Do You Die Younger Without Health Insurance?

I blog I visit a lot recently asked a very interesting question.  How risky is it to be uninsured? I particularly want to know because my husband, 64 but healthy, does not have health insurance, and never has.  (Of course, he also never goes to the doctor.)

But Chris Conover at, who poses that question, says a couple of things.  Some studies show you have an elevated risk of dying without insurance.  Try about 25% more.  But others, sifting similar data, find the risk statistically insignificant.

Why?  People who smoke and/or are obese are more likely to be uninsured, sure risks for an early death. It's possible they're more comfortable taking risks and might speed or not wear seat belts, too.  Young people, who also often do not buy insurance (they'll live forever, remember?), have as one of their greatest causes of death, automobile accidents, Conover points out. 

So, are they dying young from being hospitalized without insurance, or just because they're risk-takers overall?

"Such an excess risk of death associated with being uninsured is comparable to a number of other everyday risks," he writes. "A relative risk of 1.22 implies that on average, for any given age group, the chance of dying in the next year is 22% higher than for a statistical twin who has private coverage.  Similarly, the annual chance of dying for high school graduates is 20% higher than for a counterpart with the same characteristics who has completed at least a Masters degree in graduate school.  Likewise, people who are divorced have a 20% higher annual risk of dying compared to similar individuals who are married."

People who are obese have a 26% higher annual death rate compared to equivalent individuals of normal weight. And smoking elevates mortality risk even further. Those who smoke less than a pack a day are increasing their annual risk of death by 68% while those who smoke more than a pack a day end up more than doubling their chances of dying each year. 

Conover's point isn't that it's a fact poured in concrete that you die younger without insurance, but that the studies all say different things, and it's unlikely that you do.  (His main thesis is that it's questionable whether Obamacare will save lives, even though it is extending insurance to many who did not have it, because we don't really have reliable ways to compute whether people who are dying younger and are uninsured are dying because of that, or because of other reasons.)

He mentions in a footnote that The Institute of Medicine calculated that in 2000, 18,314 excess deaths could be attributed to lack of coverage among adults age 25-64. (He points out, however, that this analysis was based on two earlier studies showing a 25% higher risk of death for uninsured adults compared to those with employer-based coverage.)

Yet other studies say that excess deaths attributable to lack of coverage ranged from 35,327  to 44,789.  

Consider this: one recent study found that those who suffer traumatic injuries and don't have insurance often are sent to better hospitals.   But here's the flip side: some without insurance are ignored while patients with it are tended to.

It's, of course, your choice.  As long as you don't mind a financial penalty for not obtaining insurance, go for it!


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