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. 2008 Apr 19;336(7649):855. doi: 10.1136/bmj.39549.693981.DB

More than 26 000 Americans die each year because of lack of health insurance

Janice Hopkins Tanne 1
PMCID: PMC2323087  PMID: 18420687

Many more Americans die because of a lack of health insurance than previously thought, concludes a new state by state study by Families USA, a non-profit organisation that advocates health care for all Americans.

More than 26 260 Americans aged 25 to 64 died in 2006 because they lacked health insurance—more than twice as many as were murdered, Families USA said. In the seven years from 2000 to 2006 an estimated 162 700 Americans died because of lack of health insurance.

Families USA said, “The number of uninsured Americans reached 47 million in 2006, and it continues to rise. For many of the uninsured, the lack of health insurance has dire consequences. The uninsured face medical debt, often go without necessary care, and even die prematurely.”

In 2002 the US Institute of Medicine estimated in its report Care Without Coverage: Too Little, Too Late that 18 000 adults aged 25 to 64 died because they did not have health insurance. The Urban Institute, a non-partisan economic and social policy research institute, estimated that 22 000 to 27 000 adults in the same age group died in 2006 because they lacked insurance.

Families USA reported that it generated “the first ever state-level estimates of the number of deaths due to lack of health insurance.” It applied methods used by the Institute of Medicine and the Urban Institute to data at the state level.

Kim Bailey, senior health policy analyst at Families USA, said that state level reports were more useful in “getting the message to people,” because “large national reports tend to get lost in the weeds.”

Uninsured people are generally sicker and die earlier than people who have insurance, Families USA said. Lack of insurance is the third leading single cause of death among Americans aged 55 to 64, after heart disease and cancer, the organisation said.

Stan Dorn, author of the Urban Institute study, said that although some studies stated that people aged 25 to 64 were 25% more likely to die if they lacked health insurance, the risk of death was probably higher because uninsured people are less healthy than insured people. Earlier studies, he said, did not control for the effect of health status on health insurance coverage.

Insurance is important, Families USA said, because uninsured people are less likely to have a regular source of care outside emergency departments and because they go without screenings and preventive care. Uninsured people often delay or forgo medical care they need. When they do get medical care they pay more for it, because they cannot negotiate discounts on hospital and doctors’ charges, as insurance companies do.

The percentage of uninsured people in each state ranges from 10% in Minnesota to 28% in Texas. However, Ron Pollack, executive director of Families USA, advised against making comparisons across states because of differences in population size and death rate.

Dying for Coverage is available at www.familiesusa.org.


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