Megan McArdle dives into a very tricky question.
But it turns out to be really hard to determine how many people die without insurance, which is the subject of this month’s column. The most recent available study, which also had the largest sample and controlled for the most variables, found no effect at all–a result which surprised the hell out of its author, a former Clinton advisor. Other studies say the number is in the tens of thousands.
The left is predictably fond of the study which got the largest number, 45,000 a year. Unfortunately, its authors are political advocates for a single-payer system, who also helped author the notorious studies on medical bankruptcies. Those studies are very shoddily done, with parameters that somehow always conspire to produce the maximum possible number.
She’s in dangerous waters even broaching the subject, but she stumbles onto some choice factoids. (Emphasis mine.)
To give you an example of what I mean, one of the two studies that went into the most commonly cited number–the roughly 20,000 a year figure from the Institute of Medicine and the Urban Institute–found that the highest mortality was not associated with being uninsured, but being on a government health care program. (the other excluded those patients). This was true even after they’d run all their controls. Given that the bulk of the coverage expansion in both the Senate and the House plans comes from Medicaid expansion, this is a little disturbing.
Wow.
But even that is hard to square. The fact is that it is wholly undetermined how many people die from being uninsured. Props to McArdle for going there. Worth a read.
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BREAKING NEWS FROM DAVE: Older people die at a higher rate than younger people!!!!!
Once again, you highlight a part of an article that is essentially discounted by the rest of it. As McArdle goes on to say:
“But how likely is it that Medicaid is killing people? Possible, I suppose, but not really all that likely. Medicaid and Medicare patients, too, are not like the broader population. The authors in fact recognized this fact in their paper, pointing out that these patients have higher rates of disability–but then failed to address the obvious question this raised about their data on the uninsured.”
So her point isn’t that “the highest mortality was not associated with being uninsured, but being on a government health care program” but that results like these show that these types of studies are fraught with sampling and statistical problems.
But, in spite of your out-of-context emphasis, it is an excellent article and thanks for blogging on it.
I said ” but even that is hard to square.”
It really isn’t hard to square. People on Medicare and Medicaid are in populations associated with higher mortality rates. Old people tend to die more often than young people.
Did you know that on average people with smaller hands tend to live longer than people with larger hands? True fact. Think about it.
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