Blair Horner: The Battle Over Health Care Insurance Continues

 As the nation moves closer to the implementation of the Affordable Care Act, the debate continues.  The House of Representatives’ leadership will, once again, advance legislation to repeal the law.  Predictably, the effort will fail.

But new arguments surface as well.  In the New York Times last week, a columnist laid out the argument against comprehensive health insurance coverage.  He argued that research is showing that there are no differences in the health outcomes of those on Medicaid and those with no health insurance.  He cited recent analyses conducted in the state of Oregon that bolstered this claim.

The state of Oregon expanded its Medicaid program a few years ago, and researchers released the latest data on how health outcomes for the new Medicaid users differed from those for the uninsured.  The good news was that Medicaid helped people avoid huge medical bills.  But the program’s insurance guarantee seemed to have had little impact on common medical conditions like hypertension and diabetes.

The columnist conceded that Medicaid does offer economic protection and the Oregon data shows that expanding coverage does indeed protect people from ruinous medical expenses.  However, he states that the new health care reform law was sold, in part, with the promise that passage would save tens of thousands of American lives each year. 

I won’t go through his entire column, if you want to read it go to the New York Times and look for Ross Douthat’s latest.  It’s fair to say that his argument concludes with the following observation:  “if the benefit of health insurance is mostly or exclusively financial, then shouldn’t health insurance policies work more like normal insurance?  Fire, flood and car insurance exist to protect people against actual disasters, after all, not to pay for ordinary repairs.  If the best evidence suggests that health insurance is most helpful in protecting people’s pocketbooks from similar disasters, and that more comprehensive coverage often just pays for doctor visits that don’t improve people’s actual health, then shouldn’t we be promoting catastrophic health coverage, rather than expanding Medicaid?”

However, his column ignores compelling – and intuitive – findings that show that having health insurance does save lives.  For example, the American Cancer Society published peer-reviewed studies in 2007 and 2008 that found that people with health insurance are diagnosed with cancer at earlier stages than the uninsured and thus have a greater chance of surviving the disease.  Here are some key findings of those reports:

·         Ninety percent of women who have private health insurance had a Pap test in the past 3 years compared to about 60 percent of uninsured women.

·         Among men and women aged 50 to 64 years with private insurance, nearly half had a recommended colorectal cancer screening test in the past 10 years compared with only twenty percent who were uninsured.

·         Cancer patients who were uninsured at the time of diagnosis were 1.6 times as likely to die in 5 years compared to those with private insurance.

·         Uninsured patients diagnosed with early stage disease are less likely to survive cancer than privately insured patients diagnosed with later stage disease.  For example, insured patients diagnosed with Stage II colorectal cancer were more likely to survive 5 five years than uninsured patients diagnosed with Stage I cancer.

Health insurance is fundamentally different from auto or home insurance, which protect against major and costly events.  Thankfully, we won’t all experience a car crash or house fire.  But sooner or later, we will all need health care.  With access to health care coverage that helps to prevent and treat a disease such as cancer, people will have healthier lives without losing their life savings to pay medical bills.

The United States is moving toward joining the rest of the developed world in offering universal health insurance.  Those nations have longer life expectancy than the U.S.  It is clear that having access to health care makes a big difference in our longevity.  The Affordable Care Act may not get the nation all the way toward health care for all, but it’s a big step forward.

The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.