Is Lack of Health Insurance Fatal?


In my forty-two years of medicine I have never seen a death certificate that read “Cause of Death: No health insurance.” Yet Democrats are claiming this will be the outcome if the American Health Care Act (AHCA) is passed.

Here are some recent quotes of Democrats and the liberal media:

  • Bernie Sanders (D – VT)“The Republican health plan will kill people.”
  • Political dig. – “The Republican Party is the party of death.”
  • The Washington Post – ““Repealing ObamaCare will kill more than 43,000 people a year.”
  • Julia Belluz at VOX – “If 24 million people lose insurance, we’ll see more than 24,000 extra deaths per year. There’s no question that the fate of the Affordable Care Act is a matter of life and death.”
  • Michael Jeffries, The Boston Globe“House Republicans are consigning thousands of people with serious illnesses to death by making them uninsurable in an era of unaffordable treatment.”
  • Charles Blow, The New York Times – “Nearly 45,000 annual deaths are associated with lack of health insurance. The latest Republican health bill poses a “death threat” . . . for many Americans.”


Where do they come up with this stuff?

Some of this rhetoric is simply hysterical reactions to any changes to ObamaCare that threaten their beloved government control of healthcare. But some of it is based on repetition of faulty research and journalism in the past.

Glenn Kessler, The Washington Post fact checker, gave Senator Sanders Four Pinocchios (the highest possible criticism) for his statement. John C. Goodman and Linda Gorman, writing in Forbes say, “We’d like to give all these writers two dozen Pinocchios. Every claim they are making is based on “fake research” that has been thoroughly discredited by independent scholars.”

They point out that these scare tactics were also used to justify the original passage of ObamaCare. For example, “Dying for Coverage,” a report by Families USA, made the astounding claim that six people died every day in Florida because they are uninsured. Eight died every day in Texas, nine in California, and four in New York.

Fake Research Promoted

Goodman and Gorman say their research shows the fake research began over two decades ago and the false claims of that research have been promoted again and again by those seeking to justify their political agendas.

The chain began with a paper by Peter Franks et al. published in The Journal of the AMA in 1993. In the early 1970s, people were interviewed once to determine their health insurance status. In 1987, they were surveyed to see who was alive and who was dead. The researchers made the implicit assumptions that someone who was uninsured in the early 1970s remained uninsured until 1987 and that someone with private insurance was continuously covered over the same time period.

The authors made no attempt to determine the causes of death. Auto accident fatalities, gunshot victims, suicides – all these were implicitly assumed to be affected by whether people had health insurance. Armed with these assumptions, the authors bogusly concluded that being uninsured increased the probability of death by 25%.

It is well-known that being uninsured is like being unemployed. It happens to nearly everyone for brief periods of time. Most people who are uninsured regain insurance within one year and rarely remain uninsured for two decades. Furthermore, the authors made no attempt to correlate causes of death with absence of insurance.

This fake research was used by the Institute of Medicine in 2002 to calculate that 18,000 deaths a year in the U.S. are attributable to lack of health insurance using the Franks study data. The Urban Institute also promoted this claim in 2008, again using the Franks study as its basis. Then Families USA applied The Urban Institute data and the Institute of Medicine data to come up with its bogus claims.

New Research

Economists June O’Neill, former Director of the Congressional Budge Office, and her husband, Dave O’Neill, both highly respected economists, have done recent research that refutes these bogus claims. They concluded that uninsured people with lower-incomes were only 3% more likely to die over a 14-year period than those with health insurance and being uninsured had no statistically significant effect on anyone else. Other studies by Card et al. found that “any plausible effect of insurance on health status in the general population will likely be small and perhaps non-existent.”

Further evidence is continually being gained by the ongoing Oregon Health Experiment, which began in 2008, and has thus far concluded that enrolling the uninsured on Medicaid has no significant impact on healthcare outcomes. In fact, it agrees with the growing literature that suggests those on Medicaid do worse than even the uninsured, let alone the privately insured, with respect to morbidity and mortality. It is no exaggeration to say that being on Medicaid may be worse than having no insurance at all.

Yet the same voices that are shouting these false predictions of people dying if they lose health insurance want everyone to be covered by Medicaid!


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