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Care Without Coverage Too Little, Too Late (2002) / Chapter Skim
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Appendix D Estimates of Excess Mortality among Uninsured Adults
Pages 161-166

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From page 161...
... The ranges of estimates within each category and their widely varying population-level magnitudes serve to demonstrate how the impact of health insurance status on overall mortality depends on • the prevalence and mortality risks of the condition, • the age and demographic distributions of those afflicted by the condition, and • the effectiveness of appropriate health care services in reducing mortality from it. OVERALL MORTALITY RISK Two longitudinal studies reviewed in Chapter 3, one of 13–17 years' duration and the other of 5 years' follow-up, support the use of an estimate of a higher overall mortality risk for uninsured adults of 25 percent (Franks et al., 1993a; 161
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From page 162...
... The RAND Health Insurance Experiment documented a 10 percent lower overall mortality risk for adults with hypertension in insurance plans with no cost sharing compared to those in plans with any cost sharing, due to better hypertension treatment (Newhouse et al., 1993)
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From page 163...
... TABLE D.1 Estimated excess deaths among uninsured adults 25–64 for 2000 U.S. Uninsured Percent Deaths per Total Deaths Uninsured Excess Population Population Uninsured Million Estimated Deaths Estimated 2000 a 2000 (within 1999 for 2000 for 2000 Age (millions)
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From page 164...
... If the uninsured rate for all women in the 50– 64 year-old age range, 13–14 percent were used in the estimate, the number of excess deaths due to uninsurance would almost double. HIV Infection Approximately 20 percent of HIV-infected adults are uninsured, based on HIV Cost and Services Utilization Study interviews in 1996–1997 (Goldman et al., 2001)
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From page 165...
... They provide a sense of how the overall mortality risk for uninsured adults, estimated here to be on the order of 18,000 excess deaths among uninsured adults annually, is comprised of elevated mortality rates across many disease categories. All of these excess deaths among uninsured adults occur among relatively young Americans, those under the age of 65.
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Key Terms

  • excess deaths
  • mortality risk
  • health insurance
  • overall mortality
  • cost sharing

  • excess mortality
  • breast cancer
  • adults ages
  • age range
  • deaths annually

  • hiv infection
  • uninsured rate
  • insured adults
  • uninsured women
  • uninsured population

  • mortality risks
  • studies reviewed
  • undertreated hypertension
  • hypertension treatment
  • medical expenditure

  • utilization difference
  • longitudinal studies
  • million uninsured
  • calculation makes
  • society overall

  • mortality depends
  • unpublished medical
  • simplifying assumptions
  • panel survey
  • mortality rate


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