| Today's Managing Health Care Costs Number is 23 million |
Offering millions of people access to meaningful health insurance is expensive - and many conservatives have said that our country simply cannot afford expanded access. They propose to cut a trillion dollars from health care assistance for low and moderate income individuals to finance a trillion dollar tax cut aimed at the wealthy. Periodically, they suggest that there is no evidence that offering people access to health insurance improves lives, outcomes, or mortality.
Ben Sommers, Atul Gawande, and Kate Baicker have published a timely and thoroughly researched literature review (on line today from the New England Journal of Medicine without a paywall). Perhaps some Senators or their staffers will have the time to read this powerful article since there is still no Senate Republican health care bill to review as of this morning.
They found that expanded access to coverage leads to:
- Fewer medical bills sent to collection
- More use of outpatient visits and more use of and adherence to medications
- More evidence-based preventive care and screening
- Better care for chronic disease
- Earlier diagnoses of curable cancers
- Increase in likelihood of reporting good or excellent health
- A trend toward decreased mortality (although not reaching statistical significance)
They conclude:
An analysis of mortality changes after Medicaid expansion suggests that expanding Medicaid saves lives at a societal cost of $327,000 to $867,000 per life saved.By comparison, other public policies that reduce mortality have been found to average $7.6 million per life saved, suggesting that expanding health insurance is a more cost-effective investment than many others we currently make in areas such as workplace safety and environmental protections. Factoring in enhanced well-being, mental health, and other outcomes would only further improve the cost–benefit ratio.
We would not be having a public debate about taking away health care access for the rich or the well-connected. We should be debating how to finance universal access. That's a debate we had in 2009 - out in the open with dozens of hearings and hundreds of amendments. It's not the debate we are having now over the American Health Care Act. We also should be talking seriously about how to lower the cost of health care - as opposed to how to lower the number of Americans who have access to health care.
Increasing health care coverage improves lives and health. Ripping coverage away is bound to do the opposite. Republican Senators representing states like West Virginia, Ohio, Kentucky Alaska and Louisiana owe it to their constituents to refuse to support legislation that will lead to premature and preventable deaths in their communities.
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