Death by Uninsurance

By Daniel Akst
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A new Harvard study estimates that lack of health insurance kills about 45,000 Americans annually, which is 2.5 times as many as the previous best estimate commonly cited in the health care debate. This is a big difference (27,000 additional lives). But it still pales in comparison with the more than one million Americans who die annually by their own hands--which they use to light cigarettes, lift forks and convey too many alcoholic beverages to their lips.

That so many die as the result of behavioral causes is no argument against universal health coverage, and the new Harvard study bolsters the case for covering everyone, which I suspect we could do just by harvesting some of the incredible waste in the system today. But the vast loss of life associated with bad habits does suggest that we could do vastly more good by changing people's behavior, whether by exhortation, better education or sumptuary taxes.

Tobacco offers a promising precedent; smoking is down by something like half since mid-century, as I recall, and while this has contributed (perhaps significantly) to our national weight gain, on net this reduction in smoking has saved many lives and much suffering and expense. Further reductions in tobacco, as well as an assault on over-eating and unhealthy foods, might produce similarly large gains.

A pdf of the study is here (it's quite brief) and an even briefer essay on the whole subject, from the Wall Street Journal, can be found via my earlier Atlantic posting about the devastation we inflict on ourselves by our unhealthy lifestyles. There is vast room for improvement in this area, and progress in it could be a major force for reducing our runaway health-care costs--not to mention saving the lives of so many of our fellow citizens. President Obama has rightly called on students to work harder in school. Why not rally the rest of us to save ourselves from early death?

(Photo: Flickr User Siege N. Gin)

This article available online at:

http://www.theatlantic.com/business/archive/2009/09/death-by-uninsurance/26813/