“Wrong Again Mitt”: Romney Says People Don’t Die Because They Lack Insurance
In an interview with the Columbus Dispatch in Ohio published Thursday, Mitt Romney repeated a claim that already got him in trouble once this cycle and has reflects an enduring belief among Republicans: that people in the U.S. don’t die because they lack health insurance.
“[Y]ou go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital,” Romney said. “We don’t have people that become ill, who die in their apartment because they don’t have insurance.”
It’s eerily reminiscent of a statement President George W. Bush made in 2007 that haunted Republicans during the 2008 campaign — “[P]eople have access to health care in America. After all, you just go to an emergency room.”
There’s just one problem: It’s not true.
Numerous studies over the past 10 years conclude that tens of thousands of Americans die each year because they lack insurance.
A 2009 study conducted at Harvard Medical School and Cambridge Health Alliance, and published in the American Journal of Public Health concluded that “[l]ack of health insurance is associated with as many as 44,789 deaths per year in the United States, more than those caused by kidney disease. … The increased risk of death attributable to uninsurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance.”
A 2012 report by the health care reform advocacy group Families USA concluded that 26,100 people died prematurely in America in 2010 due to lack of insurance. That report extrapolated from a 2002 Institute of Medicine study — conducted when the uninsurance rate was lower — which concluded that 18,000 people died prematurely because they weren’t covered.
In a 2009 update, the IOM concluded that uninsured patients are at higher risk of mortality or poor health outcomes in the aftermath of both acute medical issues (heart attacks, serious injury, stroke) and chronic ones (cancer, diabetes).
In 2008, the Urban Institute’s Stan Dorn concluded that “[b]ased on the IOM’s methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006. Much subsequent research has continued to confirm the link between insurance and mortality risk described by IOM. In fact, subsequent studies and analysis suggest that, if anything, the IOM methodology may underestimate the number of deaths that result from a lack of insurance coverage.”
Conservatives have attacked these findings and methods and argued that, controlling for health status, there’s no difference in survival probabilities between insured and uninsured people. When the Families USA report came out, Avik Roy, a Romney health adviser, called its findings “statistical hogwash.”
To buttress his argument, he cited a thorough study by Richard Kronick — a University of Rochester health policy expert who served in the Obama administration and was a senior adviser to Bill Clinton during his push for health care reform. His conclusion? “[I]f two people are otherwise similar at baseline … but one is insured and the other uninsured, their likelihood of survival over a 2-16-year follow-up period is nearly identical.”
Further, I show that survival probabilities for the insured and uninsured are similar even among disadvantaged subsets of the population; that there are no differences for long-term uninsured compared with short-term uninsured; that the results are no different when the length of the follow-up period is shortened; and that there are no differences when causes of death are restricted to those causes thought to be amenable to the quality of health care.
However, Kronick conceded that “[g]iven the inherent uncertainties in inferring causality from the results of observational analyses, the results presented here are not able to provide a definitive answer to the question, ‘How many fewer deaths would there be in the United States if all residents were continuously covered by health insurance?’”
In an interview, Urban’s Stan Dorn praised Kronick but defended his and his colleagues’ conclusion.
“I’m aware of Rick’s study and he’s a great researcher. And I guess what I’d say is it’s an outlier,” Dorn said in an interview. “There’s a lot of research that goes beyond what we did, and it’s an outlier.”
Dorn noted that other studies focusing on particular ailments make the link between uninsurance and death quite clear. “We know that women with cervical cancer who are uninsured get their cancer detected later…. We know that people with heart disease don’t take their medicine because they can’t afford it…and sometimes die.”
And as Boston University health economist Austin Frakt noted when he engaged this same controversy in February 2010, “among recent studies in this area the evidence is greater than three-to-one in favor of an insurance-health outcome link, including mortality.”
In 2006, then-Massachusetts governor Romney himself agreed — at least to an extent. Though he did not address the mortality issue specifically, in an April 2006 presentation before the Chamber of Commerce he conceded that uninsured people who seek health care at emergency rooms experience worse outcomes.
“There ought to be enough money to help people get insurance because an insured individual has a better chance of having an excellent medical experience than the one who has not. An insured individual is more likely to go to a primary care physician or a clinic to get evaluated for their conditions and to get early treatment, to get pharmaceutical treatment, as opposed to showing up in the emergency room where the treatment is more expensive and less effective than if they got preventive and primary care.”
By: Brian Beutler, Talking Points Memo, October 12, 2012
“Dual Eligible’s”: Cut Medicaid And You Cut Health Care For The Elderly And Disabled
Gov. Romney and Rep. Ryan have been adamant that their Medicare proposals won’t affect people over 55. That may be true. But their Medicaid proposals sure will. A lot of health care for the elderly comes from Medicaid. We call those people “dual-eligibles”, because they qualify for both Medicare and Medicaid. Some dual-eligible are younger disabled people, but about two-thirds are 65 or older. The Kaiser Family Foundation reports:
Dual eligibles as a share of total Medicaid enrollees ranged from a low of 10 percent in Arizona and Utah to a high of 26 percent in Maine, due to demographic differences and policy preferences across the states. Similarly, spending on dual eligibles as a percentage of total Medicaid spending ranged from a low of 18 percent in Arizona to a high of 59 percent in North Dakota.
Lots of Medicaid money goes to the elderly. Cut Medicaid, and you likely cut some of that. Here’s more:
One quarter (25%) of Medicaid spending for dual eligibles went toward Medicare premiums and cost-sharing for Medicare services in 2008. Five percent of spending for duals was for acute care services not covered by Medicare (e.g., dental, vision, and hearing services). Another 1 percent of Medicaid dual eligible spending was for prescription drugs, a percentage that has fallen significantly since coverage for nearly all prescribed drugs for duals was shifted from Medicaid to Medicare Part D in 2006. The remaining 69% of Medicaid spending was for long-term care services, which are generally not covered by Medicare or private insurance.
That Medicaid money is going to Medicare premiums! It’s also going to actual care. Cut Medicaid, and you likely cut some of that.
It’s about time someone pointed that out. The health care proposals of Gov. Romney and Rep. Ryan will absolutely impact some elderly people way earlier than a decade. Unless they’ve changed their minds again.
By: Aaron Carroll, Washington Monthly Political Animal, September 7, 2012
“Radical And Anti-Thought”: Remember The Party Of Personal Responsibility?
The House Republicans are going to vote today to repeal the ACA, and the message they’re going to be sending to people who have cancer or diabetes or any number of other diseases but don’t have insurance is simple, and forgive my bluntness in this non-family newspaper where such language, I’m given to understand, is occasionally permisslbe. The message is: Fuck off.
Matt Miller put the matter powerfully in his Post column yesterday:
Here’s what you should do, Mr. President. In the debates this fall, pull out a small laminated card you’ve had made as a prop for this purpose. Then remind Mitt Romney that the ranks of the uninsured today are equal to the combined populations of Oklahoma, Connecticut, Iowa, Mississippi, Kansas, Kentucky, Arkansas, Utah, Oregon, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming.
Read that list slowly, Mr. President. Then ask your opponent: Would America turn its back on the citizens of these 25 states if everyone there lacked basic health coverage? That’s what we’ve been doing for decades. You knew it was right to act when you were governor of Massachusetts, Mitt. How can you pretend we don’t need to solve this for the nation? And how can you object with a straight face when your own pioneering plan was my model?
Can I get an amen to that? And then he might add something like, “As you said many times yourself, Governor, the point of requiring people to buy insurance is to instill a sense of personal responsibility. No free riders. No trips to the emergency room that the rest of us pay for. Why did you believe in personal responsibility then but are against it now?”
I swear, as I noted yesterday, this is starting to smell to me like an issue the Democrats can win votes on this fall. Believe me, if I thought the opposite, I’d say so. I did think the opposite just a few weeks ago. What changed?
John Roberts, basically. Politically, his signing on to the decision lends a bulletproofness to the Democratic position, changes the whole mentality of the debate. If it had been Kennedy with the liberals, meh. But Roberts’ stamp of approval on the plan allows the Democrats some room to play offense. And that offense is built around one simple claim: Republicans would deny coverage to sick people and let them die.
Sprinkling a little personal responsibility sugar on top can’t hurt. Use their blind extremism against them. Here is a position that was once theirs, that they came up with and that they’ve now abandoned, just because Obama took it up. It’s a great marker of how radical and anti-thought they’ve become, that they’re now willing to let people suffer and die in the hopes that they can defeat a political adversary.
By: Michael Tomasky, The Daily Beast, July 11, 2012
“A Test Of Ideology”: How Far Will Republicans Go To Deny Healthcare
Texas has a higher proportion of its population living without health insurance than any other state. But like many other states with lots of poor people, it has the misfortune of being governed by Republicans. That explains why yesterday, Governor Rick Perry announced that the state will refuse to accept the federal money offered for expanding Medicaid eligibility to everyone who makes up to 133 percent of the federal poverty level. Perry says that this expansion of Medicaid, which is almost entirely paid for by the federal government, will nevertheless bankrupt the state and put the oppressive boot on the necks of Texans. So he’s happy to keep 25 percent of his population uninsured.
In case you’re wondering, Texas currently sets eligibility for Medicaid at 26 percent of the federal poverty level, which means that if you earn more than $6,000 a year for a family of four, you’re not eligible. That’s not a typo. Six thousand dollars a year for a family of four is what the state of Texas considers too rich to get on Medicaid. Look down the list of eligibility levels, and you find that only Alabama, Arkansas, Indiana, and Louisiana set their eligibility lower. It is just so weird how those poor Southern states are the stingiest with health-care benefits, isn’t it?
It’s possible that eventually, Texas and the other states will come around to the expansion of Medicaid. Sarah Kliff explains how this happened with Medicaid’s enactment in the 1960s and the Children’s Health Insurance Program (CHIP) in the 1990s; conservatives initially resisted, but the money and the opportunity to insure their population eventually became irresistible. One of the key factors then and now is the presence of organized, influential interest groups—particularly the hospitals that have to deliver uncompensated care to the uninsured, costing them billions—that can exert their influence on the government’s decisions.
But the Republicans who resisted and then gave in were different from the Republicans of today, and this will be a test of just how far they’ll go to make a statement about their hatred of the federal government in general and their hatred of Barack Obama in particular. Today’s Republicans are the ones who would turn down a deal offering ten dollars of spending cuts for one dollar of tax increases. But that was a hypothetical question, and this question is very real. There are actual human beings whose lives are at stake. I’d love to hear someone ask Rick Perry this question: Which do you think is worse, someone living without health insurance, or someone getting health insurance through a government program? I’m not sure what he’d say, but his actions say quite clearly that he’d prefer that the person have no health insurance. Of course, we’re not talking about him personally, or his kids, or anybody he knows having to go without insurance. We’re talking about poor people. So screw them.
By: Paul Waldman, Contributing Editor, The American Prospect, July 10, 2012
“Daring The Sick And Needy”: Time to Protest Against Republican Governors For Shameful Threats
Greg Sargent reports on the decision of five Republican governors to screw impoverished and working people out of the health care they are supposed to get from Medicaid under the Affordable Care Act. As Sargent explains:
Iowa governor Terry Branstad has now become the fifth GOP governor to vow that his state will not opt in to the Medicaid expansion in the wake of the Supreme Court ruling. He joins the ranks of Louisiana’s Bobby Jindal, Florida’s Rick Scott, South Carolina’s Nikki Haley, and Wisconsin’s Scott Walker.It’s worth keeping a running tally of how many people could go without insurance that would otherwise be covered under Obamacare if these GOP governors make good on their threat.
The latest rough total: Nearly one and a half million people.
…And counting. Sargent rolls out the breakdown estimates for the five states, with Florida leading the pack with more than 683,000 citizens at risk by Governor Scott’s threat. Sargent adds,
Of course, it’s still unclear whether these governors will go through with their threats. David Dayen and Ed Kilgore have both been making good cases that they will. As Dayen and Kilgore both note, some of these GOP governors are relying on objections to the cost of the program to the states — even though the federal government covers 100% of the program for the first three years and it remains a good deal beyond — to mask ideological reasons for opting out…Dayen rightly notes that the media will probably fail to sufficiently untangle the cover stories these governors are using.
If there is a silver lining behind the shameful threats of the five Republican governors, it is that there is a good chance that their actions will provoke mass demonstrations in at least some of their states, hopefully right in front of the gubernatorial mansions, where possible. And wouldn’t it be justice, if those demonstrations were lead by people with serious health problems, bringing along their oxygen tanks, wheelchairs, dialysis machines and other health care devices, joined by nurses and hospital workers in uniforms for exactly the kind of photo ops these governors don’t want?
Perhaps the key player in mobilizing mass demonstrations against the Republican Medicaid-bashers would be the nurses unions, which did such an outstanding job of making former Governor Schwarzenegger eat crow in CA over staffing ratios in hospitals.
In a way, the five governors are daring sick and needy people to protest against being targeted for health hardships. Given the large numbers of those threatened in these states, it’s an arrogant dare they may regret very soon — as well as on November 6.
By: J. P. Green, Democratic Strategist, July 3, 2012
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 