Persistence of large numbers of uninsured and related deaths shows urgency of enacting an improved-Medicare-for-all system, physician says
The Census Bureau’s official estimate that 48.6 million Americans lacked health insurance in 2011 means approximately 48,000 people died needlessly last year because they couldn’t get access to timely and appropriate care, a health policy expert said today.
The estimated death toll is based on a peer-reviewed Harvard study published in the American Journal of Public Health in 2009, widely cited during the health reform debate, which found that for every 1 million persons who were uninsured there were about 1,000 related, preventable deaths.
Dr. Steffie Woolhandler, professor of public health at the City University of New York and visiting professor of medicine at Harvard Medical School, is a co-author of the 2009 study. She said, “The Census Bureau’s latest figure, 48.6 million uninsured, conjures up a very grim picture: a preventable death every 11 minutes.”
She said studies have shown that uninsured people with chronic illnesses like heart disease delay or forgo care, often leading to serious complications of their medical condition and, in many cases, premature death. Woolhandler continued: “As a physician, I simply cannot accept a situation where tens of thousands of people die every year because they lack insurance coverage. And lest anyone think this problem has been solved by the federal health law, the Congressional Budget Office estimates about 30 million people will still be uninsured in 2022. That figure translates into roughly 30,000 excess deaths annually – again, an intolerable picture.”
The slight drop in this year’s total number of uninsured – to 48.6 million from a record 50 million last year – was largely attributable to an increase in government health insurance coverage, particularly persons covered by Medicaid and Medicare, the Census Bureau said.
There was also a modest gain in coverage among people between the ages of 19 and 25 – 539,000 – approximately 40 percent of whom obtained coverage through their parent’s health plan as a result of the 2010 health law, the bureau reported.
Woolhandler said that while the number of persons covered by private health insurance last year was statistically unchanged from 2010, the share of Americans with private coverage, 63.9 percent, shows a slight drop and continues a three-decade-long trend of diminishing coverage through private insurance. She also noted that while the national count of uninsured went down slightly, the number of uninsured climbed in 21 states, most significantly in California, where 197,000 additional people became uninsured since 2010. The Census Bureau reported that California’s uninsured numbered 7.4 million in 2011, or 19.7 percent of the population.
“We should adopt a zero-tolerance policy toward lack of health coverage,” Woolhandler said. “Today’s Census Bureau report underscores the urgency of going beyond the federal health law and swiftly implementing a single-payer, improved-Medicare-for-all program.
“Such a program would assure truly universal, comprehensive, high-quality coverage for everyone while simultaneously ridding us of the scourge of insurance-company-related waste, bureaucracy and profiteering. A single-payer system would save both lives and money.”
Woolhandler is co-founder of Physicians for a National Health Program, an organization of 18,000 doctors who advocate for single-payer national health insurance. PNHP played no role in supporting her 2009 research study, which she co-authored with Dr. David Himmelstein, among others.
