On September 17, 2009, Dr. Andrew P. Wilper and several other Harvard researchers published the results of their study "Health Insurance and Mortality in US adults" in the online edition of the American Journal of Public Health. The study, which analyzed the relationship between death and the lack of medical insurance, concludes that the death rate of uninsured non-elderly adults is much higher than their insured counterparts – and significantly higher than had been previously estimated.
Benefits of Health Insurance
In the US, access to health care services is often determined by whether an individual has medical insurance, which can protect against the staggering costs of catastrophic illness. Those with health insurance are more likely to seek care for chronic conditions and obtain recommended medical screenings. At the same time, the insured are less likely to receive substandard care and suffer with undiagnosed chronic conditions.
According to the Harvard study, health insurance improves health in three ways:
- The insured get care when needed.
- The insured have a regular source of care.
- Continuity of medical insurance can ensure proper care.
Health Care and the Uninsured
All three mechanisms of care are disrupted for individuals who lack health coverage. The uninsured, for example, are less likely to seek medical help when first needed. Instead, they're more likely to wait until their conditions become serious and then go to emergency rooms for treatment, where they're often admitted into the hospitals as patients.
Those uninsured individuals who are chronically ill are also less likely to have a regular source of medical care. As a result, they often do not receive primary and preventative care. In addition, those with intermittent health insurance are more likely to die than those with continuity of coverage. To make matters worse, the uninsured sick can also face insurmountable debt, which can add to their reluctance to seek medical help.
Middle-Aged and Uninsured
Middle-aged individuals who are uninsured – the pre-elderly who fall at the high end of the study's age range – are particularly susceptible to a disruption of the three mechanisms that improve the health of those with medical insurance. Because individuals in this age range are beginning to face many of the same health issues as the elderly, the lack of insurance can play a significant role in their decline in health. In addition, intermittent medical coverage is common among the pre-elderly and also contributes to health declines.
It should be noted, however, that the downward trend in health is reversed at 65, when the majority of Americans become eligible to receive Medicare coverage.
Death Rate of Uninsured Americans
In the final count, the Harvard study includes data collected from 9,004 non-elderly adults. The study not only excluded children and the elderly, but also any non-elderly adults covered by Medicare, Medicaid, the Veterans Affairs, or the Civilian Health and Medical Program of the Uniformed Services.
Based on their findings, the researchers conclude that lack of insurance can be associated with as many as 44,789 deaths per year – more deaths than are caused each year by kidney disease. This is a surprising statistic, considering that the Institute of Medicine, in 2001, estimated that less than 19,000 Americans aged 25 through 64 died each year because they were uninsured.
However, medical therapeutics and the demographics of the uninsured have changed and continue to change. Yet one thing remains clear – universal health coverage would save lives. While politicians continue to negotiate with the health industry, Americans are dying, and at an alarming rate. And as long as profit is placed before human life, there's no telling how many more thousands of uninsured will die.
R.H. Sheldon - A number of years ago, long before I moved to the Northwest, I hitchhiked with a friend across Washington state to northern Idaho. We got ...
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