What Are the Mortality Risks of Being Uninsured?

This is from Chris Conover:

Since the evidence is equivocal at best, let us — for purposes of discussion — average the point estimates from 4 studies…and compare this relative mortality risk (1.22) to other factors that elevate the annual probability of death.


…[I]f the goal of health reform were simply to reduce mortality and if we believe the uninsured face a 22% higher mortality risk [I trust the first half of this post makes clear that I believe this figure greatly exaggerates that risk, and am using it merely for discussion purposes], then for each uninsured person who became newly covered under ObamaCare, we could have achieved roughly the equivalent or greater mortality reductions by a) having a high school graduate earn a graduate school degree; b) preventing one divorce; c) getting an obese person down to normal weight; or d) getting one smoker to quit.

Given that ObamaCare will (according to the CBO) spend $4,700 in subsidies per person who receives subsidized coverage on the Exchange in 2014, one obvious question is whether we could have gotten more bang for the buck by focusing on any of these alternative approaches to reducing mortality. The unequivocal answer is yes: here’s just one example of a smoking cessation program able to achieve its results at an average cost of $540 per quitter. There’s plenty more such interventions where that came from.  And remember, that’s a one-time cost, not an annual on-going cost like the Exchange subsidies will be.

Comments (17)

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  1. Matthew says:

    Is one of the primary goals of health reform to reduce mortality? I hear a lot about cost and access to care, but it is never about our rising mortality rates.

    • Thomas says:

      It would be in the long run I suppose. I feel the reason for health reform is to reduce all costs for individuals and limit barriers to entry.

      • James M. says:

        These are all factors in health reform. But if health care wasn’t so costly, more people would see a doctor. The more that see a doctor are healthier, and they healthier the longer you live and so on.

        • Matthew says:

          My point being is that the post focuses on mortality rates not being much different from being uninsured to being divorced or whatever. But health reform was not a reaction to high mortality rates. I’d rather see a post about, say, debt and health reform. For example, will hospital bills shrink because of reform?

  2. Andrew says:

    “…one obvious question is whether we could have gotten more bang for the buck by focusing on any of these alternative approaches to reducing mortality. The unequivocal answer is yes.”

    Instead of health reform, actions to get rid of cigarettes or to educate people would do just as much or more to improve mortality rates.

  3. Jay says:

    “How Risky Is It To Be Uninsured?”

    Evidently about as risky as only being a high school grad.

  4. Paul V says:

    It would be interesting to find out the relation between the same items and bankruptcy. It is widely known that one of the major point favoring Obamacare is their claims that those who were uninsured risked bankruptcy when they required treatment. If the study proves it different, it will leave Obamacare without legs.

  5. Tom says:

    Interesting! Haven’t really spent much time thinking about it in terms of mortality.

  6. Patrick S says:

    Do individuals really seek medical insurance to prevent death? Having insurance is about having peace of mind. It is about being able to face health complications without fear of bankruptcy. I don’t think that we should judge the need of insurance solely as a measure to prevent death.

    • Miguel F says:

      Agree. Those who live uninsured are not doing so because they love the thrill of having higher chances of dying, thy simply oppose the system and the concept of insurance. It is like smokers, people smoke because they like it, not because they want to die faster.

    • Jordan says:

      I don’t think it’s about death. More about getting sick

  7. Jimbino says:

    Being insured is always worse, since insurance returns less than 80 cents on the premium dollar spent. A young man who forgoes health insurance, puts his monthly premium on one spin of the roulette, invests the proceeds in the S&P500 and pays cash for his health care will be a millionaire many times over on turning 65.

    In fact, the return on the insurance dollar is so bad for a young, single man that anyone purchasing health insurance on his behalf would normally be guilty of mismanagement of his funds.