Noonan in 2008,
David Noonan. [Senior Editor]. “No Insurance? That’s a Killer. Newsweek. November 10, 2008. http://www.newsweek.com/id/166854. Accessed November 10, 2008.
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.
Drawing on the National Trauma Data Bank, which collects information from approximately 700 U.S. trauma centers and hospital emergency departments, Haider and his colleagues analyzed almost 430,000 moderate to severe cases of traumatic injury (from auto accidents, gunshots and other causes) treated between 2001 and 2005. Controlling for age, gender, type and severity of injury, they found that, overall, uninsured patients were 50 percent more likely to die from their injuries than insured patients. Among white patients, the mortality rate for those with insurance was 4.2 percent, compared with 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 study also uncovered dramatic differences in survival rates for patients of different races and insurance status. When compared with an insured white patient, black patients with equivalent injuries but without insurance had a 78 percent higher risk of dying; for uninsured Hispanics, the risk was 130 percent higher.
The findings by Haider and his colleagues erase any illusion that emergency care is the great equalizer in our health-care system, that our differences get left behind when we are rolled through those double doors, injured and in danger of dying.
