Tuesday, September 29, 2009

The 45 Million Dead - Or Not?

Statistical deaths - should we also include how many were statistically killed by the fraud, waste and abuse of an over-reaching over-bearing government?
http://www.realclearpolitics.com/printpage/?url=http://www.realclearpolitics.com/articles/2009/09/28/an_exercise_in_ego_gratification_98464.html
"One study "found that every year in America, lack of health coverage leads to 45,000 deaths," he told the committee. "No one should die because they cannot afford health care. This bill would fix that."
There was more. "These reforms would give Americans real savings," Baucus said. The Congressional Budget Office "tells us that the (insurance) rating reforms and exchanges in our proposal would significantly lower premiums in the individual market." As well, the bill wouldn't increase the budget deficit and "starts reducing the deficit within 10 years."
If only all this were irrefutable. But Baucus' claims are shaky. It's questionable whether more insurance would save 45,000 lives a year. Unfortunately, just having insurance doesn't automatically improve people's health. Sometimes more medical care doesn't really help. Sometimes people don't go to doctors when they should or follow instructions (take medicine, alter lifestyles). Indeed, many people don't even sign up for insurance to which they're entitled. An Urban Institute study estimated that 10.9 million people eligible for Medicaid or CHIP in 2007 didn't enroll.
The 45,000 figure cited by Baucus is itself an unreliable statistical construct built on many assumptions. It's based on a study of 9,004 people aged 17 to 64 who were examined between 1988 and 1994. By 2000, 351 had died; of these, 60 were uninsured. The crude death rates among the insured (3 percent of whom died) and uninsured (3.3 percent) were within the statistical margin of error. After adjustments for age, income and other factors, the authors concluded that being uninsured raises the risk of death by 40 percent. They then extrapolated this to the entire population by two techniques, one producing an estimate of 35,327 premature deaths and another of 44,789.
This whole elaborate statistical edifice rests on a flimsy factual foundation. The point is not to deny that the uninsured are more vulnerable (they are) or that extra insurance wouldn't help (it would). The point is that estimating how much is extremely difficult. Advocates exaggerate the benefits. Remember: Today's uninsured do receive care."