I don't mean to pick on Humana, folks. It's just that I couldn't resist the pun. This post is about something really fundamental. So fundamental, in fact, as to be largely assumed by pretty much everyone. But you know what they say about assumptions. The assumption is this: That having health insurance translates into better health. Actually, it's the negative form of that statement that is most concerning: Does lacking health insurance translate into poorer health? Before I jump to answering that question, I want to share an excerpt from a recent piece by Jonathan Cohn that I think does a good job of reminding us what health reform is -- or should be -- all about:
"Although it's become strangely unfashionable in elite political circles to frame health care reform as an effort to curb human misery, health care reform is, in fact, an effort to curb human misery. Numerous studies have suggested that thousands of people die every year because they cannot pay for the medical care they need. And that's to say nothing of the many more who endure severe financial hardship....There's a natural tendency in politics to assume the very best about our allies and the very worst about our adversaries...When a politician stands up for a cause we think is righteous, we tend to assume that politician is righteous. When a politician stands up against a cause we think is righteous, we tend to assume that politician is venal, craven, or callous. Sometimes that is true, to be sure. But sometimes it is not. Health care is a perfect example. It is certainly possible to oppose health care reform on principled, moral grounds. If you sincerely believe that even modest, incremental reforms will destroy innovation, crush the economy, create nightmarish bureaucracies, and spark harsh rationing for the sick and elderly, then opposing health care reform isn't putting lives at risk--it's saving lives, not to mention a way of living. And if you don't believe any of those things but do believe that, overall, health care reform will be a net negative to society, then opposing health care reform is less a matter of high principle but very much a matter of sound judgment. [It is also possible to support health care reform on similar moral grounds.]"
So, when it comes to the uninsured, the first question must be: Is the lack of insurance hurting them? In a 2002 report Care Without Coverage: Too Little, Too Late the Institute of Medicine answered that question with a resounding yes, and a 2008 report issued by the Urban Institute confirms that finding. The IOM concluded that lacking insurance equated to a 25% increase in mortality risk among working-age adults. According to Urban, this meant approximately 137,000 Americans died between 2000 and 2006 because they didn't have insurance. That's like wiping a city the size of Savannah, Georgia off the map every seven years. Obviously, as the percent of uninsured Americans increases, the volume of "excess" deaths will rise as well. You see, this isn't just a statistic, and it isn't just a matter of politics. It's a matter of life and death for a very significant number of people in this country. We may disagree over the specifics of how to fix the problem, but I sincerely hope that we can all agree that being uninsured is a problem. No American should die because their lack of health insurance prevented them from getting the care they needed. Sitting idly by while it happens to thousands and thousands of people every year is -- ironically it seems to me -- both completely un-American and yet almost uniquely American. I pray that we will rise above our pettiness of self and change that.
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