Does Lack of Insurance Cause Premature Death?
Physicians for a National Health Program (PNHP) has just repeated the exercise (with all its methodological sins) and boosted the tally to a 40% increase in the probability of dying for the uninsured. That produces a whopping 45,000 premature deaths every year — almost as bad as the Vietnam War. And, yes, we get a state-by-state breakdown. There will be 5,302 deaths attributed to uninsurance in California this year. There will be 75 in Wyoming, etc., etc. There is even a minute-by-minute tally: “The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” says David Himmelstein, one of the authors. “Now one dies every 12 minutes.”
These and other myths are mercilessly slain by yours truly at the Health Affairs blog.
Great post. I think you slayed the dragon.
Terrific piece. Congratulations.
Also, very well written. You have a way of undercutting silly ideas.
Forgive me for asking: If being uninsured increases my probability of dying, does the same premise hold true for all types of insurance? Am I more likely to crash my car if I don’t have auto insurance? Is my house more likely to catch on fire without homeowner’s insurance?
It’s not a dragon, but a zombie: Kill it as many times as you like, it will come back again and again as long as the media fall for it.
The article is a little opaque, so I might have this wrong, but the authors estimated 35,327 deaths associated with lack of health insurance when considering all Americans aged between 18-14. However, when they estimated without “age stratification”, they estimated 44,789.
Table 1 segments the sample by age: the younger groups are more likely to be uninsured than the older ones (29% for those aged 17-24 versus 9% for those aged 55-64). They are also less likely to have died at the end of the period (1% for those aged 17-24 and 11% for those aged 55-64).
So, if the model assumes (utterly unrealistically) that lack of health insurance at the initial interview persists, and adjusts the death rate as the sample ages, the more accurate conclusion is that aging is related to increased likelihood of death!
conversely, if I do have health insurance, will I never die?