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135,000 uninsured Americans will die before health reform takes effect, analysis finds

By Brad Jacobson
Tuesday, December 15, 2009 10:49 EDT
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Over 6,600 uninsured veterans will die by 2013: estimate

If Democrats manage to pull off efforts to reform the US healthcare system and ensure coverage for millions who are currently without insurance, the new system — by design — will likely still leave tens of thousands to die without insurance before reforms kick in.

A Raw Story analysis, based on a recent Harvard Medical School study, estimates that 135,000 American citizens and over 6,600 US veterans will die due to a lack of health insurance before current proposed healthcare reform measures would take effect.

One hundred and thirty-five thousand US lives far exceeds the total number of Americans who died in the Korean War, the Vietnam War and the attacks of 9/11 combined. The lives of over 6,600 US veterans is more — by over 1,300 — than the total number of US soldiers who have thus far died in both the Iraq and Afghanistan wars.

Dr. Steffie Woolhandler, a professor of medicine at Harvard University and co-author of the Harvard Medical School study, called Raw Story’s estimates “quite reasonable.”

Even more shocking is that these are conservative estimates.

Health reform policy experts who spoke with Raw Story confirmed that the House and Senate bills would do virtually nothing for currently uninsured Americans until 2013 and 2014, respectively. Raw Story’s calculations are based on the House health reform bill’s projections. The Senate bill, however, would add another year of lethal lag time, driving up the estimated death rate by tens of thousands more US citizens and veterans.

In part, the proposed Senate and House healthcare reform bills don’t begin providing comprehensive coverage for several years because they are designed to meet President Obama’s promised goal of creating a “deficit-neutral” healthcare package.

Raw Story’s analysis is based on a recent Harvard Medical School study published in the American Journal of Public Health and a subsequent report by a team of Harvard Medical School researchers who took part in the initial study.

The first study revealed that approximately 45,000 Americans die each year from lack of health insurance. The second study, released on the eve of this past Veterans Day, estimated that more than 2,200 US veterans died in 2008 due to a lack of health insurance.

In an interview with Raw Story, Dr. David Himmelstein, associate professor of medicine at Harvard Medical School and co-author of the two studies, also pointed out a rarely discussed fact: The proposed reforms in both the House and Senate bills, even in the long run, would still leave “vast numbers” of Americans uninsured and those who are partially insured with inadequate coverage.

In the House bill, for instance, even after uninsured Americans would begin receiving health insurance, a projected 18 million would still not be covered; roughly 23 million would remain uninsured in the Senate bill.

“So basically they’ve taken the bad approach and the slow approach both,” said Himmelstein, a proponent of a national single-payer healthcare system. “And there’s no particular reason other than political expediency why either of those things should exist.”

Veterans’ advocate says analysis ‘very disturbing’

Paul Sullivan, executive director of Veterans for Common Sense, called Raw Story’s analysis “very disturbing” and said the “tragic” numbers demand “immediate action by the President of the United States.”

“Veterans for Common Sense is outraged that, in 2009, veterans are dying because of a lack of healthcare,” Sullivan said. “We believe healthcare is a human right.”

He did, however, credit President Obama for taking steps to reverse what he described as former President Bush’s “deplorable” legacy of neglecting veterans’ health.

Sullivan also believes this is a national security issue and cited, for example, the correlation between the shortage of physicians in the military and the suicide epidemic.

Just last month, the Christian Science Monitor reported that the US Army is understaffed by as many as 800 mental health professionals and 300 substance abuse counselors. On Monday, Time magazine reported that the Army has so far lost 147 soldiers this year to suicide, which is the highest number of suicides since the Army began keeping track of them in 1980.

“You can’t deploy someone to war two or three times and never give them a mental health exam,” Sullivan said.

“And when a veteran says he’s having nightmares, he can’t sleep and has to see a doctor,” he continued, “but he has to wait several months before someone tells him he’s not going to see a doctor at all and then goes and blows his brains out. That’s essentially what’s happening right here. And that’s a legacy of President Bush’s failure.”

Woolhandler, who testified before Congress in 2007 about uninsured veterans, also sees these numbers, both for US veterans and everyday citizens as a national security issue.

“Other developed countries have dealt with it that way,” said Woolhandler, who supports a single-payer healthcare system. “They’ve said as a matter of national policy, we need to make our people healthy and secure financial health with health insurance and have felt that was a national obligation. I think that the other nations are correct in that regard.”

Himmelstein said that the health of our citizens and veterans is not considered a national security issue “because the powerful forces in our country don’t care about the people who die.”

“The insurance companies and the corporate interests who largely fund our government don’t actually care if 45,000 people or 2,200 veterans die,” he said. “They do care to maintain the US control of, or at least contention for, oil-rich parts of the world and strategic assets and those sorts of things. So I think it’s a matter of what’s in the interest of the corporations that by and large make policy in this country.”

Why the wait until 2013 or 2014?

While a new health insurance system certainly can’t be implemented overnight, health and policy experts believe the delay in providing uninsured Americans with health insurance is chiefly due to political considerations.

Dr. Himmelstein asked, “Why do we need to wait three or four years for a program to kick in?” and noted the speed with which Medicare went into effect.

President Lyndon Johnson signed Medicare into law on July 30, 1965 and millions of seniors began receiving coverage within 11 months.

Himmelstein said the reason for the delay in either of the health reform bills is “very simple” and called it an “accounting trick.”

“It’s because it’s so expensive that in order to get a ten-year budget estimate that’s under the $900 billion figure, you have to delay it for three or four years,” he explained. “It’s really a budget estimate that’s only six years worth of reform. That’s the only way they can keep the cost estimate down to something that’s conceivable.”

Agreeing with Himmelstein’s assessment, Dr. Woolhandler said, “Logistics are doable in a very short timeframe. The politics are the difficult part.”

She added, “Ten years of taxes and six or seven years of benefits, so of course you can make something break even.”

Steve Findlay, senior health policy analyst at Consumers Union, the independent non-profit publisher of Consumer Reports, thinks that’s “absolutely” the case and described it as “a tried and true” method of funding big government programs.

“Part of the drill here is to start collecting money and then the benefit doesn’t actually kick in until later,” Findlay said. “Once you begin to parse things out, you realize that one of your most substantial ways of saving money or of making the budget work is to, well, let’s just put that off for a year.”

Congressional Budget Office spokeswoman Melissa Merson declined to comment for this article.

Findlay, though, did point out that it’s going to take time to set up the new marketplace.

But he added, “Could they do it faster than 2014 or 2013? You know, you go to war sometimes in two weeks. So I mean when you want to do things, you can do them. But in this case, arguably it’s not war. We would love to see it implemented sooner.”

Additionally, Findlay sees “industry influence” as a deciding factor in the lag time.

He explained that whenever large-scale changes and “mega programs” like this are launched they usually have an implementation process that takes two to three years.

“But the reason for that, speaking very frankly,” Findlay said, “is industry influence on the process. Industry will always be arguing in the hallways of Congress, ‘If you’re going to do it, you know, at least give us a few years.’ And their argument is always the same really: ‘It’s going to cost us a lot of money to do this. We have to change our systems. We have to readjust our products and our services.’ And blah, blah, blah.”

“That’s an argument that almost always prevails with respect to whether it’s environmental regulations, welfare policy, you name it,” he continued.

But Findlay noted the stimulus package, in which some of our largest financial institutions received a government bailout in a much shorter timeframe, was an exception.

Margaret F. Riley, a health law professor at the University of Virginia, thinks the budget is a “huge” reason for the delay. Yet she also believes there are other reasonable political considerations at play, such as the desire to avoid negatively affecting the health insurance of Americans who are already receiving benefits in the process of rolling out a new system.

Still, she said, “I’m not a fan of the delay. I think there are many reasons the delay runs risks.”

Her primary concern is what might transpire in the interim.

“In the political world,” Riley noted, “four years is an eternity and anything could happen to any bill passed.”

The White House, Senate Leader Harry Reid’s office, and House Leader Nancy Pelosi’s office did not return Raw Story’s calls for comment.

Brad Jacobson is a contributing investigative reporter for Raw Story.

 
 
 
 
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