Having health insurance does not make you less likely to die.

nurse2033, MSN, RN · Jul 16, 2012

I think this would bolster the argument that we already have a health system that serves everyone, whether they have insurance or not. If I read this correctly, self-reporting heath and smoking status were included in the new study. Other studies have shown that people do not accurately self report health data (don't have reference sorry). I wonder if this was considered. Interesting article, thanks for the post.

JZ_RN · Jul 16, 2012

People without insurance have to work harder to find resources and end up with debt is the difference. I've never given different care for a person with insurance versus a person without. They may have therapies, treatments, certain meds denied which affects their outcomes but as far as from ME, the RN, same care, same respect. I'm not the insurance police. I just am there to help people.

Tragically Hip · Jul 17, 2012

People who go to emergency rooms for their primary care might get adequte treatment (which is hard to believe, given the lack of continuity of care), but their care is extraordinarily expensive. They are left with an enormous debt, and if they can't pay it, guess who does?

Or maybe our health care system is a monumental placebo.

Someone ought to do a study on the causal relationship between the lack of (adequate) health insurance and personal financial ruin.

2BRN123 · Jul 17, 2012

[quote=SC_RNDude;6709011

"The Institute of Medicine's estimate that lack of insurance leads to 18,000 excess deaths each year is almost certainly incorrect. It is not possible to draw firm causal inferences from the results of observational analyses, but there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States," the authors write."

Health Insurance Coverage and Mortality Revisited - Kronick - 2009 - Health Services Research - Wiley Online Library

Interesting article, I wonder what the study would yield if people were to report their quality of life (with regards to health).

I can think of a few diagnoses off the top of my head that might not kill someone but without access to treatment would certainly and significantly reduce the quality of their life. And really...isn't health care just as much about saving life as it is about preserving and improving it?

zoey8 · Jul 17, 2012

i feel the same way

Zookeeper3 · Jul 18, 2012

There are many caveots that this article, altough well meaning, meant to look at another side of the insured vrs. uninsured. I work in an inner city ER in VA, where the poorest of public housing is a mile away. I wish the authors spent a weekend in my ER.

1. The uninsured come in self pay. Show up for UTI's, pregnancy tests, STD exposure, bug bites (seriously), a cough, asthma (because an inhaler is $75/month), nausea for two hours... ya get the picture. They have no transportation and call 911 to get care. They come in with BP's of 180/95, blood glucose levels in the 300's. Nothing to admit for, and we are not a primary care clinic to treat, nor do they follow up and see the clinic and manage those co-morbidities. They just want a quick fix.

So the tax payers and those with insurance pay for this. In ten years, these folks will have shot kidneys, need dialysis, have limbs amputated from neuropathy, not be able to work, and cost more money. The total costs and long term longetivity is not yet in the calculations, although much of it has been ignored in this study.

2. The UNDER insured person, has a yearly deductable of $700-1K in outright payments before insurance covers. They only come in in emergencies. Their insurance only covers 60-70% of treatment once in the system for care. At this point, they either go bankrupt, have already crappy payment and don't pay, and the tax payers and those that HAVE insurance pay for it.

3. Young people, 20-40, think they don't need it, or choose to not pay the premiums and a car accident (only auto insurance pays), or a catastrophic diagnosis like cancer comes and they either are bankrupt, or don't pay. Then the tax payers or those with insurance cover those costs.

4. People like me, have excellent health insurance, have an auto accident with their kid, and insurance doesn't cover it and leaves it for auto, lawyers, legal fees, and two hard working very insured parents have the choice to declare bankruptsy on daughters $250k bill, not pay it, or do payment plans (all while we have excellent insurance that won't pay and the lawyers take all the settlement from auto, fighting the health insurance to pay).

Then my kid has a PRE-EXISTING condition, that won't be covered by my health insurance for a year. Costs us around 500$/month for seizure meds and neurologist and ortho.

So we can look at this study for what it is trying to prove by number fudging... as any study can do, or we can be educated and simply think.... those that go without any basic care have the same morbidity and mortalitiy rates? SERIOUSLY??? Sure, seems really reasonable to me. And even if this fallicy could be true.... who paid for it?

WE DID.

Zookeeper3 · Jul 18, 2012

One more point, thanks for putting up with me on my rant. I'm abit hot on this topic, as I've just changed my own BP meds, to more affordable ones with more side effects that drive me nuts, to save money so I can afford to pay for my daughters co-pays. My cupboard are stocked with ramen noodles. I'm an RN, my husband is an engineer and we do this to pay off the debt and not loose our house.

At some point soon, my daughters health will be affected, as will ours, with our financial challenges and our quality of life will suffer.

People don't realize, it happens to the educated, hard working and insured. It I happen to live with, every single day.

allnurses Guide · Jul 18, 2012

"People without health insurance have about the same mortality rate as people with health insurance, according to an observational study published online April 21 in Health Services Research.
Richard Kronick, Ph.D., of the University of California at San Diego School of Medicine in La Jolla, and colleagues followed up on 672,526 adults ages 18 to 64 years who reported being uninsured or insured privately on the National Health Interview Survey during the years 1986 to 2000. From the survey baseline, mortality in the group was followed through 2002. Cox proportional hazard survival analysis was used to assess the association between insurance status and mortality.
Researchers found that the risk of mortality for uninsured survey respondents was not significantly different than respondents who had employer group insurance (hazard ratio, 1.03 after adjustments for health status, demographics and health behaviors). Leaving health status out of the adjustment calculation increased the risk of mortality (hazard ratio, 1.10) and leaving smoking status and body mass index out of the adjustment calculation also increased the risk of mortality (hazard ratio, 1.20).
"The Institute of Medicine's estimate that lack of insurance leads to 18,000 excess deaths each year is almost certainly incorrect. It is not possible to draw firm causal inferences from the results of observational analyses, but there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States," the authors write."
Health Insurance Coverage and Mortality Revisited - Kronick - 2009 - Health Services Research - Wiley Online Library

Maybe the uninsured people who died did not participate in the survey?

Ruby Vee, BSN · Jul 18, 2012

well, duh! we all have a 100% mortality rate. nobody lives forever.

**RosesrReder, BSN, MSN, RN** · Jul 18, 2012

lmbo :)

SC_RNDude · Jul 19, 2012

Zookeeper,

I'm not sure what your point is. I am in total agreement with you that our healthcare system needs to be fixed. It is my belief that the ACA will not do it. In fact it will make it much much worse and will damage our economy at the same time. My posting this article was in response to the argument I always here (including in another thread in this forum) about how many people die because they don't have insurance. It doesn't sound like insurance is doing what is needed for your family, and it doesn't sound like it will fix the problems you see in your ER.

I don't know who paid for the study, but the author is Richard Kronick. He was a senior healthcare policy advisor in the Clinton Administration and was a major contributor to Clinton's healthcare reform proposal.