Yes, insurance status does matter for your health

October 11, 2012

Mitt Romney talked to the Columbus Post Dispatch Thursday morning about health care in the United States, making the case that those without coverage can still seek adequate care.

The uninsured, he said, "go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital."

“We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack.'"

Actually, we sort of do. Researchers at Johns Hopkins University published a study this summer looking at morality rates for heart attack victims. They separated out the patients who had insurance coverage and those who didn't. They adjusted for the severity of the disease and also the patient's neighborhood of residence, a proxy for socio-economic status. They found the uninsured had a risk of death 31 percent higher than those with private coverage after a heart attack.

That's not necessarily because the uninsured received worse care for their heart attack, the researchers point out. Instead, it likely has to do with all the preventive care that patients may have skipped out on:

In this analysis, insurance status is likely a proxy for access to care and subsequent poor or incomplete management of cardiovascular risk factors among those with CVD. The phenomena associated with being underinsured, including insurance instability, problems with clinics accepting payments, and inability to afford medications, may be some of the factors that define this high-risk group and contribute to poor disease management.

Other research has found a connection between insurance status and health care outcomes. University of Pennsylvania's Zeke Emanuel pointed me to this chart, which segregates out cancer survival rates by insurance status.


"In almost every way we've looked at it," Emanuel says, "If you're uninsured you get worse or more delayed care. In the case of cancer, this is something that can be a matter of life or death." 
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Dylan Matthews | October 11, 2012