Study Links 45,000 U.S. Deaths a year to lack of Insurance (1 Viewer)

[N.O.Bronco]

WASHINGTON (Reuters) - Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.

"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

The findings come amid a fierce debate over Democrats' efforts to reform the nation's $2.5 trillion U.S. healthcare industry by expanding coverage and reducing healthcare costs.

The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance.

An similar study in 1993 found those without insurance had a 25 percent greater risk of death, according to the Harvard group. The Institute of Medicine later used that data in its 2002 estimate showing about 18,000 people a year died because they lacked coverage.

Part of the increased risk now is due to the growing ranks of the uninsured, Himmelstein said. Roughly 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reported last week, up from 45.7 million in 2007.

Some critics called the study flawed.

The National Center for Policy Analysis, a Washington think tank that backs a free-market approach to health care, said researchers overstated the death risk and did not track how long subjects were uninsured.

http://www.reuters.com/article/newsOne/idUSTRE58G6W520090917

http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf



Even if it is partially flawed, even if it is half of what the results say, its unacceptable. People shouldn't be dying because they cant afford medical coverage.

 

[BullDawg]

To put this into perspective, according to the CDC for 2006, the leading cause of death was heart disease standing at 631,636. That was out of the total of 2,426,264 deaths. Therefore the number of deaths attributed to the lack of insurance is less than 2% of the total.

http://www.cdc.gov/nchs/fastats/deaths.htm

 

[TulsaSaint]

Therefore the number of deaths attributed to the lack of insurance is less than 2% of the total.

Does this make 45,000 deaths acceptable? I guess since drunk driving kills even fewer Americans per year, perhaps we shouldn't worry about DUI either, eh? C'mon, BD, don't try to muddy the waters.

 

[BullDawg]

Does this make 45,000 deaths acceptable? I guess since drunk driving kills even fewer Americans per year, perhaps we shouldn't worry about DUI either, eh? C'mon, BD, don't try to muddy the waters.

It's not muddying the waters. It's clarifying the subject.

Consider this. In any successful management plan known to man, you identify your biggest problems first and focus on them. Why focus your limited resources on the <2% when your biggest problem, heart disease, is responsible for >26% of your annual deaths?

 

[BullDawg]

To go further, you break down the root causes for heart disease. I don't have the numbers right in front of me and don't really have the time to research them all at this time of day while I'm trying to catch up from the past 2 weeks. But suffice to say the leading indicators have reportedly been tobacco use and obesity. So you again break down the leading indicators (I believe obesity has surpassed tobacco but won't swear to it) and you'll find the obvious two...diet and exercise. Now you would be hard pressed to force people to exercise, but you could offer incentives to businesses that encourage and support daily exercise programs, increase your physical activities at public schools, etc. You could also look at the root cause of dietary problems such as high-fructose corn syrup (which the government could do something about) and whatever other factors can be identified through in-depth analysis.

Not only would you be saving more lives, you would decrease the need for medical visits thereby lowering insurance costs. Lower insurance costs would result in less of your population lacking adequate coverage.

 

[Yatman]

As long as we're going to spend all this cash, someone might want to address hospital-caused deaths, which are more than quadruple the cited total due to inadequate care through lack of insurance.

An estimated 200,000 Americans will lose their lives in 2009 alone due to preventable medical errors and hospital infections. This startling information comes from a new investigative report released by the Hearst Corporation called “Dead By Mistake.”

 

[MamaSaint]

Perhaps many of the 45,000 had untreated heart disease due to lack of insurance.

Each of those 45,000 has a face, a name, family and/or friends. If the deaths of even half of that number could have been easily prevented if insurance was available for treatment, it is an unacceptable number in our society.

Jan

 

[cdogg]

To go further, you break down the root causes for heart disease. I don't have the numbers right in front of me and don't really have the time to research them all at this time of day while I'm trying to catch up from the past 2 weeks. But suffice to say the leading indicators have reportedly been tobacco use and obesity. So you again break down the leading indicators (I believe obesity has surpassed tobacco but won't swear to it) and you'll find the obvious two...diet and exercise. Now you would be hard pressed to force people to exercise, but you could offer incentives to businesses that encourage and support daily exercise programs, increase your physical activities at public schools, etc. You could also look at the root cause of dietary problems such as high-fructose corn syrup (which the government could do something about) and whatever other factors can be identified through in-depth analysis.

Not only would you be saving more lives, you would decrease the need for medical visits thereby lowering insurance costs. Lower insurance costs would result in less of your population lacking adequate coverage.

Add healthy school lunches. Why are we feeding pizza and french fries every single day to kids K-12th grade? That's a travesty. Or at least they were when I was in school.

 

[Severum]

Not only would you be saving more lives, you would decrease the need for medical visits thereby lowering insurance costs. Lower insurance costs would result in less of your population lacking adequate coverage.

Yep. Any serious health care reform plan would focus on lowering the incidence of preventable diseases while expanding coverage to everyone in order to save both lives and money.

 

[saintsfanflorida]

How much is one life worth? That is what we're trying to quantify here, right?

 

[N.O.Bronco]

It's not muddying the waters. It's clarifying the subject.

Consider this. In any successful management plan known to man, you identify your biggest problems first and focus on them. Why focus your limited resources on the <2% when your biggest problem, heart disease, is responsible for >26% of your annual deaths?

hmm, never knew you couldn't do more than one thing at a time. Good to know.

We should probably go ahead and quit focusing on curing cancer or trying to find cures for HIV as well, it isn't killing nearly as many people.

Im being sarcastic obviously. There is no rule that says you can't deal with both. the problem is is that it is much more difficult to deal with eliminating heart disease than it is stopping these unnecessary deaths. And yes, in that process of providing them insurance you are also going to bring down that numbers because as mamasaint said, there is no doubt some people dying of heart disease that could have been prevented had they had insurance.

Heart disease is a cultural, individual, systemic, agricultural and economic problem. To say we should postpone covering those people until we completely fix this problem is asking the impossible. You cant control everyones food, you cant magically change the culture and habits of 300 million people and the amount of political capital and support it would take to eliminate most of those subsidies and things like corn syrup are much harder than getting healthcare reform passed. Theres a reason Obama stopped quoting Michael Pollan once he got elected.

 

[AeonSaar]

This kinda reminds me of a 2005 Scientific American article entitled "Sick of Poverty". Apparently, your overall economic level has an effect on your susceptibility to sickness and disease.

Rudolph Virchow, the 19th-century German neuroscientist, physician and political activist, came of age with two dramatic events--a typhoid outbreak in 1847 and the failed revolutions of 1848. Out of those experiences came two insights for him: first, that the spread of disease has much to do with appalling living conditions, and second, that those in power have enormous means to subjugate the powerless. As Virchow summarized in his famous epigram, "Physicians are the natural attorneys of the poor."

Physicians (and biomedical scientists) are advocates of the underprivileged because poverty and poor health tend to go hand in hand. Poverty means bad or insufficient food, unhealthy living conditions and endless other factors that lead to illness. Yet it is not merely that poor people tend to be unhealthy while everyone else is well. When you examine socioeconomic status (SES), a composite measure that includes income, occupation, education and housing conditions, it becomes clear that, starting with the wealthiest stratum of society, every step downward in SES correlates with poorer health.

It is not a subtle
statistical phenomenon.
When you compare the highest
versus lowest rungs of the
socioeconomic ladder, the risk
of some diseases varies 10-fold

Inadequate Explanations
s o , t o u s e a m a r v e l o u s p h r a s e common to this
field, how does SES get “under the skin” and influence health?
The answers that seem most obvious, it turns out, do not hold
much water. One such explanation, for instance, posits that
for the poor, health care may be less easily accessible and of
lower quality. This possibility is plausible when one considers
that for many of the poor in America, the family physician does not exist, and medical care consists solely of trips to the
emergency room.
But that explanation soon falls by the wayside, for reasons
made clearest in the famed Whitehall studies by Michael G.
Marmot of University College London over the past three decades.
Marmot and his colleagues have documented an array
of dramatic SES gradients in a conveniently stratified population,
namely, the members of the British civil service (ranging
from blue-collar workers to high-powered executives). Office
messengers and porters, for example, have far higher mortality
rates from chronic heart disease than administrators and
professionals do [see top illustration at right]. Lack of access
to medical attention cannot explain the phenomenon, because
the U.K., unlike the U.S., has universal health care. Similar
SES gradients also occur in other countries with socialized
medicine, including the health care Edens of Scandinavia, and
the differences remain significant even after researchers factor
in how much the subjects actually use the medical services

Either way, it is undoubtedly a moral priority.

 

[abnrgr]

I'm not trying to argue, but I do want to understand some points here:1. The people didn't die of lack of health care. They perhaps died of a condition which could have been identified IF they had coverage and went in to get checked. I'm not trying to be a wise guy but that is a giant leap of logic. Would medical coverage have saved them or were they going to die anyway? I don't know the details or how they reached these conclusions.2. If we approach this from a legal standpoint (DUI/seatbelt analogy), do we simply make it a law that a person must have medical insurance? Wouldn't that be better than a completely government subsidized program?3. I really do care about people w/o coverage but if there are 45 million people w/o coverage how can the government pay for this? This is a huge problem that I think will burden the government.4. What level of care does anyone think government coverage will provide? I have visions of VA hospitals and waiting lines which take hours to get through. I am just trying to think is it realistic to think we can fix this through government programs?5. What about people with medical coverage who don't go to the hospital and die? What do we do about the stubborn? I am making a silly point here but why should the government take responsibility? What are the alternatives to a wholesale government program providing health care?

 

[BullDawg]

Perhaps many of the 45,000 had untreated heart disease due to lack of insurance.

Each of those 45,000 has a face, a name, family and/or friends. If the deaths of even half of that number could have been easily prevented if insurance was available for treatment, it is an unacceptable number in our society.

Jan

First off, nothing is free. So in order to ensure everyone has "adequate" insurance means resources have to be reallocated from somewhere. Do you risk removing those resources from where you can do the most good? Take a look at the following and identify common trends.

Number of deaths for leading causes of death:

• Heart disease: 631,636
• Cancer: 559,888
• Stroke (cerebrovascular diseases): 137,119
• Chronic lower respiratory diseases: 124,583
• Accidents (unintentional injuries): 121,599
• Diabetes: 72,449
• Alzheimer's disease: 72,432
• Influenza and Pneumonia: 56,326
• Nephritis, nephrotic syndrome, and nephrosis: 45,344
• Septicemia: 34,234

I've already mentioned obesity. Now look at the cumulative effect of tobacco use. Heart disease, cancer, strokes, and lower respiratory diseases are all caused/exasperated by smoking tobacco. Eliminate, or dramatically mitigate, that risk factor alone and you've potentially saved over a million lives annually. In short, you can't possibly save everyone. So where can you save the most?

hmm, never knew you couldn't do more than one thing at a time. Good to know.

We should probably go ahead and quit focusing on curing cancer or trying to find cures for HIV as well, it isn't killing nearly as many people.

Im being sarcastic obviously. There is no rule that says you can't deal with both. the problem is is that it is much more difficult to deal with eliminating heart disease than it is stopping these unnecessary deaths. And yes, in that process you are also going to bring down that number because as mamasaint said, there is no doubt some people dying of heart disease that could have been prevented had they had insurance.

Again, let's look at it statistically then. If 1.85% is the magic number, by focusing on health insurance coverage instead of the root cause(s) for the heart disease mortality rates, you'd potentially save 11,685 lives annually. That's less than half the number of fatalities attributed to alcohol abuse not counting alcohol-vehicle related incidents. Does that mean we should re-introduce alcohol prohibition in order to save those lives?

Yep. Any serious health care reform plan would focus on lowering the incidence of preventable diseases while expanding coverage to everyone in order to save both lives and money.

My counter argument is that by dramatically lowering the preventable, you would nearly eliminate the "need" for government mandated coverage. In other words, insurance would become more affordable for all by default. Would you still have uninsured? Of course you would for many reasons. At what numbers? I would postulate a fraction of what you see now.

 

[BullDawg]

Heart disease is a cultural, individual, systemic, agricultural and economic problem. To say we should postpone covering those people until we completely fix this problem is asking the impossible. You cant control everyones food, you cant magically change the culture and habits of 300 million people and the amount of political capital and support it would take to eliminate most of those subsidies and things like corn syrup are much harder than getting healthcare reform passed. Theres a reason Obama stopped quoting Michael Pollan once he got elected.

So to use a medical analogy, we go for the band-aid approach and call it a day?

If anyone is really serious about the health care of this nation, they have to be prepared to make the hard choices that truly make a difference. Even if every American had insurance coverage, we'd still be losing over a million people annually to mostly preventable diseases.