Excess Mortality Associated With Lack of Health Insurance: 44,000 people a year.

Yesterday I saw an editorial cartoon that noted, with the appropriate figure of Death, that 44,000 Americans were dying every year due to a lack of health insurance.  I hadn’t seen anything in the headlines about it, so (naturally) I Googled the phrase.  The first result to show up was a .pdf file of a research article published in 2009 in the American Journal of Public Health.  This study found a relative risk (RR) of mortality, adjusted for the most likely confounders, of 1.40, meaning that if you don’t have health insurance (even if it’s because you’re a drunk) you are 40% more likely to die.  The RR, adjusted only for age and gender, of adults between 17 and 64, was 1.80, meaning that certain conditions, like smoking and drinking, raise your risk of not having health insurance in addition to making you sick.

So the figures, when extrapolated to the entire USA (the only developed country in the world that doesn’t have universal health insurance), come out to almost 45,000 people a year dying simply because they do not have health insurance.  Not because they don’t have access to care, because they can still buy it with cash (or go to the emergency room) and do when they can afford it.  But simply because they don’t have health insurance.  They can still get treated for their heart attacks and strokes in the emergency room, but they can’t afford to take preventive care, nor can they afford aftercare once they are released from the hospital (assuming they survive.)

This is a crime, and it ranks right up there with drunk driving, deaths due to firearms, and medical misadventures (getting killed by medical treatment.)

The ACA (Obamacare) will help a little, but there will still be eight million people who can’t get Medicaid or subsidized insurance because their Republican state governments have refused to accept (free!) expansion of Medicaid in their states.  That’s less than the 47 million or so people who now don’t have insurance, but it’s still far from “universal”, which every other developed country in the world has.   Whatever happened to America the greatest country in the world?  Oh, well, at least we still have the most firearms per capita and the most people in jail as a proportion of the total population.

I know I sound like a broken record, but there really is no substitute for universal health “insurance”, by which I mean everyone has health care, paid for by the government through progressive income taxes.  There is also a desperate need for reform of the medical supply and pharmaceutical industry in this country.  In addition to not having universal health care, we also have approximately double the cost of health care delivery compared to every other developed country.  We must pressure our elected officials to take care of these problems, because we can easily demonstrate that they are killing tens of thousands of Americans every year.

If you are interested in the original study, here is the URL: http://www.pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf