Bad news comes to those without health insurance. Individuals without private medical insurance are more likely to die, according to a new study, "Health Insurance and Mortality in US Adults," published in the September issue of the American Journal of Public Health.
In fact, they have a 40% higher risk of mortality when compared to people who have insurance, said researchers at The University of Washington School of Medicine in Seattle, and the Cambridge Health Alliance/Harvard Medical School in Boston.
Researchers surveyed 9,000 adults between the ages of 17-64, using nationally representative data from the CDC and the National Health and Nutrition Examination Survey. The study results confirmed their initial hypothesis that not having insurance is linked to mortality.
The latest numbers reiterate previous studies that date back to the 1980s, when researchers found the correlation between lack of coverage and death. Despite advances in medicine, those statistics haven't changed much.
Today, the current lack of health insurance is associated with nearly 45,000 deaths in the U.S., according to the study. With 46.3 million Americans lacking health insurance, according to the latest U.S. Census Bureau report, the link between "uninsurance" (as researchers call it) and mortality rates is suggesting there is a nationwide risk.
"What this study implies for those individuals [without insurance] and for our society as a whole, is that these are people who, because of their limited ability to access the healthcare system, have a higher risk of death," said Andrew P. Wilper, MD, MPH, lead study author and internal medicine physician at University of Washington School of Medicine. "They have a higher risk of not living as long as people who do find a way to find coverage."
Who are the underinsured?
The uninsured population are individuals without any type of healthcare cost coverage, as opposed to underinsured individuals who may receive limited care. The uninsured tends to be younger, poorer, and less educated, according to study results. In addition, those without coverage are traditionally minority (non-Caucasian) groups.
Has the economic downturn affected the number of people who can afford care? Unfortunately, it may have. The number of people without insurance rose by 600,000 in the last year, according to the census.
Most people receive health insurance through employment-sponsored coverage, so those who recently lost their jobs could be a greater risk for uninsurance and lack of care.
"People who are less likely to have work are also less likely to have a health policy," he said about his patients who have lost coverage from their work or state-level Medicaid programs. "Individuals without health insurance often delay care to their determinant. I've seen dramatic tragedies occur in people who have delayed care for very treatable illness."
The political ramifications
As the Senate Finance Committee this week marks up the healthcare reform bill, estimated to cost $900 billion, many wonder who will care for the uninsured and where that money will come from.
"Individual physicians, hospital administrators—everyone's efforts make a difference. This is a society-wide problem that we have been unable to tackle for the last 100 years," Wilper said. "'How are we going to ensure that people in our society can have access to medical care?' is a political question."
Congress is expected to vote on the bill by year's end.
Karen M. Cheung is associate editor at HCPro, Inc., and blogger for HospitalistLeadership.com. She can be contacted at kcheung@hcpro.com.