Is Being Uninsured a Health Hazard?

While attending  graduate school, and studying psychology, our professors did not try to hide the disdain they felt for the academic studies carried out by medical doctors. Our professors pointed out that MD’s did not receive the kind of training necessary to design a study properly and then conduct valid statistical analysis. Critiquing scientific studies was a central part of our education. For our Masters thesis, we were given the opportunity to design and implement a controlled study; an opportunity most MDs never experience.

At the time, I did not share my professors’ anti-MD sentiments. I believed PHD vs. MD envy played a role in their perspective.  Over the years, however, I noticed over and over again that the poorest examples of scholarship seemed to emanate from studies carried out by MD’s.

Mistakes Were Made, is an excellent book by Tarvis and Aronson; published in 2007.  One chapter reviewed the failed theory of repressed memories. This theory resulted in the destruction of many families, and even the incarceration of innocent people. It was the Psychiatric community that discovered repressed memories, promoted the theory as fact, failed to study the theory scientifically, neglected to provide appropriate peer review, and upheld this myth in the face of severe external criticism. I don’t have time to get into the details here, but it is a fascinating saga. The authors of Mistakes Were Made were much less kind to these MD’s than even my professors were. A key reason for this tragedy was that, “…most psychiatrists , who have medical degrees, learn about medicine and medication, but they rarely learn much about the scientific method, or even about basic research …”

With that introduction behind us, we can consider whether being uninsured is a health risk.  In December of 2009, five Harvard MD’s published a report, Health Insurance and Mortality in U.S. Adults,  where they concluded that the absence of health insurance resulted in the deaths of nearly 45,000 people a year in the US.  This report has been broadly quoted and used as evidence in support of the health care bill. The authors came to their conclusion by monitoring the death rates of a group of insured compared to a group of uninsured, over a nine-year period. The American Thinker did a story on this study, and titled it How Four Deaths Became 401, 309. The story is short, but statistical.

The study is about as poorly designed as is possible and not straightforward. However, according to the American Thinker review of the study, the bottom line is this – out of 9,005 uninsured in the study, 351 died during the nine-year period. This was roughly 4 more people than died in the comparable “insured” group. The authors of the Harvard study then interpolated out over the entire population to turn those four additional deaths into nearly 45,000 per year and over 400,000 over nine years.

However, the study did not control for accidental deaths, violent deaths, suicide, drug use or abuse, etc. Considering that behaviors leading to “non-medical” deaths would be at least somewhat more common among the uninsured group, it is very surprising that only 4 more people died in this group. Actually, a more appropriate outcome of the study would be to question whether health insurance in actually unhealthy – leading to unnecessary procedures that cause more harm than good.

Whether the Harvard doctors are under educated or biased isn’t known, but their study results are misleading and have no value.

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