Klein vs. McArdle on Insurance and Mortality

Ezra Klein is one of the country's leading experts on health care. Megan McArdle is a respected blogger and thinker on economics. So when the Washington Post blogger and Atlantic editor lock horns, the debate is highfalutin and heavy on facts.

In recent weeks, the duo have sparred over a critical but often overlooked issue in the health care debate: whether health insurance actually decreases mortality rates. McArdle fired the first salvo in her column for the March 2010 issue of The Atlantic:

Even a rough approximation of how many people die because of lack of health insurance is hard to reach. Quite possibly, lack of health insurance has no more impact on your health than lack of flood insurance.

Klein swiftly rebutted her claim:

At its base, [McArdle's column] takes a methodological difficulty (it's hard to measure mortality) and blows it into something approximating a conclusion (insurance coverage has no effect on mortality). It gives an accurate impression of one of the problems bedeviling efforts to answer this question, but an inaccurate impression of the conclusions the best researchers draw from the best research.

McArdle fired back at Klein and other critics:

I have not asserted that insuring the uninsured wouldn't save anyone's lives, so I don't know why they're making this argument while linking to me.  What I said is, the studies so far done often cannot exclude the possibility that there is no effect.

Irked, Klein stepped up his offensive and added a personal gripe:

What we're really left with is a sudden skepticism of health-care coverage being made by people with health-care insurance who believe in medical technology and who are using methodological difficulties to argue against the value of an expansion of health-care insurance to the poor--who, for that matter, appear to be helped more by health-care insurance than the rich.

Without waiting for McArdle to respond, Klein tagged in health care researcher Stan Dorn to round out the verbal barrage:

At bottom, McCardle suggests that health is not crucially affected by the access to health care that insurance provides. I doubt that many of us fortunate enough to have health insurance would drop coverage based on the strength of her arguments.

As of yet, McArdle has not offered a rejoinder.