Megan on Med

How Many People Die From Lack of Health Insurance? … The most recent available study, which also had the largest sample and controlled for the most variables, found no effect at all. … The left is predictably fond of the study which got the largest number [dead], 45,000 a year.  Unfortunately, its authors are political advocates for a single-payer system, who also helped author the notorious studies on medical bankruptcies.  Those studies are very shoddily done. … The right, meanwhile, shuns the subject like the plague.  It will not do anyone’s career any good to be attached to an argument that sounds like the health care equivalent of “let them eat cake”.

That is Megan at her blog.  More from her in the Atlantic:

Ezra Klein declared that Senator Joseph Lieberman, by refusing to vote for a bill with a public option, was apparently “willing to cause the deaths of hundreds of thousands” of uninsured people. … In the ensuing blogstorm, … few people addressed the question that mattered most: …  If we lost our insurance, would this gargantuan new entitlement really be the only thing standing between us and an early grave?  Perhaps few people were asking, because the question sounds so stupid. Health insurance buys you health care. Health care is supposed to save your life. So if you don’t have someone buying you health care well, you can complete the syllogism. …

The possibility that no one risks death by going without health insurance may be startling, but some research supports it. Richard Kronick of the University of California at San Diego’s Department of Family and Preventive Medicine, an adviser to the Clinton administration, recently published the results of what may be the largest and most comprehensive analysis yet done of the effect of insurance on mortality. He used a sample of more than 600,000, and controlled not only for the standard factors, but for how long the subjects went without insurance, whether their disease was particularly amenable to early intervention, and even whether they lived in a mobile home. In test after test, he found no significantly elevated risk of death among the uninsured. …

The only truly experimental study on health insurance, a randomized study of almost 4,000 subjects done by Rand and concluded in 1982, found that increasing the generosity of people’s health insurance caused them to use more health care, but made almost no difference in their health status. … Analyses of the effect of Medicare, which becomes available to virtually everyone in America at the age of 65, show little benefit. In a recent review of the literature, Helen Levy of the University of Michigan and David Meltzer of the University of Chicago noted that the latest studies of this question “paint a surprisingly consistent picture: Medicare increases consumption of medical care and may modestly improve self-reported health but has no effect on mortality, at least in the short run.” …

We should have had a better handle on the case for expanded coverage—and, more important, the evidence behind it—before we embarked on a year-long debate that divided our house against itself. Certainly, we should have had it before Congress voted on the largest entitlement expansion in 40 years. Unfortunately, most of us forgot to ask a fundamental question, because we were certain we already knew the answer.

Forgot?!  This is no random memory failure.  For many decades health economists have known that the best available evidence shows little or no relation at the margin between med and health.  The health economists advising all the major sides have long known this.  When the data is this noisy, there will always be exceptional studies, and as Megan says, the left prefers to cite exceptions that find more med tied to more health; the right prefers to avoid the issue.

These tactics are far from random accidents; neither side wants to contradict the US public, with their religious-level faith in the healing powers of medicine.  If we were considering a vast new grocery store or car entitlement, the public would hardly “forget” to wonder if that would really give us more nutrition or a faster commute.  But the US public has little religious-style fervor on grocery stores or cars.

How often do you see theists wonder if God is really as good as folks say, or patriots wonder if their nation really deserves their allegiance?  That’s how often you will see the US public question the value of medicine.

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