http://www.msnbc.msn.com/id/32882064/ns/health-health_care
No health coverage tied to 45,000 deaths a year
Tally rises from previous estimates of about 18,000 annually, study says
updated 4:33 p.m. PT, Thurs., Sept . 17, 2009
Nearly 45,000 people die in the United States each year — one every 12 minutes — in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.
"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.
Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.
The findings come amid a fierce debate over Democrats' efforts to reform the nation's $2.5 trillion U.S. healthcare industry by expanding coverage and reducing healthcare costs.
President Barack Obama's has made the overhaul a top domestic policy priority, but his plan has been besieged by critics and slowed by intense political battles in Congress, with the insurance and healthcare industries fighting some parts of the plan.
The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance.
An similar study in 1993 found those without insurance had a 25 percent greater risk of death, according to the Harvard group. The Institute of Medicine later used that data in its 2002 estimate showing about 18,000 people a year died because they lacked coverage.
Part of the increased risk now is due to the growing ranks of the uninsured, Himmelstein said. Roughly 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reported last week, up from 45.7 million in 2007.
Another factor is that there are fewer places for the uninsured to get good care. Public hospitals and clinics are shuttering or scaling back across the country in cities like New Orleans, Detroit and others, he said.
Study co-author Dr. Steffie Woolhandler said the findings show that without proper care, uninsured people are more likely to die from complications associated with preventable diseases such as diabetes and heart disease.
Some critics called the study flawed.
The National Center for Policy Analysis, a Washington think tank that backs a free-market approach to health care, said researchers overstated the death risk and did not track how long subjects were uninsured.
Woolhandler said that while Physicians for a National Health Program supports government-backed coverage, the Harvard study's six researchers closely followed the methodology used in the 1993 study conducted by researchers in the federal government as well as the University of Rochester in New York.
The Harvard researchers analyzed data on about 9,000 patients tracked by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics through the year 2000. They excluded older Americans because those aged 65 or older are covered by the U.S. Medicare insurance program.
"For any doctor ... it's completely a no-brainer that people who can't get health care are going to die more from the kinds of things that health care is supposed to prevent," said Woolhandler, a professor of medicine at Harvard and a primary care physician in Cambridge, Massachusetts.
state-by-state
A look at excess deaths caused by lack of health insurance
State................. Uninsured, 2005 Total deaths Excess deaths
Alabama 21.1% 13,219 1,031
Alaska 22.7% 1,368 114
Arizona 24.7% 12,065 1,085
Arkansas 23.6% 7,726 668
California 23.9% 60,815 5,302
Colorado 19.9% 8,244 609
Connecticut 14.3% 5,876 318
Delaware 14.4% 1,885 103
District of Columbia 17% 1,877 120
Florida 26% 41,739 3,925
Georgia 23.6% 21,387 1,841
Hawaii 11.5% 2,312 102
Idaho 18.6% 2,473 171
Illinois 17.6% 24,694 1,626
Indiana 17.2% 14,330 921
Iowa 11.1% 5,192 220
Kansas 14% 5,238 278
Kentucky 16.6% 10,830 676
Louisiana 25.5% 11,940 1,104
Maine 12.9% 2,794 137
Maryland 17.4% 12,173 790
Massachusetts 12.7% 11,450 556
Michigan 14.3% 22,570 1,218
Minnesota 10.2% 7,765 305
Mississippi 22.6% 8,998 748
Missouri 15.5% 13,214 774
Montana 19.4% 2,042 147
Nebraska 14.3% 3,096 168
Nevada 21.2% 5,779 453
New Hampshire 13.1% 2,267 113
New Jersey 18.3% 15,884 1,084
New Mexico 24.5% 4,209 376
New York 17.5% 34,496 2,254
North Carolina 19.6% 20,085 1,461
North Dakota 14.3% 1,088 59
Ohio 15% 25,911 1,463
Oklahoma 24.3% 9,036 801
Oregon 20.8% 7,261 558
Pennsylvania 12.7% 27,620 1,334
Rhode Island 15% 1,917 108
South Carolina 23.3% 11,222 955
South Dakota 15.3% 1,526 88
Tennessee 18.1% 15,344 1,033
Texas 29.7% 44,056 4,675
Utah 20.2% 3,646 272
Vermont 15.5% 1,035 60
Virginia 16.1% 15,366 931
Washington 17% 11,105 708
West Virginia 24.2% 5,355 472
Wisconsin 12.1% 9,798 451
Wyoming 17.9% 1,116 75
Source: Centers for Disease Control, U.S. Census Bureau
No health coverage tied to 45,000 deaths a year
Tally rises from previous estimates of about 18,000 annually, study says
updated 4:33 p.m. PT, Thurs., Sept . 17, 2009
Nearly 45,000 people die in the United States each year — one every 12 minutes — in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.
"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.
Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.
The findings come amid a fierce debate over Democrats' efforts to reform the nation's $2.5 trillion U.S. healthcare industry by expanding coverage and reducing healthcare costs.
President Barack Obama's has made the overhaul a top domestic policy priority, but his plan has been besieged by critics and slowed by intense political battles in Congress, with the insurance and healthcare industries fighting some parts of the plan.
The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance.
An similar study in 1993 found those without insurance had a 25 percent greater risk of death, according to the Harvard group. The Institute of Medicine later used that data in its 2002 estimate showing about 18,000 people a year died because they lacked coverage.
Part of the increased risk now is due to the growing ranks of the uninsured, Himmelstein said. Roughly 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reported last week, up from 45.7 million in 2007.
Another factor is that there are fewer places for the uninsured to get good care. Public hospitals and clinics are shuttering or scaling back across the country in cities like New Orleans, Detroit and others, he said.
Study co-author Dr. Steffie Woolhandler said the findings show that without proper care, uninsured people are more likely to die from complications associated with preventable diseases such as diabetes and heart disease.
Some critics called the study flawed.
The National Center for Policy Analysis, a Washington think tank that backs a free-market approach to health care, said researchers overstated the death risk and did not track how long subjects were uninsured.
Woolhandler said that while Physicians for a National Health Program supports government-backed coverage, the Harvard study's six researchers closely followed the methodology used in the 1993 study conducted by researchers in the federal government as well as the University of Rochester in New York.
The Harvard researchers analyzed data on about 9,000 patients tracked by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics through the year 2000. They excluded older Americans because those aged 65 or older are covered by the U.S. Medicare insurance program.
"For any doctor ... it's completely a no-brainer that people who can't get health care are going to die more from the kinds of things that health care is supposed to prevent," said Woolhandler, a professor of medicine at Harvard and a primary care physician in Cambridge, Massachusetts.
state-by-state
A look at excess deaths caused by lack of health insurance
State................. Uninsured, 2005 Total deaths Excess deaths
Alabama 21.1% 13,219 1,031
Alaska 22.7% 1,368 114
Arizona 24.7% 12,065 1,085
Arkansas 23.6% 7,726 668
California 23.9% 60,815 5,302
Colorado 19.9% 8,244 609
Connecticut 14.3% 5,876 318
Delaware 14.4% 1,885 103
District of Columbia 17% 1,877 120
Florida 26% 41,739 3,925
Georgia 23.6% 21,387 1,841
Hawaii 11.5% 2,312 102
Idaho 18.6% 2,473 171
Illinois 17.6% 24,694 1,626
Indiana 17.2% 14,330 921
Iowa 11.1% 5,192 220
Kansas 14% 5,238 278
Kentucky 16.6% 10,830 676
Louisiana 25.5% 11,940 1,104
Maine 12.9% 2,794 137
Maryland 17.4% 12,173 790
Massachusetts 12.7% 11,450 556
Michigan 14.3% 22,570 1,218
Minnesota 10.2% 7,765 305
Mississippi 22.6% 8,998 748
Missouri 15.5% 13,214 774
Montana 19.4% 2,042 147
Nebraska 14.3% 3,096 168
Nevada 21.2% 5,779 453
New Hampshire 13.1% 2,267 113
New Jersey 18.3% 15,884 1,084
New Mexico 24.5% 4,209 376
New York 17.5% 34,496 2,254
North Carolina 19.6% 20,085 1,461
North Dakota 14.3% 1,088 59
Ohio 15% 25,911 1,463
Oklahoma 24.3% 9,036 801
Oregon 20.8% 7,261 558
Pennsylvania 12.7% 27,620 1,334
Rhode Island 15% 1,917 108
South Carolina 23.3% 11,222 955
South Dakota 15.3% 1,526 88
Tennessee 18.1% 15,344 1,033
Texas 29.7% 44,056 4,675
Utah 20.2% 3,646 272
Vermont 15.5% 1,035 60
Virginia 16.1% 15,366 931
Washington 17% 11,105 708
West Virginia 24.2% 5,355 472
Wisconsin 12.1% 9,798 451
Wyoming 17.9% 1,116 75
Source: Centers for Disease Control, U.S. Census Bureau
