Is being uninsured a fatal disease?
April 23rd, 2008 | by Brian T. Schwartz |The Bill Summary for Colorado Senate Bill 08-217 (which I’ve written about here ), which would make it a crime for Coloradans not to buy politician-approved medical insurance, includes a link to a report by a group that calls itself "Families USA"* titled Dying For Coverage , which claims that lacking health insurance causes thousands of Coloradans to die each year. The Rocky Mountain News also ran a story on it in March.
But is this true? In a Speakout today’s in the Rocky Mountain News , Michael Tanner of the Cato Institute debunks this claim.
Even the Urban Institute’s Jack Hadley, who co-authored a similar Institute of Medicine study cited by Families USA has said that "observational studies . . . cannot answer the question of whether health insurance directly affects health outcomes." And a detailed review of the academic literature by Helen Levy and David Meltzer of the University of Chicago Harris Graduate School of Public Policy Studies found little proof of a "causal relationship" between health insurance and better health.Similarly, a study published in The New England Journal of Medicine last year found that, while far too many Americans were not receiving the appropriate standard of care, "health insurance status was largely unrelated to the quality of care."
"Income is a better predictor of health than insurance states, writes Greg Scandlen in a policy brief for the National Center for Policy Analysis:
If insurance coverage is the primary determinant in getting adequate health care, people on Medicaid should be at the head of the line for good outcomes. But they are not. In fact, in many cases, they have worse outcomes than do people with no insurance at all. This is consistent with other available information that income is a better predictor of health than is insurance status. Medicare enrollees, for instance, are all covered by the same insurance program, but those with low incomes are twice as likely to report being in poor health as those with higher incomes.
* You gotta love the name "Families USA." If you disagree with their policy recommendations, you must be against families, and worse yet, the USA!
Update, May 3 2008: John Goodman has more analysis of the FamiLIES USA study.
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