45,000 Excess Deaths Annually Linked To Lack Of Health Insurance

Harvard study:

A study published online today [Thursday] estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The new study, "Health Insurance and Mortality in U.S. Adults," appears in today's [Thursday's] online edition of the American Journal of Public Health.

The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

Lead author Dr. Andrew Wilper, who worked at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, said, "The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease -- but only if patients can get into our offices and afford their medications."

The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.

Bin Laden killed 3,000 people on 9/11. Lack of health insurance kills fifteen times that number every year.

It's easy to forget what we're fighting for with all the ranting and raving and lying going on. This isn't about soaking the rich or getting votes or growing government or turning the country into a socialist utopia; it's about saving a lot of lives and improving the quality of life for a lot more people.

Let's try to remember that.

(HT: Andrew Sullivan.)

Pop Quiz: What Percentage of Americans Oppose The War In Afghanistan?

CNN:

Opposition to the war in Afghanistan is at an all-time high in a new national poll. Fifty-seven percent of Americans questioned in a CNN/Opinion Research Corporation survey released Tuesday say they oppose the U.S. war in Afghanistan, with 42 percent supporting the military mission.

57% of Americans oppose the war.

57% of Independents oppose the war.

But that's not exactly the picture you get from the media, is it?

On yesterday's Meet the Press, which was devoted in large part to "debating" the war, 100% of the panelists supported it. (The other half of the show was devoted to "debating" health care, in which 75% to 100% of the panelists opposed the public option. A majority of Americans support the public option.)

Liberal media, my ass. Not only are liberal views not represented even when a majority of Americans hold them, they're not even treated by the media as "serious" or "legitimate" views to hold. To be taken seriously by the media, you have to be a hawk and a fiscal conservative. Socially, you can be a little more liberal. As long as you favor war and limiting social spending, of course.

Greenwald:

Yesterday, Meet the Press hosted a panel discussion to debate two primary issues: (1) foreign policy -- specifically, the war in Afghanistan, and (2) health care. The panel: Rudy Giuliani, Tom Friedman, Harold Ford, Jr., and Tom Brokaw (as Jay Rosen often notes, Meet the Press is doing a fantastic job of fulfilling its pledge to present "fresh voices" in its discussions).

With regard to Afghanistan, there is a major debate currently taking place about whether we should stay in that country. A majority of Americans now opposes the war. But there was not a single participant there who shares that view. All of them believe that it is imperative we remain, and put on their little General hats to exchange deeply Serious analyses of how we need to adjust our strategy and tactics for greater mission success. Of course, all of three of those whose views were known about Iraq -- Friedman, Ford and Giuliani -- were vehement supporters of the invasion. As always, not only does support for that war not produce shame or even impair one's credibility and Seriousness, but the opposite is true: having supported it is a prerequisite for being considered credible and Serious, which is why those are the only people -- still -- from whom we hear when it's time to convene Serious discussions of foreign policy. What an odd filtering standard for The Liberal Media to use.

On health care, the same dynamic repeated itself. The prime controversy in that debate is over the inclusion of a "public option," with large numbers of Americans supporting it. Yet once again, not a single member of the panel advocated it (though David Axelrod was interviewed before the panel and paid lip service to the public option on his way to clearly signaling it would not be part of the ultimate plan). Guiliani warned there would be no health care with a public option; Ford told his "liberal friends in Congress" that they will have to be disappointed by the outcome; Friedman insisted that Obama adopt the proposals of Mitt Romney and John McCain and ensure he has the support of centrist Republicans (Brokaw offered some mild pushback against the attempt to demonize the public option). The words "single payer" were never spoken.

What you had with the health care discussion, just as was true with the Afghanistan debate and the lead-up to the Iraq War, is one that -- by design -- completely excluded any views to the "left" of DLC Chair Harold Ford, even where such views are held by large numbers of Americans. With very rare exception, that is the spectrum of opinion typically allowed on Liberal Media shows like Meet the Press. The Liberal Media doesn't even pretend to include liberal views.

Big Government and the Bailouts Saved the Day

Krugman:

So it seems that we aren’t going to have a second Great Depression after all. What saved us? The answer, basically, is Big Government.

Just to be clear: the economic situation remains terrible, indeed worse than almost anyone thought possible not long ago...

For all that, however, the latest flurry of economic reports suggests that the economy has backed up several paces from the edge of the abyss...

So what saved us from a full replay of the Great Depression? The answer, almost surely, lies in the very different role played by government...

Probably the most important aspect of the government’s role in this crisis isn’t what it has done, but what it hasn’t done: unlike the private sector, the federal government hasn’t slashed spending as its income has fallen...

In addition to having this “automatic” stabilizing effect, the government has stepped in to rescue the financial sector. You can argue (and I would) that the bailouts of financial firms could and should have been handled better, that taxpayers have paid too much and received too little. Yet it’s possible to be dissatisfied, even angry, about the way the financial bailouts have worked while acknowledging that without these bailouts things would have been much worse.

The point is that this time, unlike in the 1930s, the government didn’t take a hands-off attitude while much of the banking system collapsed. And that’s another reason we’re not living through Great Depression II.

Last and probably least, but by no means trivial, have been the deliberate efforts of the government to pump up the economy. From the beginning, I argued that the American Recovery and Reinvestment Act, a k a the Obama stimulus plan, was too small. Nonetheless, reasonable estimates suggest that around a million more Americans are working now than would have been employed without that plan — a number that will grow over time — and that the stimulus has played a significant role in pulling the economy out of its free fall.

All in all, then, the government has played a crucial stabilizing role in this economic crisis. Ronald Reagan was wrong: sometimes the private sector is the problem, and government is the solution.

And aren’t you glad that right now the government is being run by people who don’t hate government?

Yglesias points out that "“bailouts saved the economy” and “bailouts were structured so as to be very favorable to politically influential financiers” are not exclusive options."

I think that's right. The stimulus worked, but it could have worked better if it had been targeted solely at... stimulus, and less at, oh, say Goldman Sachs.

If there are any responsible Republicans left, please take lessons from this for the healthcare debate. You can't stop it, like you couldn't stop the stimulus. (In fact you shouldn't stop it, like you shouldn't have stopped the stimulus.) But if instead of fearmongering and holding your breath and throwing tantrums, you direct your opposition to things that actually should be opposed, you could affect positive change.

With regard to the stimulus, you could have held your fire, not smeared Obama as Stalin-incarnate, not ridiculed the very idea of stimulus, and instead insisted on making sure that the stimulus was as trim and directed as possible. Oh, you'll say you did argue against some of the waste and misdirected funds, and of course you did, but that was lost among the greater lunacy.

Now you have an opportunity to make sure that the health care plan does what it sets out to do rather than rewarding corporate interests at the expense of everybody else. But you've got to stop lying about everything, smearing Obama as a socialist, pretending that Obama's coming for grandma, insisting that government can never do good, and generally engaging in fearmongering. Instead, be a responsible opposition party. The Dems put forward a plan, respond with the same plan slightly improved. Stay on message. Say you support the plan, but you want to include tort reform. Or you want less money for X and more for Y. You can do that. If you put all your energy on making the plan better and none of it on insanity, you could not only cause a better health care plan, but take great strides in restoring a civil democracy.

Or you can scream "Socialism" and tear at your hair and have to live with whatever the Democrats manage to ram through without your help. Your choice.

The Emotions of Today

I'm excited and giddy. I was proud to vote for Obama. I'm glad to be part of history.

It's not just about the first black president, although that's a huge milestone. It's about the conquest of hope over fear. I realize that sounds trite, that to Republican ears, it's just propaganda. But it's true. We're kicking out the man who ran as a uniter but acted as a divider, a man who seized the moment of unity after 9/11 to push for a war that was unnecessary and counterproductive.

We're kicking out the "if you're not with us, you're against us" guy and voting against the candidate who believes that there are "pro-America" parts of America and presumably "anti-America" parts of America. We're rejecting the team that divides America into "real" (i.e. Republican) and "fake" parts.

We're ridding government of people who think government cannot be effective and do their best to fulfill that prophecy. We're getting rid of an administration and a party that thinks talking to the enemy is a sign of weakness and that derides domestic opposition as traitorous and sympathetic to terrorists. We're getting rid of an administration that thinks habeas corpus and the Geneva Conventions are inconveniences. We're getting rid of an administration that authorized torture.

We're voting for the party of science rather than dogma. The party that recognizes a healthy economy requires regulation rather than one that adheres to extremist theories of laissez-faire economics. The party that didn't try to turn the justice department into a branch of the Republican party.

Barack Obama isn't perfect. He's opposed to gay marriage and supports faith-based initiatives. He's young and relatively untested. I'm skeptical of his push for more troops in Afghanistan. But he is smart and open-minded and willing to fight for people who need fighting for.

If he does nothing but roll back the previous eight years of tax cuts for the rich, disastrous foreign policy, and cronyism in government, it will be a huge improvement. But if he listens to the experts -- not the partisan "experts" as Bush did, but the real experts who follow the truth wherever it leads -- he might just be able to lead us through the economic meltdown and get us back on the right path. He might be able to disentangle us from Iraq and then, I hope, from Afghanistan. He will certainly make sure that literally millions of Americans will get health care they desperately need and otherwise would not have gotten.

But also he will restore our image in the world. Colin Powell said that "it's killing us" abroad that Americans have been calling Obama a Muslim and an Arab and implying that either one would disqualify a man from the presidency. Before George Bush, (many) people everywhere looked to America as a beacon of freedom and diversity and tolerance. Now we're more famous for war and torture and Guantanamo Bay.

But how many kids named "Hussein" are there growing up in Saudi Arabia and Iraq and Pakistan and the Palestinian territories who are going to see the U.S. elect a man named Barack Hussein Obama -- despite those Republicans who wield his name as a weapon -- and realize that all the terrible things their parents and teachers say about America are not true -- that we really are a land of opportunity and tolerance and meritocracy? And how many black kids have heard over and over again that they can be anything they want to be, but haven't been able to really believe it?

Republicans like Sarah Palin and Ronald Reagan have used John Winthrop's phrase "The Shining City Upon A Hill" to describe America. I love that (and am reminded of Judaism's notion of being a "light unto the nations") and I think we have that potential. The last few years have been a little darker and a little lower than most of us would like. Obama's election can makes us shine bright again.

These photos of Obama, by the way, are great.

Elsewhere: Universal Health Care, Regulations, and Capitalism; David Foster Wallace

• Matt Haughey argues that universal health care might be good for capitalism:
  

  Everyone I know that freelances or works a day job and wishes they could quit and follow their dreams of launching a company complains about the lack of healthcare. Whenever I used to talk about freelancing at tech conferences, the first question was always about healthcare coverage. I've heard that in places like Berlin where you don't have to worry about where your healthcare is coming from or how much it costs, up to 35% of working age adults are freelancers. It may sound crazy and anti-capitalist to consider healthcare for all, but if we flipped a switch tomorrow and everyone had health coverage I swear a million small businesses would launch overnight. I know lots of people that keep a job just to get healthcare that are wasting their creative talents because they had a cancer scare or were born with a defect or otherwise are deemed uninsurable on their own.

  
  
• In a similar vein, Yglesias points to an example of regulation improving the market.


• Via Kottke, an excerpt of a sort-of biography of David Foster Wallace, and an interview with the author of that biography.

The Human Toll of Republicanism

Ezra Klein writes about the real-world ramifications of a McCain victory:

It's almost inarguable that a McCain presidency will push policies leading to an increase in illness and homelessness. Last year, McCain voted against expanding S-CHIP, which would have extended pubic health insurance to millions of currently uninsured children. Many of those children will become sicker than they would have if they'd been able to access a doctor early in their illness. Some may well die. In 1995, McCain voted for a GOP plan to balance the budget by cutting Medicaid by $182 billion over 10 years. Many adults would have been tossed off the rolls, been incapable of accessing a doctor, and fallen ill, or even died as unchecked hypertension led to cardiac arrest or a small lump grew into a full-body cancer. You can find similar examples of McCain trying to chop apart the safety net in almost every year of voting since.

...

There's a tendency to want to sugarcoat the outcomes of elections. You can say you disagree with McCain's policies because universal health care is important and humane and social programs are just and decent and upper-crust tax cuts are regressive and shameful and he's on the other side of all those opinions. What you're not supposed to say is that if John McCain is elected, the policies he has signaled he will pursue will harm the country's health, defund its safety net, lead to untreated illnesses, reduce mitigation of the ravages of poverty, and, in many cases, the outcome will be sickness and death and homelessness and, for those cut off from health coverage and help, probably hopelessness, too. McCain, for his part, would argue that even so, tax cuts are a matter of fairness and it's more important that health insurance is primarily private than that health insurance is actually accessible. And fair enough. But no reason we should ignore the implications of that philosophy.

It's easy to forget the real human cost of the right's political philosophies. They have a rationalization for everything -- progressive taxation is a priori immoral, higher taxes will kill the economy, universal health care will kill the economy, etc. -- but when you put their rationalizations on one side of the scale and the reality of those who will suffer as a direct and inevitable result of their policies, you've got to be awfully confident in the rationalizations for it to balance out.

When they make predictions that fly in the face of experience -- such as the claim that returning the tax code to Clinton's levels will kill the economy -- you really have to question their calculus.