Being Uninsured Can Kill You

| Mon Nov. 16, 2009 11:14 PM EST

Today comes news of a new study on emergency medical care:

Patients who lack health insurance are more likely to die from car accidents and other traumatic injuries than people who belong to a health plan — even though emergency rooms are required to care for all comers regardless of ability to pay, according to a study to be published Tuesday.

Well, no surprise there.  But this is a surprise:

Trauma physicians said they were surprised by the findings....Dr. Frank Zwemer Jr., chief of emergency medicine for the McGuire VA Medical Center in Richmond, Va., said he was "kind of shocked. "

"We don't ask people, 'What's your insurance?' before we decide whether to intubate them or put in a chest tube," said Zwemer, who wasn't involved in the research. "That's not on our radar anywhere."

The surprise is that these guys are surprised.  How much evidence do we need about the disproportionate rate of poor outcomes among the uninsured before everyone understands that lousy American healthcare coverage really is killing people?  You'd think that doctors, at least, might be aware of this.

In fairness, part of the result in the trauma study might be due to selection bias.  To some extent, the uninsured are more likely to lead risky lives and more likely to have preexisting conditions of one kind or another.  But mostly it's this:

The researchers offered several possible explanations for the findings. Despite the federal law, uninsured patients often wait longer to see doctors in emergency rooms and sometimes visit ERs at several hospitals before finding one that will treat them. Other studies show that, once they're admitted, uninsured patients receive fewer services, such as CT and MRI scans, and are less likely to be transferred to a rehabilitation facility.

Patients without insurance may have higher rates of untreated underlying conditions that make it harder to recover from trauma injuries, the researchers said. They also may be more passive with doctors and nurses since they don't interact with them as often. All of these factors could influence whether a trauma patient is able to recover from his or her injuries.

A lot of people die unnecessarily every year because we have lousy, expensive healthcare coverage in the United States.  It's about time to start doing something about it.

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