Surprise! Better Health Insurance Saves Lives.


Does health insurance save lives? Since death is the least frequent outcome of poor medical care, I’ve never believed that mortality is an especially good way of measuring the value of different interventions. Even if an intervention is high value, the odds are good that it will have only a small effect on mortality.

This makes the results of a recent study in Massachusetts all the more impressive. Three researchers studied the effect of Mitt Romney’s universal health care plan and concluded that it’s saved a lot of lives so far. Adrianna McIntyre provides the summary:

Benjamin Sommers, Sharon Long, and Katherine Baicker estimate that overall mortality in Massachusetts declined 2.9 percent relative to control counties between 2007 and 2010; mortality amenable to health care declined 4.5 percent. This translates to one death prevented for every 830 people who gain insurance, and the effects were larger in counties with low income and low pre-reform insurance rates—the counties we would expect to be most favorably impacted by reform.

….If you think the study’s primary findings are impressive, consider their implications: “mortality amenable to health care” does not just magically decline. If fewer people are dying, that is almost certainly because diseases are being better treated, managed, or prevented—because of improved health. It’s hard to come by data on objective measures of health at the state level, but the “improved health” story is consistent with other findings in the paper: individuals had better self-reported health, were more likely to have a usual source of care, received more preventive services, and had fewer cost-related delays in care.

What makes this even more impressive is that the elderly in Massachusetts were already covered by Medicare. These results are strictly for those under the age of 65, who don’t die very often to begin with. Within this group, a reduction of 4.5 percent in mortality amenable to health care (the only kind we care about in this context) is a lot.

The implications for Obamacare are obvious since Obamacare was explicitly modeled on the Massachusetts program—though it’s unlikely that it will produce quite such dramatic mortality improvements since its coverage isn’t as universal as the Massachusetts plan. Still, Obamacare has so far shown that it has a lot in common with Romneycare, so there’s good reason to hope that it will demonstrate mortality improvements as well.

But don’t hold your breath for study results. Given the way research like this works, we probably won’t get them until 2020 or so.

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THE BIG QUESTION...

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