When promoting health care reform there was an implicit assumption that having health care insurance is beneficial. While few rational people would deny this, we now have more data to back up this assumption. The Annals of Internal Medicine published a study comparing counties in Massachusetts to comparable counties in other states to show a reduced mortality among those who received health care coverage. They estimated that giving 830 adults insurance coverage would prevent one death per year.
In this case, supporting health care reform is definitely the pro-life position.
There are a number of variables affecting a reduction in mortality so I would be cautious about extrapolating this number exactly to other areas. The New York Times estimates that the three percent drop in mortality seen would lead to a reduction in 17,000 deaths per year nationally. Harold Pollack extrapolated the reduction of 830 deaths per year to the entire uninsured population, providing an estimate that extending health care to all could lead to a reduction in 24,000 deaths per year. To put this in perspective, “That’s almost the number of Americans who die in auto crashes. It’s more than the number who die of AIDS or the number who are murdered every year.”
Some conservatives have questioned the value of this by arguing that there could be less costly ways to save the same number of lives. This misses the point that there are multiple other benefits of having insurance beyond the reduction in mortality. Providing health care coverage could lead to a reduction in the number of diabetic patients who go blind or lose limbs. Insurance coverage for people with hypertension could reduce the number who have to live with the effects of a stroke. Health care reform also spares people from going bankrupt to pay medical bills.
Some conservatives have also twisted the results of a previous study on those who received Medicaid coverage in Oregon to claim that receiving the coverage is not of benefit. The study actually did show benefits, but was not conducted for a long enough period to show significant differences in those with chronic medical problems. The Massachusetts study published this week helps to clarify this issue. Of course if conservatives want to argue that providing Medicaid is not of value, I would be very happy to see a system in which instead of receiving Medicaid the poor are provided the public option initially proposed, or even regular insurance through the exchange, in place of Medicaid. (Due to their lower incomes, it would also be necessary to provide coverage for the co-pays and deductibles, comparable to how Medicaid covers these costs for those duel eligible for Medicare and Medicaid.)
If providing access to health care saves lives, the converse would also be true. Denying people access to health care coverage would lead to more deaths. The Health Affairs Blog looked at the consequences of denying expanded Medicaid coverage in many of the Republican controlled states:
We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.
Those denied access to the expanded Medicaid program is probably the largest group who could be covered under the Affordable Care Act as originally passed but are not able to receive coverage. Considering the amount of misinformation being spread by the right wing, and outright campaigns to encourage people not to enroll, there are undoubtedly some people who are not obtaining coverage due to falling for right wing propaganda. The old cry during the Bush years and Iraq war was that “Bush Lied, People Died.” Down the road the sad truth about conservative misinformation on health care might be “Fox Lied, People Died.”
Originally posted at Liberal Values