250 state deaths yearly blamed on insurance gap
26.03.2008 04:02
Health
- Source: JS Online
Nearly five people die each week in Wisconsin because they don't have health insurance, according to an estimate released Tuesday by a national group that supports universal coverage. That figure - roughly 250 people a year - is based on an update of an estimate released in 2002 by the Institute of Medicine, an affiliate of the National Academy of Sciences. Families USA, a national health care consumer group, is releasing state figures based on the estimate in part to draw attention to the issue in the coming presidential election. "This makes this hidden tragedy much more visible and quantifies the human toll of the health insurance crisis," said Robert Kraig, program director for Citizen Action of Wisconsin, a grass-roots political group that works on health care and other issues. Nationally, an estimated 22,000 people die each year because they lack health insurance, according to a report released last year by the Urban Institute, a policy research group. That report updated the earlier estimate by the Institute of Medicine that 18,000 people died in 2000 because they lacked coverage. Those figures are estimates and open to argument. Len Nichols, a health care economist at the New America Foundation, described the Institute of Medicine estimate as a "statistical guess" at a conference on insurance coverage in December. But Nichols also said, "I don't think there's anybody who actually treats the uninsured in real life who would argue with the fact that people in our country are dying because they don't have access to health care." Many if not most doctors also can cite first-hand examples of patients who put off seeking needed care because they lack health insurance. In the teleconference on the Families USA report, Barbara Horner-Ibler, medical director for the Bread of Healing Clinic, a free clinic in Milwaukee, cited the example of a 48-year-old man without insurance who died of colon cancer because he did not get the needed screenings despite a family history. Wisconsin has one of the highest rates of insurance coverage in the country and accounts for only a small fraction of the estimated 22,000 people estimated to die each year nationally because of lack of insurance. The U.S. Census Bureau estimated an average of 514,000 people, or 9.4% of Wisconsin's population, were without coverage over a three-year period. Surveys by the state consistently put the figure lower. The most recent estimated that 5% of the population in 2006 was uninsured for the full year and 8% was uninsured at a point in time. Estimates on the number of people without health insurance vary, and no one really knows how many people are without coverage. The uninsured also are far from a homogenous group. For example, the estimates include children and adults who would be eligible for existing state programs. They also include people who are without coverage for brief periods of time, illegal immigrants and young adults who may be able to afford a high-deductible plan. But U.S. Rep. Steve Kagen (D-Green Bay), who participated in the teleconference, said there are 59,000 to 89,000 people in his district who have no insurance coverage. Kagen, a physician, did not answer a question on whether he thought Congress would be willing to raise taxes to expand insurance coverage. But he said that expanding coverage could be done without raising taxes, in part by spending money more wisely. Few question that the health care system can be made more efficient. But economists question the contention that coverage could be expanded to low-wage workers and people with pre-existing conditions - the two groups that make up the bulk of the long-term uninsured - without increasing costs. One of them is Shoshanna Sofaer, a professor of health care policy at Baruch College in New York and a member of the Institute of Medicine committee that produced the initial estimate on the number of people who die because they lack coverage. Expanding coverage or achieving universal coverage, she said in an e-mail, will cost additional money, at least initially. "People who run away from that are actually not doing the cause of coverage expansion or universal coverage real favors," Sofaer wrote, "because it makes us look either ignorant or untrustworthy." Thomas R. Oliver, a visiting professor at the University of Wisconsin School of Medicine and Public Health, agreed. "We haven't found a formula that can instantly expand coverage without increasing costs for somebody's bottom line," Oliver said. Reports such at the one released by Families USA on Tuesday draw attention to the problem. "But that's a very different question than who will pay," Oliver said. "And as soon as you get into who will pay, the political terrain gets very unstable and threatening to all parties."
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