Health consequences of private insurance

Health consequences of private insurance

********************************************************************** 

Wilper AP, Woolhandler S, Lasser KE, McCormick D, Bor DH, Himmelstein DU. Health insurance and mortality in US adults. American Journal of Public Health, December 2009; Vol. 99, No, 12.

44,000 excess deaths from lack of access to health care.

**********************************************************************

Scot J. Paltrow. Insurers’ Black Box: Now-Secret Claims Denial Rates Could Tell Consumers a

Lot About Their Insurance Company. Center for American Progress, October 21, 2009

**********************************************************************

http://www.americanprogress.org/issues/2009/10/pdf/insurers_black_box.pdf

Management influence on medical decisions by claims physicians

**********************************************************************

Davis K. Will consumer directed health care improve system performance? Commonwealth Fund, Washington DC, August 2004

Consumer driven health care and high deductible private insurance postpone care and increase costs

**********************************************************************

Woolhandler S, Himmelstein DU. Consumer directed health care: Except for the healthy and wealthy, it’s unwise. Journal of General Internal Medicine 2007;22:881

Consumer directed health care means the poor get no health care

**********************************************************************

Krugman P. Passing the buck. New York Times, April 22, 2005

Competition for insurance companies means avoiding the most expensive enrollees and denying the most care

**********************************************************************

Associated Press. Study: Health insurers are near monopolies. April 18, 2006

Private insurers have near monopolies in 95% of HMO/PPO metropolitan markets

**********************************************************************

Goldman DP, et al. Prescription drug cost sharing: Associations with medication and medical utilization and spending and health. JAMA 2007;298:61-88

Deductibles and co-pays worsen clinical outcomes

**********************************************************************

Soumerai SB et al. Effects of Medicaid drug payment limits on admission to hospitals and nursing homes. New England Journal of Medicine 2004;325:1072-7

**********************************************************************

Newhouse JP. Consumer-directed health plans and the RAND health insurance experiment. Health Affairs 2004;23(6):107-13

Consumer driven health care leads to worse outcomes and higher costs

**********************************************************************

Collins SR, et al. Squeezed: Why rising exposure to health care costs threatens the health and financial well being of American families. Commonwealth Fund, September, 2006

58% of individuals shopping for insurance could not afford what was available

**********************************************************************

Richard Epstein. Letters. JAMA, March 11, 1998

It is wrong to redistribute wealth to provide the poor with free health care

**********************************************************************

Urban Institute. Uninsured and dying because of it: Updating the Institute of Medicine analysis on the impact of uninsurance on mortality (2008). www.urban.org/Uploaded PDF/411588_uninsured_dying_.pdf

22,000 die annually because of unaffordable health care

Accident victims without insurance are 37% more likely to die than the insured

Uninsured cancer patients 30-50% more likely to die

**********************************************************************

Thomas Bodenheimer, Kevin Grumbach. Understanding Health Care Policy: A Clinical Approach. Lange Medical Books, 2005, p. 3, 25…………….

79% of Americans want “fundamental changes” or “complete overhaul” of health system.

p. 109 Correlation between gun availability and death rate among those under 25 yo

p. 25 Those with annual incomes below $10,000 and 3-6 times more likely to die before age 64 than those with incomes over $25,000

**********************************************************************

Institute of Medicine – http://www.iom.edu/CMS/3809/4660/17632.aspx

Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States

**********************************************************************

Trivedi AN, Moloo H, Mor V. Increased ambulatory care copayments and hospitalizations among the elderly. N Engl J Med 2010;362:320-8.

http://content.nejm.org/cgi/reprint/362/4/320.pdf

Higher co-pays decrease primary care and outpatient visits, increase hospitalizations and overall health care costs in Medicare patients. This is amplified among the poor, uneducated, and those with chronic diseases (hypertension, diabetes, and coronary artery disease).

**********************************************************************

http://www.amq.ca/congres2006/pdf/Compelled_to_Act-Robert_Petzel.pdf, Slide 28, Robert Petzel to Quebec Medical Society, 2005

1 in 7 (15%) hospital admissions occurs because care providers do not have access to previous medical records.

20% of laboratory tests are requested because previous studies are not accessible.