So while still trying to find something about the uninsured vs. insured dying becuase they simply didn’t go to the doctor, rather than blame it on coverage, I found a CBS article and noted that they said John Goodman was in disagreement with their statistics of people dying simply because they lacked insurance. So I went over to Dr. Goodman’s blog and found several articles. The following exerpts are from the two I thought were the best.
Does Lack of Insurance Cause Premature Death? Probably Not
As for the public policy implications of all this, the PNHP authors are on record as favoring Canada’s system of single-payer national health insurance. Yet insured patients in Canada fare worse than the uninsured in the United States. The O’Neills find that:
- Among US women age 40 to 64, 87% of those with insurance had a mammogram within 5 years.
- The rate for Canadian women is 65% — the same as for uninsured women in the US.
- Canadian women also have the same rate of screening for cervical cancer as uninsured US women (80%), over five years. Among insured US women, the rate is 92%.
- Among uninsured US men, 31% were screened for prostate cancer, compared with 16% of Canadian men. For insured US men, the rate is 52%.
People are Dying for (Media) Coverage
Families USA applied the Urban Institute updates and the IOM method to even more imprecisely estimated state data to produce its Dying for Coverage series. Page 2 of the Urban Institute report explains the methodology used to create the IOM estimates, the Urban Institute estimates, and the Families USA estimates. Consider 25 to 34 year olds. Deaths are allocated among the insured and uninsured for this group in the following way:
- Take the percent of insured (79%) and the percent uninsured (21%) in this age group from the Current Population Survey.
- Let X be the rate at which the insured in this age group die.
- Assume that the rate of uninsured death is 1.25 times X (from Franks).
- Add the death rate of the insured and the death rate of the uninsured together to get total deaths. Using U.S. vital statistics data this yields 40,548 = (0.79*X) + (0.21*(1.25*X)).
- Do simple algebra to get 40,548 = 1.05*X.
- Divide by 1.05 to get the number of deaths assumed to be attributable to the insured population, 38,617.
- Claim that the 1,931 difference between total deaths and the deaths attributable to the insured population are “excess deaths” due to a lack of health insurance.
Note that in the seven steps listed above, there is no point at which anyone from Families USA actually examines a medical record. There is no interview with any doctor, any patient or any family of a deceased patient. There is only algebraic mumbo jumbo in support of an unsupportable claim.