You might think it’s obvious that health insurance saves lives but it is actually very hard to prove. In a broken health care system like ours where so many people don’t have health insurance, it would be hard to do a comparison of groups of people with and without health insurance that doesn’t have lots of bias – things like rich people are more likely to have insurance or people who are sick are more motivated to get insurance… In fact, many leading economists have been skeptical that health insurance has a mortality impact. But a recent confluence of events has to lead to a nifty and convincing proof that health insurance saves lives.
A study that was was recently reported was done by the US Treasury Department at the end of the Obama administration and before the Trump administration did away with the individual mandate. The individual mandate required you to get health insurance if you could afford it, or pay a tax penalty. They mailed a letter to a random group of 3.9 million people who had paid the tax penalty for not having health insurance. The letter said they had paid a fine for not carrying health insurance and suggested possible ways to enroll in coverage. Because of budgetary restraints, 600,000 of the people who had to pay the fine didn’t get one of these letters. In the group that got this letter a few more families than in the group that didn’t get the letter did go get insurance. For every 87 letters from the IRS, the researchers found that one household got one year of insurance. Over the 2 years of observation, that small difference saved about 700 lives. For every 1,648 households that got the letter, one less person died. It’s kind of like seat belts. Sometimes humans have to be encouraged to do right by other humans AKA our democratic system of humans.
Besides getting rid of the individual mandate the Trump administration has now also cut funds for the health law’s outreach budget by 72 percent. So these I.R.S. letters will probably remain a one-time experiment.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- [email protected] or phone-354-6605