Saturday, December 22, 2007

The price of no insurance, or of Scrooge-like insurance companies:DEATH

A report has come out using data gathered by the American Cancer Society showing that lack of insurance is directly correlated with an increased number of deaths in cancer patients.

Not that this is surprising, as the lack of health insurance influences everything from the decision of people to seek treatment or get screenings that they may have a hard time paying for, to the decisions by hospitals and healthcare providers not to provide more than the minimum amount of care they can knowing they may not get paid for it.

ATLANTA: Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling medical care obstacles.

People without insurance are less likely to get recommended cancer screening tests, the study found, confirming earlier research. And when these patients finally do get diagnosed, their cancer is likely to have spread.

The new research, analyzing information from 1,500 U.S. hospitals that provide cancer care, is being published in CA: A Cancer Journal for Clinicians.

It is true that only about four percent of cancer deaths actually occur in patients who lack health insurance (whereas the overall percentage of Americans without health insurance is around sixteen percent and rising) but that figure is misleading since the vast majority of fatal cancers occur in people over 65, all of whom are covered by medicare.

Of course, as we tragically saw in the case last week of Natalie Sarkisyan*, a seventeen year old who died needing a liver transplant even though one was available because her HMO, Cigna health, refused to authorize payment until the case hit the national media and by then it was too late, even having health insurance may not save you if the insurance company simply decides that they'd rather have you dead than cut the check.

Now, there are those who will continue to advocate that we should have the system we have now, where people can 'choose' to buy (or not to buy) health insurance. They conveniently ignore the fact that most people who don't have health insurance are not without it because they don't want it, but because they can't afford it. It is still true that for those who can afford it, there are more high tech, specialized treatments available in America than elsewhere. For those who can't, it might as well be a trip to the moon. The truth is, we have no real options available for the uninsured to get adequate treatment, other than don't get the treatment, or go far into debt to pay for it (so far that most hospitals, when they see that a patient is uninsured, will automatically 'fast-track' them out of the hospital with the minimum treatment they can, knowing that the large majority of them won't be able to pay.)

However, you may be one of those who will defend to the hilt the present system and say that the choice not to buy insurance, for whatever it's drawbacks are, outweighs all other alternatives.

Fine. But be advised that we now have hard data, in the form of this cancer study, indicating that one of those drawbacks is the increased numbers of deaths in Americans without insurance. If the death of other Americans is an acceptable price for maintaining the system we have now, then go ahead and advocate for it. But don't pretend that it is a benign system, or is something that it is not.

*-- On a personal note, I might add that I am an organ donor, should that ever occur. But the circumstances surrounding the Sarkisyan case cause me to wonder whether I should be, or how I should discuss organ donation with my kids. I've always felt that if I (or one of my kids, one of whom has said she would be willing to be a donor) were ever in a position in which my organs could save a life, then to do so. But I feel uncomfortable now, given what happened in this case, knowing that my organs could simply become available, not based on need but based on who is insured and whether their insurance company would pay. That would be one criterion I would absolutely NOT want used to determine who received my liver or other organs, or those of my family members.


shrimplate said...

Just stopping by to say Merry Christmas, Eli.

Eli Blake said...

Thanks, Shrimplate.