the missing dead

47 Million.  I don't even have to say 47 million what. You already know who they are.  Google recognizes it before you even finish typing it -- start keying 47 million into Google, and before you finish the prompt is begging to complete your query: 47 million uninsured Americans.  No health insurance.

It sounds bad.  Tragic, even.  And you can't gloss over it.  Even when you know that ten million or more of our uninsured are young, healthy people who've simply elected to forgo coverage during times of good health, it's still a tragedy -- even for them.  After all, young people do get cancer occasionally.  They take foolish risks, and end up having more accidents.  Dying in childbirth.

Even among ten million healthy young uninsured, there must be thousands -- probably tens of thousands -- of life threatening medical emergencies each year.  And without insurance that can only mean certain death for tens of thousands of precious young lives.  Right?

But insurance, after all, is just a security thing.  I mean, 47 million Americans who are exposed to risk doesn't sound nearly as scary as how many people must be actually dying for lack of healthcare, does it?  And it's not fair to limit the death toll to just the uninsured -- because we all know that health insurers regularly deny expensive treatment to insurees, and technically those poor victims are all dying untreated even with insurance.  We can't just leave them out, can we?

So I thought I'd cut to the chase, blow through the cloud of uncertainty, and get right down to the nitty gritty.  Forget insurance: How many Americans are actually dying because they can't afford healthcare?  Not just the uninsured, but also insured people whose greedy insurance companies simply won't pay?

I mean, 47 million is a lot of people, but that's just people without insurance.  If you want to elicit an emotional response; if you want to stir up a little activism; if you want to create a groundswell of political will to actually do something about our health insurance crisis -- then you have to put up the gory, bloody, no-fooling body count.

So I went looking for it.  And looking.  And looking.  It's like it's not out there.  Sure, there are some estimates, but they're all over the map.  It's not like anyone's published a comprehensive, scientific, peer-reviewed report with a big, scary, these-are-real-people-dying-here tragic number on it.  It's as if, in all the commotion over the 47 million tragically uninsured, everyone forgot to count how many are actually dying.  I must say, it's hard to believe such an oversight has occurred!

After all, you know they're out there.  Why, every year or so there are headlines about some poor kid who's denied a transplant because the so-called "medical science" (now there's a bureaucratic term if I ever heard one!) says it can't possibly save them.  And transplant or not, they invariably die, so you just know somebody out there is keeping a tally.  But where is it?

Anyway, I just thought it was interesting that, despite all the talk of the 47 million uninsured, for some reason we can't find out how many of them are dying as a result.  Curious, huh?

Now, on a completely unrelated note, I was just noticing how expensive my health insurance is.  I pay a lot.  And I was thinking, if there are, say, 253 million Americans who are all paying too much for healthcare -- like I am -- then there must be a lot of money left over.

Even after subsidizing Medicare through cost-shifting, and even after all the unnecessary procedures and defensive medicine brought about by the trial lawyer lobby, we must still be wasting a ton of money on our healthcare.

In fact, I was thinking it's so much money that, if only there was some sort of back-channel way it could be funneled -- some sort of informal economy; a mechanism for just transferring it -- we probably overpay so much for our insurance that it's enough to subsidize all the urgent care for millions of uninsured.  Tens of millions, even.  Maybe almost 50 million.  Our overpriced healthcare could be subsidizing the urgent care of all our uninsured.

If only the private sector had the means to write off losses and subsidize "free" care with our insurance premiums instead of just making a greedy profit!

If only all the hospitals and foundations could use their expertise and private-sector discretion, to channel their overcharges to provide for the urgent needs of our uninsured, there might just be enough to cover it all.

And if I knew how many of our uninsured were dying, I could tell you how many lives it would save.  But, for some reason, nobody will say how many that is.

But that's all on a completely unrelated note, of course.

And, as even the stupidest liberal knows, it'll never work that way.

That's the John Galt Line.

Comments

[JohnJ]

Well, I know someone who knows someone who heard about someone who died without insurance, so that proves that people can't be trusted to make such important decisions for themselves. Freedom is slavery!

/liberal

[JohnJ]

Plus the fact that no one with insurance ever dies. That's like, I dunno, a fact or something.

You want people to die!

/idiot

[Tyler Mitchell]

I work in a hospital. It's so frustrating seeing that the uninsured get better 'healthcare' than the insured. They get taken through every test the hospital can offer while the insured have to pick and choose which services they get because their insurance won't cover certain procedures. Plus, they know they'll still be paying the co-pay for months after they're out. The uninsured demand more because they know they don't have to pay for it.

[Dagny]

Here's a little tip for the uneducated: Health insurers take only 3 cents of every premium dollar as profit. It is the least profitable of all big industries.

If we could only have folks use common sense (get to a clinic for preventive care, offered on a sliding scale), we wouldn't even NEED urgent care so much! I agree that private funds could be used to help the uninsured or underinsured.

Getting there is the biggest hurdle.

We have to figure out a way to motivate US citizens to use common sense in eating, exercising, and preventive care habits. On their own. Then & only then can we possibly have the basis for viable health care reform.

[John Galt]

Actually, my point was that private funds already are subsidizing all of the free care. I wrestled with whether I was being clear enough about this when I wrote the post. Maybe I wasn't.

A major reason healthcare is so expensive is because providers are writing off so much care for people who don't pay their fair share. That includes Medicare which underpays by paying fixed prices -- providers simply raise rates to other groups to make up the difference, a well-documented (but poorly publicized) process known as "cost shifting."

And the reason we don't hear about millions of uninsured people dying is because even without insurance they're receiving all this urgent care. While this system doesn't have the security blanket feeling that liberals demand, it's effective enough that they don't want you to know how successful it is. In other words, you don't see how many few lives are lost due to lack of insurance because that's not the same as lack of care, and in fact plenty of care is being provided. And if word of this success ever got out, it would threaten the entire socialized medicine movement. The truth must be suppressed, and that is why there is no reporting on how few people actually die for lack of care.

Additionally, more and better care are provided when hospitals and providers can exercise their discretion to apply resources where they will do the most good, compared to a government policy that simply requires treatment for all who demand it. The money that "leaks" from this system provides exceptional care to the people who truly need it, and all of that quality goes in the toilet when we nationalize.

As far as individual responsibility is concerned, that won't be on the table until insurers can make individual assessments of risks. Nearly all health insurance today has group pricing (this has to do with the deductibility of group insurance), and most individuals do not feel the individual cost of the unique risks they present to their entire group.

[ThirdParty2012]

You're missing the point. Health care is important because it keeps us productive and happy, not because it barely keeps us from dying. You can count how many people die from lack of health care, but your partisan attacks make me wonder if you would feel the same way about other government programs.

For example, how many people would be illiterate if we eliminated public education? If this number is very low, would you support ending government schools?

How many invasions has the US military had to repel in the last 100 years? If there were no credible threats to our safety (see: Switzerland and Costa Rica) would you advocate ending publicly funded military spending?

Would we be able to travel from place to place without the government paving roads for us? Surely. But our interstate system and roads and bridges allow us to take direct, fast routes and make us more productive.

Are people unable to play in their own yards? Do they really need the government to provide them with parks to play in? Maybe not, but this is a big quality of life issue that most people agree is a reasonable government expense, as its cost is miniscule when spread throughout the population.

Yes, we could likely survive pretty well without health care. I have gone for years without seeing a doctor. But health care is there to provide stability for families, to provide productivity for the workforce, and to protect the quality of life of the entire population by ending suffering and illness. Measuring this by the number of deaths is like measuring the quality of our economy by the number of jobs we have, while ignoring the salary paid. The big picture is important.

[John Galt]

I don't have a problem with healthcare. I have a problem with healthcare that's not principally funded by healthcare consumers. In particular, I have a problem with the wealthy being asked to compromise their healthcare to provide care for the poor, and for the healthy to be coerced into providing for the care of the sickly.

And I have a problem with all the hype about "47 million" people without insurance when in fact virtually nobody is dying for lack of care. I sure as hell don't see it as justification for dismantling the system which gets no credit whatsoever for saving the lives of the entire "47 million" when they get sick even if they don't have insurance.

For example, how many people would be illiterate if we eliminated public education? If this number is very low, would you support ending government schools?

Even if the number was high. You're damned right I would. In a minute.

"How many invasions has the US military had to repel in the last 100 years?"

You'd be writing in German right now if we didn't have a military. Or Russian. And probably everyone in Switzerland and Costa Rica, too. Assuming your parents and grandparents hadn't been killed during the invasion(s), that is.

"Do they really need the government to provide them with parks to play in?"

Hell, no. Ever heard of Orlando? There are no provisions in the Constitution for national parks, and there's no reason that even government parks couldn't be funded entirely by the proceeds from user fees.

When's the last time you spoke up in favor of making cheap healthcare legal instead of making overpriced healthcare free?

The piece is not about counting bodies -- it's about how and why there are no actual bodies to count.

[elocin]

my mom died from cancer
because the insurance company
wouldn't pay for a cureable "expiramental" ((bullshit)) treatment.

so dont FUCKING tell me no one with insurance ever dies.

body count;
one and counting...

[John Galt]

I'm sorry for your loss.

I'll bite: What was this "experimental" treatment, and what makes you so sure it would have saved your mother? Do national medical plans in countries like Canada pay for this treatment? Did you and your siblings sell everything you owned to help pay for Mom's treatment when the insurance company said it would not?

If we'd had a national medical plan that would have paid for this treatment, thereby saving your mother, what makes you so sure other people wouldn't have died on waiting lists for other procedures? Aren't you just a little biased to be concluding that would have been better?

My original point is that people without insurance are not having significantly worse outcomes than people with insurance. Since your mother had insurance and died anyway, are you sure you're not making my point?

[Just Some Internet Guy]

Came across this post while arguing about health-care on another internet forum about the merits of a public option etc and though this post is old and there may have been follow-ups I figured I'd just go ahead and clear up a question asked in the post.

44,000 Americans die each year from treatable illnesses due to lack of insurance: http://www.scientificamerican.com/blog/post.cfm?id=lack-of-insurance-causes-more-than-2009-09-17

It's also worth noting that on top of that about 62% of all personal bankruptcies in the US are also caused at least in part by medical bills:
http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm

Both of the studies that collected this information were released after this blog post was written so I certainly don't expect that it should include these numbers, but it may be relevant here in the comments section as an update.

[John Galt]

People don't die from lack of insurance -- though they could die from lack of care.

Having insurance does not ensure timely care, and it turns out that people in countries with universal "insurance" die every day while waiting for care.

Consider a recent estimate of 7000-9000 Britons per year who die because they do not get a ration of care, and then account for the fact that our population is five times theirs: 35000-45000. Not a strong argument that universal care would save more lives -- just an argument that it might save different lives.

And even this relies on the accuracy of the 44000 number in the first place, which itself is debatable:
http://maaadddog.wordpress.com/2009/09/19/study-shows-persons-without-medical-insurance-more-likely-to-die-than-those-who-do-have-medical-insurance/

An argument for reform needs to rely on the improvement it would make over the current system -- not on some arbitrary shock figure that purports to show how bad the current system is. Big difference.

[Jimmy]

The problem with raising that argument, John, is that liberals expect you to have all the answers. IF you intend to refute the idea that socialized medicine isn't a good solution, then you'd better be able to come up with one that is, off the top of your head, immediately, or you may as well just "go with this one." It's like a chickenshit straw man Pascal's wager.

It's an epidemic problem. Our society fights ignorance with more ignorance all over. The whole "color-blind movement" is a glaring example. It takes a political, social, economic genius to come up with a plan all on his own that he could easily articulate to you in a short enough span of time that you'd listen to fix the obvious wrongs, but the left would like to paint every reasonable person that doesn't see the merits of THIS particularly awful plan as a heartless old-lady killer.