Wednesday, June 28, 2017

28,600 excess deaths due to lost health care coverage

Here’s another item from Sarah Kliff’s VoxCare email.

“The hard-to-answer question at the core of the health-care fight: How many more people might die?”: “It’s certainly the case that a hard number on the tally of deaths from loss of insurance is tough (and perhaps not even possible) to determine. In broad strokes, [Sen. Bernie] Sanders’s assessment that thousands more would die annually appears to be supported by the data: If some 800,000 people lack insurance in a given year, about 1,000 would be expected to die. Under the Senate bill, 15 million more people would be uninsured next year alone, according to the CBO.” —Phillip Bump, Washington Post

Bump provides some supporting evidence in the Post’s story.

This month, the Annals of Internal Medicine published a meta-analysis of recent studies aimed at determining how a lack of insurance coverage affects mortality. Some of the studies, like the one in Oregon, yielded statistically insignificant results. Overall, though, the researchers found that “[t]he evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.”

What does that mean in practical terms? “Roughly between a 3 percent and a 29 percent higher risk of dying for the uninsured than for comparable insured people,” David Himmelstein, one of the study’s co-authors, explained to us on Tuesday. “The majority of the evidence clusters roughly in the middle of that, so something like a 17 percent, 16 percent increase in risk of dying.”

For every 800 people who are uninsured for a year, existing studies suggest that there would be one death, Himmelstein said. For those 22 million the CBO estimates would lose coverage under the Senate bill — 28,600 excess deaths. And that, Himmelstein said, is the middle of the range of estimates.

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“The thing that was most striking to us was the strength of scientific consensus on this issue,” Himmelstein said. “The medical scientific literature is really quite clear at this point and quite in agreement that there is a significant mortality effect. Exactly how big? There’s still considerable uncertainty around that.”

But, he said, “it’s quite clear that there are deaths from people being uninsured — and a substantial number.”

Gov. John Kasich had scathing words for his fellow Republicans:

Appearing in Washington, Gov. John R. Kasich of Ohio cited the 22 million projection and expressed bewilderment that fellow Republicans would be on board with the bill.

“And they think that’s great?” he asked. “That’s good public policy? What, are you kidding me?”

Actually, I suspect that congressional Republicans deep down know that the House and Senate bills are not good public policy. But they have convinced a large part of the public that Obamacare must go. And they have promised for the last seven years to repeal it. Now they have to deliver - even if it means increasing the number of deaths among the uninsured.

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