No Insurance? That's a Killer.

There was an article in Newsweek on November 10, 2008, that reiterated an article that appeared in the October issue of Archives of Surgery, particularly this one sentence: "In brief, insurance represents more than just the ability to pay a bill."

As Newsweek science editor David Noonan recounts in his article, "Of course, what insurance (and the lack of it) often represents, as numerous studies have shown, is the difference between care and no care, between an early cancer diagnosis and a late diagnosis, between properly managing a chronic condition like asthma and waiting until a dangerous attack occurs. For some of the patients in the Archives of Surgery study, which was led by Johns Hopkins trauma surgeon Adil Haider, what insurance represented was nothing less than the difference between life and death."

The study found that, overall, uninsured patients were 50 percent more likely to die from their injuries than insured patients. This conclusion was based on data collected from 700 trauma centers and emergency departments around the U.S.

Quoting from the Newsweek article: "Among white patients, the mortality rate for those with insurance was 4.2 percent, compared to 7.9 percent for the uninsured. The numbers for minorities were worse. Uninsured African-Americans died at more than double the rate of the insured, 11.4 percent to 4.9 percent. And while 6.3 percent of insured Hispanic patients died after traumatic injury, the rate for uninsured Hispanics was 11.3 percent."

The cause and effect implied here is confusing. Is it that the uninsured have underlying conditions due to lack of routine care? Are they delayed in seeking help after trauma? Or -- and this is a possibility we have to study more -- are we treating uninsured and/or minority patients differently?

Here's the entire Newsweek article.