caused by a vitamin deficiency, then it can be a c.o.d. but that day is not today, thank you and good night.
Reply | Report Abuse | Link to thisThough I admit that the statment:
Reply | Report Abuse | Link to this"uninsurance is to blame for some 44,789 adult deaths across the U.S. every year, according to a new study published online today in the American Journal of Public Health. "
is weaselly, the report doesn't not claim causality but relates the two discrete causal domains (no insurance, mortality) correlatively with sufficient evidence to back it up.
When I read the "socialism," part, I realized you were regurgitating industry written nonsense, passed along through Glenn Beck.
Reply | Report Abuse | Link to thisDemocrats have been trying to pass health insurance for at least fifty years.
The private insurance industry and their Republican enablers kill more Americans every single week than Osama Bin Laden killed on 9/11.
Reply | Report Abuse | Link to thisSocialism and propaganda This is all about greed.In the fairytale world people would not smoke and would follow doctors orders eat well. Half the people i work with have no insurance but they brag about the new car and now me the responsible one have to pay again . You play you PAY!
Reply | Report Abuse | Link to thishow about figuring in the higher death rate of patients who have "good insurance"
Reply | Report Abuse | Link to thisALL THESE ARE DEATHS PER YEAR:
* 12,000 -- unnecessary surgery
* 7,000 -- medication errors in hospitals
* 20,000 -- other errors in hospitals
* 80,000 -- infections in hospitals
* 106,000 -- non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!!
how about figuring in the higher death rate of patients who have "good insurance"
Reply | Report Abuse | Link to thisALL THESE ARE DEATHS PER YEAR:
* 12,000 -- unnecessary surgery
* 7,000 -- medication errors in hospitals
* 20,000 -- other errors in hospitals
* 80,000 -- infections in hospitals
* 106,000 -- non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!!
how about figuring in the higher death rate of patients who have "good insurance"
Reply | Report Abuse | Link to thisALL THESE ARE DEATHS PER YEAR:
* 12,000 -- unnecessary surgery
* 7,000 -- medication errors in hospitals
* 20,000 -- other errors in hospitals
* 80,000 -- infections in hospitals
* 106,000 -- non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!!
SORRY FOR 3 XS SUBMISSION I DIDN'T REALIZE IT HAD been accepted
Reply | Report Abuse | Link to thispeople without insurance have less deaths then those who do!!!! if you believe this article
Reply | Report Abuse | Link to thisIf the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).
Reply | Report Abuse | Link to thisAnother analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings,with:
* 116 million extra physician visits
* 77 million extra prescriptions
* 17 million emergency department visits
* 8 million hospitalizations
* 3 million long-term admissions
* 199,000 additional deaths
* $77 billion in extra costs
The high cost of the health care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care.
However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.
An estimated 44,000 to 98,000 among them die each year as a result of medical errors.
"LogicalPhallacy". Once is enough. Personally, I'm baffled as to how anyone can deny that if someone can't afford to go to the doctor, that they could delay treatment until it's too late. I've been without insurance. It can be a scary situation. Especially with kids.
Reply | Report Abuse | Link to thisBiased, liberal articles like this is why I am only a web site reader and not a subscriber to SciAM. Can't we at least have some journalistic integrity in a SCIENCE magazine? We know we can't count on the MSM.
Reply | Report Abuse | Link to thisYou do realize that SA is not making a normative claim in this article, right? They are merely reporting the results of study published in an academic journal. Even that study doesn't provide any normative ('should') commandments on how we should handle this from a policy perspective. The study results purportedly show a correlation between being uninsured and a higher risk of mortality. That is all. If you're reading a normative statement into it, then that's YOUR problem.
Reply | Report Abuse | Link to thisLogicalPhallacy correctly identifies that the study only shows a statistical correlation, and not strong causation between uninsurance and increased mortality, however, I think a lot of people commenting here are committing another fallacy, namely missing out on the distinction between descriptive and normative claims as stated above.
Reply | Report Abuse | Link to thisObviously skewed. They're taking the standards of care developed by privately insured medical care and saying that if our government had been running the system for the last several decades these deaths would not have occured. The standard of care would be much lower if our government was running the system, for the several decades it takes to get ill and die from the cited diseases.
Reply | Report Abuse | Link to thisYes it is skewed, by it's nature; accurately predicting how the load on the health system would effect the quality of care is prohibitively difficult. But the skew could be in the studies favor; you can't really say if increased government involvement in healthcare would be detrimental to its quality.
Reply | Report Abuse | Link to thisdeath to the insurance companies
Reply | Report Abuse | Link to thisjpschaeffer ... Congratulations. It is rare and interesting to see someone engage in the American Health System debate with facts and figures. Your response is unlike "LogicalPhallacy" who makes a valid point regarding the article cited by SA then adds all the screams and righteous indignation of most pundits engaged in the debate. SA should be the one place that actually examines the purported facts of the debate. "Facts", presented by the right or left.
Reply | Report Abuse | Link to thisDuring the last part of my career, I got to examine Health Systems around the world. The American debate is so far from reality, so filled with ideology, with no desire to check facts, numbers or experience that it is unlikely you will be able to make the right decisions for yourself.
One fact, probably not know by Americans. Because we in Canada are following your debate with interest, American proponents of each (every) side have appeared on Canadian TV and in other Media. Their discussions are usually factual, friendly and collegial even if opposing. Switch to an American TV channel and there they are again -- yelling and screaming at each other.
I don't understand it.
"Previous research by the Institute of Medicine (IOM) employing older data had put the risk of death due to uninsurance closer to 25 percent."
Reply | Report Abuse | Link to thisSo, 25% of people without insurance die every year?
It seems to me that many of the comments responding to this article are based on a predisposed ideology, which then becomes the prism through which the article is interpreted. Not exactly the type of reasoned response one would expect from Scientific American readers.
Reply | Report Abuse | Link to thisIt seems to me that many of the comments responding to this article are based on a predisposed ideology, which then becomes the prism through which the article is interpreted. Not exactly the type of reasoned response one would expect from Scientific American readers.
Reply | Report Abuse | Link to thisSorry, but not being able to afford insulin will not kill you. If your income is that low, there are government programs that will pay for it.
Reply | Report Abuse | Link to thisSpeaking of the government, this study was funded by the government. Interesting timing isn't it. Reminds me of the tobacco company studies that confirmed smoking was not hazardous to your health.
Nothing wrong with SciAm running this, but it strictly belongs under the Society and Policy category.
maybe I'm wrong for taking publically published articles, or interperitations of them at face value, but I do. I understand that 44,000 people a year don't die as a direct result of lacking insurance coverage, and I can only assume that sciam, and perhaps the blogger that wrote the article covering the study understand this as well from having more experience in journalism feilds than I have. but the misleading title was still chosen either with, or without regard of it's potential implication. so I can only the decision to accept the article with it's current title is irresponsible at best.
Reply | Report Abuse | Link to thisyes, once is indeed enough. sorry for the muliple posts but this site slows my browser down something fierce and I thought the screen froze agian. any way, legally (in this country any way) no medical institution can deny medical treatment to those who need it.
Reply | Report Abuse | Link to thisto leizmonk: actually I didn't make that correction, but thank you for giving me pkamer's credit. all I did was question the language of the interperating article.
I am Canadian. None of my realtives have ever had to go without care. None have ever had to "spend down" for care, especially when they were elderly. In US, The Medicaid Estate Recovery Act can take ALL you have after Medicare cuts off which is after only 100 days in a nursing home.
Reply | Report Abuse | Link to thisThe reason Limbaugh et al hammer on "wait times" is because Canada was responsible enough to set up a panel to study wait times. And each province and each county has their own wait times.
In US, there is no panel. If you must wait 2 years to see a neurologist, no one can tell you if that is normal wait time or not. No one is trying to reduce wait times in US because it is the wild west.
Say what you like, the Canadian system is beyond better...it preserves life. Bottom line. And that is why the Canadians have a longer life span. Worth every extra tax, which is not that much. It's been rated the best place to live 6 years in a row.
Darwin
Reply | Report Abuse | Link to thisI am not quite sure what you use to base the idea that the standard of care would be much lower if our government would be running it - unless one assumes that anything that the government does is, by definition inferior. I would suggest that this is a fallacy. Every time it seems that the government is doing a poor job, I would suggest that it is because the government has outsourced the job to a for-profit organization.
Reply | Report Abuse | Link to thisI realize that this is against the conventional wisdom, but given the debacles of late that have occurred in for-profit organizations keeling over one after the other, it is time to examine the shaky foundations of these assumptions. Consider the fact that there are dozens of countries out there whose governments are capable of providing better healthcare than our for-profit health "care" system. If one thinks about it for more than a few seconds, this makes sense. A for-profit organization wants to make a profit. The government organization wants to provide a service. For anyone who doesn't work for an insurance company, this is a good deal.
I would suggest that this study underestimates the deaths due to lack of insurance. Every year, about 600,000 Americans suffer bankruptcy due to unpayable medical bills. Over the course of an approximately 50-year adult lifetime, that's 30 million people, or 10% of the population. It is possible that the simple stress of having to live under such a system could explain the fact that Americans have a lower life expectancy than our European counterparts.
Reply | Report Abuse | Link to thisAt this point in time, the "healthcare" industry can be expected to steal 2-3 years of life from the average American. Unfortunately, this number is only going to rise. Unless we get what Obama is trying to get for us, healthcare costs will continue to rise and more and more people will go bankrupt because of being unable to pay their medical bills.
There are too many people doubting the accuracy of the figures. Whether or not there are people dying every 12 minutes, whether or not you are a republican or a democrat, whether or not you believe the news, it is time for all of us to grow up. As Americans, we seek to eliminate the dangers and pain and suffering in our society. We have police forces to guard against certain dangers. We have systems in place for the military, the safety of our airlines, guarding us against many things including bad roads or poor water quality.
Reply | Report Abuse | Link to thisA national health plan to offer competitive rates to the uninsured makes sense and is not a threat to all of you who have private insurace. Time to grow up and act like a true American. You will have friends and neighbors and children dying if you continue to oppose a health plan. This would have been much less expensive if it had been passed into law in 1976, the first year I can remember such a bill being presented. All of our health costs would have been reduced for over a quarter century. Blocking this bill today will make things more expensive in the future even for those who are insured.
Grow up.
All of these innocent "victims" (including not a few children) were murdered by the AMA aided and abetted by all the right-wingers for whom "socialism" is a fate worth than death as long as it is not their death.
Reply | Report Abuse | Link to thisThe opposition to a viable health-care plan seemingly believe that THEY will never themselves be struck down by this "bankruptcy bug". Most likely 600,000 is a low-end estimation. And it will only get worse and worse. Thank the stars that I live in a civilized country with socialized health care. I do not have to worry night and day that I will end my old age in misery, living on the street just because I fall ill.
Reply | Report Abuse | Link to thisCertainly, jpschaeffer, the actual numbers of deaths due to iatrogenic causes are higher, but the researchers took into account all mortality, and found that the uninsured had a significantly higher mortality rate. If more people were uninsured, the overall mortality rate would be higher. Your comments demonstrate a lack of understanding of statistics. There are more deaths per 100 uninsured people than per 100 uninsured people.
Reply | Report Abuse | Link to thisVery well said. The trouble, however, is that the people against this plan (including a lot of professed "Christians") care not an iota about the suffering and death of even little children, not even their neighbors. What they care about is only themselves. This is sometimes described as the "me" generation, and it will only grow worse. Your voice, sadly, is one crying in the wilderness. Interestingly, so-called secular nations have national health-care plans to care for everyone, but not "Christian" America.
Reply | Report Abuse | Link to thisMany diseases are silent killers, with symptoms only caught by an alert physician. If you do not see your physician yearly, you may die even with insurance. Blood pressure can skyrocket in less than a month due to a blockage. When did you last check your BP? How many people use the free BP machine at the mall? If you don't have insurance, you probably don't want to know. You will probably ignore or put off checking on that lump or fuzzy mole - if you even find it.
Reply | Report Abuse | Link to thisThis fool is from Sri Lanka or never-never land. The Democrats just "took over" Congress a c few months ago. I suppose that he thinks Obama took us to war with a country that was absolutely no threat to us. Between Bush and Cheney and their lies..."they are going to get us with their weapons of mass destruction"...their torture, their spying on us, their taking of more of our freedoms, signing statements, etc...poor Obama's task of running this once great nation is one of the biggest challenges ever taken on by any president. I'm just glad that we're rid of that messianic evangelical freak, Bush, and his whole administration.
Reply | Report Abuse | Link to this1. Who want to see 'Cash for Clunkers' in the US Medical Industry? This is a terrible program favoring one industry over others with subsidies and destroying vehicles that are re-usable and can be salvaged for parts. We think the costs are so puny to start with. Wait until it's a 70 billion a year program, knocking out any real solution that might come along. This is what we'll get with government run health insurance.
Reply | Report Abuse | Link to this2. It is false reasoning to suggest that people are responsible for killing others because we won't have our taxes raised and let the government control more of our lives in order to pay their medical insurance. This is the immoral, false reasoning at the center of Liberal-Fascism: you are to blame for a child starving because you live the way you choose. And you also killed her parents because you wouldn't pay their insurance for them.
3. The real issue is Universal Health Care no matter what it is you do to yourself. People who practice good, preventive health care should have their insurance cut in half; people who want to do what they will should have their insurance raised; and people who can't afford insurance who are very healthy should have their insurance paid by government matching grants with charities, private foundations, and elective donations by individuals. People who are poor who don't take good care of themselves usually need other programs for addicition or mental health.
4. I'm tired of hearing from Canadiens with their 'swim in the wake Socialism'. It's great that they can prosper while swimming in our wake but they're not doing the heavy lifitng or pulling. Maybe if we all find someone's wake we can swim in we can have peace on Earth, eh?
Pensatulla, no one is asking you to pay for anything. All we are asking is that we be allowed to pool our bargaining power so that we can negotiate favorable rates with insurance companies. If you don't like it, you don't have to pay.
Reply | Report Abuse | Link to thisMedicare was formed and stays because insurance companies don't want to pay for high risk patients - the oldest ones. In a true enterprise system, we would cancel Medicare. But that would mean that insurance companies would have to fend for themselves. Some of us are tired of giving government handouts to the insurance companies.
Having no insurance can be beneficial as well as is shown in one of the latest articles in Journal of Pediatric Surgery.
Reply | Report Abuse | Link to thisOperations for congenital anomalies can be complicated and are usually transferred to tertiary centres. But if you have an insurance, even non specialized hospitals will try to keep these babies to earn big money. If you are not insured you will be transfered. "The paradocal effect of medical insurance on delivery of surgical care for infants with congenital anomalies"
Its a very good one blog
Reply | Report Abuse | Link to thisalso check this out
http://www.needinsuranceusa.blogspot.com/