Is Lack of Insurance Responsible For Tens of Thousands of Deaths in America?

By G. Keith Smith, M.D.

The myth that lack of health insurance is a cause of 18,000 deaths per year, along with nearly a million bankruptcies, has been promulgated yet again in The New York Times by economist Paul Krugman.

One of his outrageous fact-free claims is that uninsured people avoid the emergency rooms for fear of large bills, and so they die. But if the poor are avoiding the emergency rooms, how can health care for the poor in the emergency rooms be bankrupting hospitals? This claim is also false. Otherwise, why is there a building crane in front of every big city emergency room I've ever seen?

"So there's no real question that lack of insurance is responsible for thousands, and probably tens of thousands, of excess deaths of Americans each year," writes Krugman. But the Institute of Medicine's estimate that lack of insurance leads to 18,000 excess deaths each year is almost certainly incorrect. Richard Kronick's recent study debunks this idea completely. He concludes: "It is not possible to draw firm causal inferences from the results of observational analyses, but there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States."

Krugman's Claims Proven False

Krugman asserts that expansion of Medicaid, on which ObamaCare depends for its claim of increasing coverage, saves lives. This has been proven false by Professor June O'Neill, former director of the Congressional Budget Office. Patients might as well wear their Medicaid card around their neck rather than keeping it in their wallet. It is like a scarlet letter that precludes entrance into most physicians' offices. This card gives many, just like our Canadian brethren to the north, only a right to hope for care.

Many physicians are also curtailing their exposure to Medicare patients because of payment and regulatory hassles, threats of stiff penalties (including jail time for miscoded claims), and government price controls mandating artificially low payments.

Coverage Does Not Translate Directly To Care

"Coverage" doesn't mean care. It can instead be a barrier to access to care. Think about it. If you have "insurance" coverage (whatever that means) and your insurance company decides that they don't want to pay for a bone marrow transplant, or they set the payment for one so low that no one will do it (one and the same thing), you are not going to get a bone marrow transplant. Period.

If the IPAB (Independent Payment Advisory Board) decides that the payment to a physician for an open heart surgery is less than anyone is willing to do it for, guess how many open heart surgeries will be done? Folks like Krugman, not the market, will be in charge of deciding what these types of procedures are worth. Even more government involvement in health care is what he is advocating.

Krugman Ignores True Figures

Of the 1.5 million individual bankruptcies declared every year, 62% involve medical bills. Less well known is that 78% of those filing for medical bill reasons had insurance. These folks have "coverage." Is this the security Mr. Krugman would bring to us all?

Concerning bankruptcy, keep in mind that Krugman is the poster child for Keynesian economics, the economic thought that holds that an individual or a government can borrow its way to prosperity. This economic theory has prevailed in this country for a long time, primarily because big-government advocates love to spend the wealth belonging to future wage earners, as the future voter's wrath represents no threat to them. Krugman, as a mouthpiece for this insanity, which will bankrupt both federal and state governments, bears a lot of responsibility. The central bank and deficit spending have no greater advocate than he.

Krugman's economic myths can cause real mortality. But neither he nor The New York Times can be sued for economic malpractice.

Dr. G. Keith Smith is a board certified anesthesiologist in private practice since 1990. In 1997, he co-founded The Surgery Center of Oklahoma, an outpatient surgery center in Oklahoma City, Oklahoma, owned by 40 of the top physicians and surgeons in central Oklahoma. Dr. Smith serves as the medical director, CEO and managing partner while maintaining an active anesthesia practice.

Operation of this free market medical practice, arguably the only one of its kind in the U.S., has gained the endorsement of policymakers and legislators nationally. More and more self-funded insurance plans are taking advantage of Dr. Smith's pricing model, resulting in significant savings to their employee health plans. His hope is for as many facilities as possible to adopt a transparent pricing model, a move he believes will lower costs for all and improve quality of care.