Plan B Forum

The very purpose of a Bill of Rights was to withdraw certain subjects from the vicissitudes of political controversy, to place them beyond the reach of majorities and officials and to establish them as legal Principles to be applied by the courts. One's right to life, liberty, and property, to free speech, a free press, freedom of worship and assembly, and other fundamental rights may not be submitted to vote; they depend on the outcome of no elections. ~ Justice Robert H. Jackson, West Virginia Board of Education vs. Barnette, 1943

I think it is safe to assume that there are many people in the US with untreated chronic conditions (e.g. hypertension, coronary and vascular disease, diabetes) and other diseases etc.

MajGenl.Meade wrote:And who are these people dying every day? They need to stop it at once. (I mean, data please. How many, where and why?)

New study finds 45,000 deaths annually linked to lack of health coverage

Uninsured, working-age Americans have 40 percent higher death risk than privately insured counterparts

September 17, 2009
By David Cecere, Cambridge Health Alliance
Nearly 45,000 annual deaths are associated with lack of health insurance, according to a new study published online today by the American Journal of Public Health. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

“The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health,” said lead author Andrew Wilper, M.D., who currently teaches at the University of Washington School of Medicine. “We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”

The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking into account education, income, and many other factors, including smoking, drinking, and obesity. It estimated that lack of health insurance causes 44,789 excess deaths annually.

Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.

Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease. An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths, as the uninsured are more likely to go without needed care. Another factor contributing to the widening gap in the risk of death between those who have insurance and those who do not is the improved quality of care for those who can get it.

The researchers analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.

The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those who examining physicians said were in fair or poor health (222 percent increase).

Steffie Woolhandler, study co-author, professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance, noted: “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”

“The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” remarked David Himmelstein, study co-author, associate professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance.
“Even this grim figure is an underestimate — now one dies every 12 minutes.”

Other authors include Karen E. Lasser, Danny McCormick, David H. Bor, and David U. Himmelstein. The study was supported by a National Service Research Award.

bigskygal wrote: "...

People all over this country die every day from the simple lack of healthcare.

How does that not violate their most basic fundamental civil rights?


Discuss.

Joe Guy wrote:I noticed that all of the rights in Justice Roberts' examples are things that we as individuals have an inherent right to do on our own. Healthcare requires a person to help heal or medically treat another individual.

Is it correct to believe that healthcare a civil right that allows us to demand it from another individual or group?

One assumes that in a true world of liberty, people are free to live or die as they please without everyone else paying for their success or failure

But I thought I'd take a minute to deal with an even more fundamental question: How sure are we that the Affordable Care Act is saving lives?

At this point, the answer is "not very." I think it's quite possible that five years hence, the mortality rate charts will show a sharp inflection point starting around 2014. However, I also think it's quite possible that five years hence, the mortality rate charts will show ... nothing at all. Forget those eye-popping statistics we've all heard about how a lack of insurance costs tens of thousands of lives a year. When you look at a broad array of studies, the evidence is surprisingly mixed, with some studies showing large effects, and others showing no improvement in mortality. Two randomized controlled trials, the gold standard for medical research, have been done on the benefits of generous health coverage; both showed no significant medical impact from paying for people's health care. Oh, you can pull out subgroups and say that hypertension got better among these folks, but there's a risk with that sort of thing that surprised researchers are simply committing the Texas sharpshooter fallacy.

Now, that doesn't mean there's no effect -- the studies are hard to do, and even a very well done study (which both of these were) can show spurious effects simply by random chance. Moreover, it's pretty clear that there are significant nonmedical impacts; people like having health insurance, and it protects them from the negative financial impact of large medical bills. This is not the most surprising result, either: If you pay for stuff that people buy, they will have more money in their pockets, and they'll be pretty happy about that. But it is an impact. Whether you think that was worth spending $1 trillion on is an exercise that must be left to the reader.

I know what you're thinking: This must be baloney. Obviously, health insurance makes us healthier. How could it not? It buys us health care.

All I can say is that history is filled with obvious things that turned out not to be so. Our intuitions are a poor substitute for evidence -- and people's intuitions are doing a simply enormous amount of lifting in the interpretation of the various studies about the benefits of health insurance.

The US has by far the highest first-day death rate in the industrialized world. The report states, “An estimated 11,300 newborn babies die each year in the United States on the day they are born. This is 50 percent more first-day deaths than all other industrialized countries combined.” The 33 other industrialized countries for which data was collected recorded a combined total of 7,500 first-day deaths each year.

1 Japan 84.6 yrs
9 Australia 83 yrs
28 United Kingdom 81 yrs
36 United States 79.8 yrs

The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from the most recent three Commonwealth Fund surveys of patients and primary care physicians about medical practices and views of their countries' health systems (2007–2009), confirms findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the most recent (2008) U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.

Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by the U.K. and Australia. The 2010 edition includes data from the seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.

http://www.commonwealthfund.org/publica ... ror-update

Long Run wrote:I take BSG's question as a philosophical rather than legal question since there is no "right" to healthcare, any more than there is a right to a house or to a job, etc., except to the extent one goes out and obtains such good or services on their own.

However, as to the belief that health insurance results in better health:

But I thought I'd take a minute to deal with an even more fundamental question: How sure are we that the Affordable Care Act is saving lives?

At this point, the answer is "not very." I think it's quite possible that five years hence, the mortality rate charts will show a sharp inflection point starting around 2014. However, I also think it's quite possible that five years hence, the mortality rate charts will show ... nothing at all. Forget those eye-popping statistics we've all heard about how a lack of insurance costs tens of thousands of lives a year. When you look at a broad array of studies, the evidence is surprisingly mixed, with some studies showing large effects, and others showing no improvement in mortality. Two randomized controlled trials, the gold standard for medical research, have been done on the benefits of generous health coverage; both showed no significant medical impact from paying for people's health care. Oh, you can pull out subgroups and say that hypertension got better among these folks, but there's a risk with that sort of thing that surprised researchers are simply committing the Texas sharpshooter fallacy.

Now, that doesn't mean there's no effect -- the studies are hard to do, and even a very well done study (which both of these were) can show spurious effects simply by random chance. Moreover, it's pretty clear that there are significant nonmedical impacts; people like having health insurance, and it protects them from the negative financial impact of large medical bills. This is not the most surprising result, either: If you pay for stuff that people buy, they will have more money in their pockets, and they'll be pretty happy about that. But it is an impact. Whether you think that was worth spending $1 trillion on is an exercise that must be left to the reader.

I know what you're thinking: This must be baloney. Obviously, health insurance makes us healthier. How could it not? It buys us health care.

All I can say is that history is filled with obvious things that turned out not to be so. Our intuitions are a poor substitute for evidence -- and people's intuitions are doing a simply enormous amount of lifting in the interpretation of the various studies about the benefits of health insurance.

http://www.bloombergview.com/articles/2 ... e-or-death

People all over this country die every day from the simple lack of healthcare.

How does that not violate their most basic fundamental civil rights?