In 2008, the state held a lottery and allowed poor, healthy, uninsured adults to sign up for Medicaid. For every 10,000 people who enrolled in the health insurance program, 13 lives were saved, the study found.
The results were not statistically significant, although Woolhandler says she believes that was because the study had too few subjects. But, she says, “If you save 13 lives for every 10,000 people you insure, for me, as a doctor, that’s really meaningful.”
On Monday, the American Medical Association registered its opposition to the proposed Republican Senate healthcare bill. If enacted, the physicians’ group said the legislation would make it harder for low- and middle-income Americans to afford healthcare and would violate the precept of “first, do no harm.”2
Although most researchers believe loss of coverage would result in more deaths, the question of mortality benefits from insurance remains unresolved for Black. “It’s not like I’m saying there is no effect,” he says. “I’m saying we don’t know, and let’s go look.”
The question of mortality is not the only question facing members of Congress as they consider reforming healthcare, says Dr. Matthew Davis, a professor at Northwestern University’s Feinberg School of Medicine.
“Even before this study, members of Congress—and the American public who elected them—already have a strong personal sense of the value of health insurance,” he says in an email.
“I have had uninsured patients who were grateful they survived a health problem even though they did not have coverage, but I have never had a patient who told me that the reason they survived is that they were uninsured,” he says.
The Senate’s healthcare proposal aims to undo former President Barack Obama’s signature healthcare law, which has provided coverage to 20 million Americans since 2010. The bill would repeal the 3.8% net investment income tax on high earners and would phase out Obamacare’s expansion of the Medicaid program for the poor.
- Woolhandler S, Himmelstein DU. The relationship of health insurance and mortality: Is lack of insurance deadly? Ann Intern Med. 2017 Jun 27. doi: 10.7326/M17-1403. [Epub ahead of print]
- American Medical Association. Letter to Senate Majority Leader McConnell and Senate Minority Leader Schumer. 2017 Jun 26.