I just found out about this MinnPost article today, although it’s almost a month old. The author, Dr. Belzer, is the medical director/chief medical officer of Hennepin County Medical Center. In the article, he talks about being uninsured as a potentially fatal disease, which I found really interesting.
The uninsured are a well-studied but misunderstood group. In the United States there are an estimated 47 million uninsured and, contrary to common belief, undocumented or newly arrived immigrants compose only a small fraction of this number. The uninsured are not elderly; typically they are under the age of 40. More than 80 percent of the uninsured are from working families, and 20 percent — or nearly 8.7 million of the uninsured — are children.
Unsurprisingly, uninsured people are sicker, have worse health status, and die younger. Dr. Belzer cites a couple of studies that show just how much more at risk the uninsured are. For example, the uninsured have a 25 percent higher risk of death and are 3.2 times more likely to die in the hospital than the insured.
The excess mortality seen in the uninsured is not only due to lack of screening, patient inability to afford prescription drugs or ability or lack of willingness to seek preventive care. A 2003 study from the Massachusetts Institute of Technology looked at an unplanned medical event: auto accidents. This study amazingly found that the uninsured receive 20 percent less overall treatment for their condition and are 37 percent more likely to die of their injuries than those with insurance.
The reason Dr. Belzer describes being uninsured as a potentially fatal disease is that if uninsurance were to be classified as a disease it would be the third leading cause of death in the near elderly. Put in these terms, it seems incredible that with GAMC ending in about a year, approximately 36,000 more Minnesotans will become uninsured. It also makes me think that the Mayo Clinic offers a model of medical efficiency. Although it is unrealistic to expect hospitals to become the Mayo Clinic, Mayo anesthesiologist Dr. Michael Joyner says the question is more about applying the Mayo Clinic’s principles locally. Read the whole article at MPR.
The Senate committee on Health, Education, Labor and Pensions (HELP) health reform proposal offers nearly universal coverage through a combination of regulation and subisidies. All firms employing more than 25 people are required to offer their workers insurance or pay a penalty, which takes care of a big problem with the earlier version of the plan. Paul Krugman of the New York Times lays out the costs of this plan:
The budget office says that all this would cost $597 billion over the next decade. But that doesn’t include the cost of insuring the poor and near-poor, whom HELP suggests covering via an expansion of Medicaid (which is outside the committee’s jurisdiction). Add in the cost of this expansion, and we’re probably looking at between $1 trillion and $1.3 trillion.
There are a number of ways to look at this number, but maybe the best is to point out that it’s less than 4 percent of the $33 trillion the U.S. government predicts we’ll spend on health care over the next decade.
The HELP plan indicates that health care can not only be reformed, but in an affordable way.