Lack of health insurance a leading cause of death
Study: Number of uninsured at all-time high
CAPITAL REGION In 2010, 1,247 New Yorkers between ages 25 and 64 died due to a lack of health coverage, according to a new report.
The study, “Dying for Coverage: The Deadly Consequences of Being Uninsured,” was put together by Families USA, a Washington nonprofit organization that advocates for affordable health care for all Americans. Its release was timed to coincide with the U.S. Supreme Court ruling on the constitutionality of President Barack Obama’s health care reform bill, which is expected early this week.
According to the report, the number of uninsured Americans hit 50 million in 2010, an all-time high, and it claims 26,100 people between the ages of 25 and 64 died prematurely due to lack of health coverage.
In 2010, the number of premature deaths due to a lack of health coverage ranged from 28 in Vermont to 3,164 in California, according to the report. New York was the state with the fourth-highest number of premature deaths due to a lack of insurance, it said.
Ron Pollack, executive director of Families USA, said states with bigger populations will see more residents die due to a lack of health insurance. He said that New York has done a good job of making sure children have health insurance, but not enough for adults.
“There’s nothing close to universal coverage in New York,” Pollack said.
Pollack said it’s a myth that uninsured people can get the care they need in emergency rooms.
“If you go to a hospital, you’re not entitled to get hospital care unless you’re at immediate risk of life or limb,” he said. “If you go with a tummy ache, they’re not required to treat you. If you’re experiencing the onset of an illness, you might not see a doctor or get checked out.”
Schenectady County has several options for under-insured and uninsured people.
The Schenectady Free Health Clinic provides free health care to people who lack health insurance, who often make too much money to qualify for Medicaid, or do not receive insurance through their employers but cannot afford to buy insurance on their own. Hometown Health Center provides affordable health care to low-income people, and the medical home at Ellis Medicine aims to provide comprehensive health care, with a particular emphasis on serving the poor.
William Spolyar, executive director of the Schenectady Free Health Clinic, said research indicating a lack of health insurance is the sixth leading cause of death in the U.S. helped spur the creation of the free clinic in 2003.
“I don’t think anyone can deny the fact that a lack of health insurance is a cause of death in the U.S.,” Spolyar said. “This is not a new issue.”
He said that there are at least 10,000 uninsured people living in Schenectady County, and the Schenectady Free Clinic provides care to about 2,500 of them.
People who lack health insurance are more likely to forego preventive screenings and treatment, and are thus more likely to seek care only when they’re in crisis, when illnesses are more advanced and harder to deal with, Spolyar said.
The Schenectady Free Health Clinic provides free pre-employment physicals for people who are required to get a physical as part of an application process — something that’s fairly common for low-level service sector jobs. Many of the people applying for such jobs lack insurance, as well as the funds to pay for a physical, Spolyar said. He said that last year the clinic provided 520 free physicals, and more than 400 of those people succeeded in getting jobs.
“Many of the people who come in for physicals haven’t seen a doctor in a long time,” Spolyar said. “When they come in, it’s not unusual to find that they have two or three chronic issues that they’re not even aware of, such as diabetes. And this is all because they haven’t had the primary care physicals that most everyone who has insurance is able to get.”
Some have questioned the veracity of studies showing that tens of thousands of people die due to a lack of insurance each year.
In a 2009 report for the Libertarian think tank the Cato Institute, former Congressional Budget Office Director June O’Neill and her husband, economist Dave O’Neill, wrote that “lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured — particularly the voluntarily uninsured — have multiple disadvantages that in themselves are associated with poor health,” such as education level and income.
After a 2009 Harvard Medical School study found that 45,000 deaths each year can be attributed to a lack of health insurance — a much higher estimate than in the Families USA study — FactCheck.org, a website run by the Annenberg Public Policy Center at the University of Pennsylvania, decided to take a closer look at the issue.
FactCheck.org said it couldn’t determine whether the 45,000 estimate was accurate, but noted that “earlier studies also have put the number of excess deaths from lack of insurance in the thousands,” and cited some of those studies, such as a 2007 report sponsored by the National Heart, Lung and Blood Institute that found the uninsured have a 26 percent higher mortality rate than the insured.
Albany physician Dr. Andrew Coates is president-elect of Physicians for a National Health Program, a group that advocates for single-payer health care, a system in which a single entity, such as a government-run organization, collects all health care fees and pays for all health care costs. He said the fact that thousands of uninsured people die each year is “deplorable for any 21st century developed nation.”
Between 2005 and 2010, 6,481 New Yorkers ages 25 to 64 died due to a lack of health coverage, according to “Dying for Coverage.”
Peter Constantakes, a spokesman for the state Department of Health, said the state is moving forward with plans to create a health insurance exchange — an open marketplace where individuals and small businesses can shop for affordable plans. Under the health care reform bill, each state is required to create an exchange, with the idea that the exchanges will enable consumers to compare plans much more easily and that the competition among health care plans will keep prices affordable.
According to the Health Department, nearly 2.7 million New Yorkers under age 65, about 16 percent of the state’s population, do not have health insurance, and the majority of the uninsured are workers and their families. If the health care reform bill goes into effect, about 1 million of those people will obtain insurance, according to the state.
“Dying for Coverage” uses the same methodology as a 2002 study by the Institute of Medicine, titled “Care Without Coverage: Too Little, Too Late.” That report estimated that in 2000, 18,000 adults between the ages of 25 and 64 died because they did not have health insurance.
Among other things, the health care law bars insurance companies from denying coverage or charging higher premiums to people with pre-existing medical conditions. It also requires people to obtain health insurance, a provision, known as the individual mandate, that has proven controversial and which many legal experts expect to be struck down by the Supreme Court. Opponents to the law have focused on the individual mandate, questioning Congress’ power to enact such a law.
A Gallup poll from several months ago found that about 72 percent of the public believe the individual mandate is unconstitutional, while 47 percent said they oppose the health care reform bill altogether. Just 33 percent expressed support for the law.
“There’s no question that health care for everyone in the country ought to be a right and not a privilege,” Spolyar said. “The problem is: How do you provide it, and how do you pay for it?”
After the health care reform bill passed, some people wondered whether the Schenectady Free Health Clinic was still needed, Spolyar said. He noted that even if the Supreme Court upholds the entire law, experts estimate that 20 million people will still lack coverage.
“(The health care reform bill) is really feeble,” he said. “Even if everything goes according to plan, there will still be 20 million uninsured people. There will still be people dying.”