the study measured actual death rate of the sample group over a 12 year period
It did.
The number came out 45K at the national level
Yes, it did that, too. So what?
Let's look at what is claimed in the report you linked on the study. This is from the first paragraph: "nearly 45,000 annual deaths are associated with lack of health insurance."
Here's what you read into that "nearly 35,000 annual deaths are caused by lack of health insurance." To the reporter's credit, and unlike your later link, he didn't lie about cause. Whether intentionally or not, he just left you to form a bogus conclusion if you were predisposed to do so.
It's pointless to reduce that to your simple .3% increased risk...it the sample group is large enough, .3% (assuming that's correct) can easily extrapolate to 45K people at the national level.
Huh? First of all, it was .2%, not .3%. The annual risk of dying for a 40 year old is about .05%. The article you linked stated that being uninsured increases one's relative risk by 40%. So I tacked an extra 40% onto the .05% risk and came up with an actual risk of .07. That's high because the base included both insured and uninsured but it's close enough for our purposes. My purpose was to demonstrate the difference between relative and actual risk. 40% looks scarier than .02%. But, you're right, assuming the numbers in the report are correct, that still comes out to 45K people.
Now, 2.5 million people die each year. So that would mean that .02% of the people who die each year are uninsured. That's a calculation of 45K/2.5 million. I'm not about to do a statistical-significance calculation but ya gotta wonder if .02% reaches that threshold. So, despite 45K being a big number, we're in iffy territory already when it comes to statistical accuracy.
To make it even iffier, let's look to see what was measured. Remember that we're talking about the deaths of insured vs insured people and from that we're trying to infer how many of those deaths are CAUSED by not being insured. The inference that it's all of them is bogus.
"after taking into account education, income, and many other factors, including smoking, drinking, and obesity. It estimated that lack of health insurance causes 44,789 excess deaths annually."
Now they're claiming cause. They adjust for whatever the data allow and then claim the rest of the deaths as caused by lack of insurance. Good grief! First, they're using largely observational data, people reporting. say, how much red meat they ate each day for the last x years. Second, the data base doesn't include all relevant variables so it measures what it has. That's like looking for your car keys under the lamp post. If you die in a Scuba accident of Cozumel, does it really matter if you had insurance? For that matter, if you're obese, does it really matter if you had insurance? Conversely, if someone with insurance got CT scans every time they turned around and then died of cancer, do they count that as dying from having rather than lacking insurance?
Now, let's apply a bit of proportion here. Yes, 45,000 is a big number. The report states: "Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease." That's true. And still saying "associated with" rather than "caused by" is good. But that big number is in the neighborhood of the number who die of the flu each year. The flu, for heaven's sake.
Also, please note that the numbers we're talking about were people who died without insurance. We have no clue how many of them were receiving health care. If they were receiving health care although uninsured, then what does that do to the conclusions?
Sure, there are probably some people who would have lived longer had they had insurance. But how many, we don't know. How much longer, we don't know. Pretending we do is bogus. |
