As members of the Obama administration and Congress met on Thursday to
try to find common ground on health care, a new report warned that
without comprehensive legislation, more than 275,000 adults nationwide
will die over the next decade because of a lack of health insurance.
Nearly 14,000 of those deaths would occur in New York State.
An earlier study by the Institute of Medicine estimated that 18,000
people died prematurely in 2000 because they lacked insurance; the
Urban Institute updated that figure to 22,000 in 2006. The new study,
by liberal advocacy group Families USA, applied the same methodology
used in the previous reports to drill down and calculate, on both a
national and state-by-state basis, the latest figures.
“This is only the tip of the iceberg, and the most severe
consequence, which is death,” said Kathleen Stoll, director of health
policy at Families USA. In addition, thousands of other citizens,
perhaps millions, are experiencing a reduction in the quality of their
lives and their health because they lack insurance, she said.
Not surprisingly, many of the states with the largest number of
projected premature deaths also have the largest populations. The top
12 states, in order of estimated premature deaths, are: California
(34,600), Texas (31,700), Florida (25,400), New York (13,900), Georgia
(11,500), North Carolina (9,600), Illinois (9,400), Ohio (8,900),
Louisiana (7,700), Michigan (7,600), Pennsylvania (7,500) and Tennessee
(7,500).
In 2008, roughly 46 million people in the United States lacked
health insurance, according to the Census Bureau. The new report
estimates that currently 68 adults under age 65 die every day because
they don’t have coverage. Absent a significant change in coverage, the
figure will climb to 84 by 2019, the study projects.
A growing body of research has explored the connection between a
lack of health insurance and an increased risk of death. Uninsured
people are more likely to skip screenings and other preventive care, so
their medical problems are often diagnosed later, when they are more
advanced and tougher to treat. The uninsured are also more likely to
skimp on necessary medical care, whether it’s prescription drugs to
keep their blood pressure in check or surgery to clear up clogged
arteries.
“The bottom line is that if you don’t get a disease picked up early
and you don’t get necessary treatment, you’re more likely to die,” said
Stan Dorn, a senior fellow at the Urban Institute and the author of the
organization’s earlier study.
Experts say that the new study’s estimates of premature death likely
err on the conservative side. The report calculated that lack of
insurance increased mortality rates by 25 percent. But research
conducted using more recent data found that not having insurance
increases death rates by 40 percent.
In addition, these numbers don’t include children. Children are
generally very healthy, and many are eligible for coverage under public
programs like the state Children’s Health Insurance Program. But many
children aren’t enrolled in Medicaid or other programs for which
they’re eligible. According to research cited in the Families USA
study, hospital mortality rates were 60 percent higher for children
without insurance.
In addition to projecting premature deaths, the new study estimated
the number of people who had died since the last major push for health
care legislation in the early 1990s. It found that between 1995 and
2009, lack of insurance was responsible for more than 290,000 premature
deaths.
Any estimate of this sort depends on the type of health care
legislation under discussion. For this report, Families USA relied on
Congressional Budget Office estimates regarding the bills that were
passed by the House and the Senate, which would increase the number of
insured by some 30 million. A health overhaul like the one proposed by
Republicans, which would increase the number of insured by about three
million, would yield much less bang for the buck.
“Clearly you wouldn’t see the same amelioration of the consequences,” Ms. Stoll said.