Researchers: Lack of Health Insurance kills 45,000 yearly in US

Originally posted by uaocteaou
reply to post by Eurisko2012

 

What I have cited is FACT, not partisan theory, such as you jus presented here.

A scientific study was done, these are the results, quoting the standard GOP line of BS is not helpful, nor does it lend any merit to your silly statement.

Really? You do know Dr.David Himmelstein is a founder and spokesperson for Physicians for a National Health Program, correct? Shocker, his study happens to back up his cause...

link

reply to post by uaocteaou


Gee, that's almost as many people as are killed by medical malpractice each year.

I'd hate to not be killed by a doctor because I don't have insurinks.

I thought the left loved mother earth? Sounds like less carbon footprinting to me!

Originally posted by harvib
I am trying to understand as I am not a statistician. Doesn't a statement like the one above mean isolating causation? If so how was this done? What assumptions must be accurate in order for the model to be accurate? What if a variable is dependent on another variable (i.e. unemployment vs. likelihood of insurance).

You can say the same for all experimental approaches. For example, I might use what you think is a true experiment, and assess the effect of some IV on some DV, physically controlling a number of other variables (i.e., what kiddies know as 'fair tests'). But it is impossible to control for all variables. That would, firstly, expect omniscience and, secondly, also make experimental methods impossible, lol. So we pick the most important and relevant.

Claims like 'correlation does not imply causation' (although I always add - but can be suggestive) applies to simplistic bivariate models (pearson-product, spearman etc). Where we might show that x is related to y, but have no information on the impact of a wealth of other important variables. Moreover, these sort of bivariate models possess no IV or DV.

So if we find that paranoia is related to time on ATS, we don't know whether time on ATS causes paranoia, or whether paranoia causes people to spend time on websites like ATS. We might also have a third (4th, 5th, 6th etc) unknown variable that could influence either paranoia or time on ATS.

Multivariate regression models do contain IV and DV. But the cox model is actually calculating a probability of an event rather than whether x has a signifcant effect on y (or for normal regression, how much variance of the DV can be explained by a factor). And for the example you gave (employment vs. insurance status), that is controlled for - they are attempting to isolate particular variables by controlling for the effects of the other variables (which they show in Table 2).

All stats include numerous assumptions - which are tested during analysis. In fact, there will be several for the Cox model - if I say, the strata should show proportional hazards, which is assessed by log-log analysis - does that mean anything to you? As noted, the assumptions are readily tested during analysis. The same applies here to all analysis, from basic t-tests to MANOVA to mixed effects models.

If you're looking for holes in the study, I can easily give you an obvious one - the 95% CI is actually 6% - 84%. Which does cover a previous study in 1993 which showed 25% increased mortality, though. And the limitations outline a number of potential issues. Forget about the stats. The cox model is pretty good. Indeed, most stats are. But they are only as good as the data used. GIGO, basically.

Also if I am reading this correctly being unemployed also leads to a 40% increased probability of death, being black leads to a 32% increase, being male leads to a 37% increase. The model most certainly can't lead one to reasonably believe that those variables are the direct cause of death as the article infers about being uninsured. Can it?

Wut? It's a probability analysis. So being male compared to female leads to a 37% increased probability of mortality (before 65). Do you doubt such numbers? Considering the raw data shows 2.6% death in females and 3.6% death in males, not a big surprise - the difference in the cox model is that it takes into account a large number of other relevant factors.

So, take the 37%. If you are male it would say you have a 37% increased likelihood of death before 65. A more illustrative example would be to say that for every 100 females that die before 65, 137 males would. Do you find that surprising? Thought it was well-known.

You might then ask the obvious question for male mortality - why? Would include higher risk-taking behaviour, IMO.

And the same applies for lack of insurance - why? Would include lack of preventative treatment, IMO.

What it won't include is the wealth of other variables already controlled for (e.g., your example of employment vs. insurance status).

Edit to add: I hope I am not coming across as antagonistic or argumentative, I am genuinely trying to understand. I have just always been under the impression that for statistics to accurately predict causation that certain accurate assumptions must be made. However I am ready to stand corrected.

No worries.

For the reliable implication of causation, we need to use methods that control for other variables in an IV/DV type experiment. Which the cox model does.

I just think you're pissing in the wind on the stats issue. It is a data model and not reality, but if you just want to take all stats out doesn't leave science much more than subjective art. Look at the study itself for its weaknesses, which are clear enough.

[edit on 20-9-2009 by melatonin]

Originally posted by stevegmu
Really? You do know Dr.David Himmelstein is a founder and spokesperson for Physicians for a National Health Program, correct? Shocker, his study happens to back up his cause...

link

Wasn't really his study.

Andrew Wilper designed and undertook the study under Steffie Woolhandler's supervision. Himmelstein just contributed to the write-up with a number of other researchers. The research was funded by the HRSA - a government funding body.

It's in the paper. Wilper would be awfully upset to lose primary status in his own study.

The data speaks for itself. Doesn't need Himmelstein for anything more than frills. Are you suggesting fraud on their part or something? The data source is clearly stated, and the data prep and analysis technique is outlined - you can attempt to replicate it and string them up if fraud was involved. Alternatively, if there is a better approach to getting an answer to the question (what effect does lack of insurance have on mortality) you're welcome to have a bash.

Moreover, a previous study showed a 25% increase in mortality in the uninsured. Not as if it's a novel or unusual study. I'm amazed that people appear to be arguing against this study - are people surprised that lack of effective healthcare (e.g., preventative approaches) leads to greater chance of death?

Science of the bleedin' obvious, really.

[edit on 20-9-2009 by melatonin]

reply to post by melatonin


Star for your post! Thank you!

So, take the 37%. If you are male it would say you have a 37% increased likelihood of death before 65. A more illustrative example would be to say that for every 100 females that die before 65, 137 males would. Do you find that surprising? Thought it was well-known.

It is well known. However my point is that being male is probably not the direct cause of the early death. The root cause must still be identified. And it may be a little irresponsible to state that being male leads to an increased probability of an early death because using the word leads indicates that being male is the cause, and as you point out in your next statement there is most likely an explanation to why the study shows an increased probability of an early death associated with being male.

are people surprised that lack of effective health care (e.g., preventative approaches) leads to greater chance of death?

Did the study evaluate the effects of lack of health care? I believe it didn't. This is the problem I have with the interpretation of the study. The authors of the study are trying to assign lack of insurance as the cause of an early death. The study seems to show nothing of the sort.

Originally posted by harvib
It is well known. However my point is that being male is probably not the direct cause of the early death. The root cause must still be identified. And it may be a little irresponsible to state that being male leads to an increased probability of an early death because using the word leads indicates that being male is the cause, and as you point out in your next statement there is most likely an explanation to why the study shows an increased probability of an early death associated with being male.

But the root causes are all the consequence of being male. So males work in riskier environment, undertake riskier behaviour etc. It's not the case that riskier behaviour or working in coal-mine makes you male, lol.

What we would want to know is what exactly is it about males that results in such outcomes.

Similarly, for lacking insurance the question would now be what exactly is it about lacking health insurance that leads to such poor health outcomes. Lacking health insurance has consequences, much like being male has consequences.

Did the study evaluate the effects of lack of health care? I believe it didn't. This is the problem I have with the interpretation of the study. The authors of the study are trying to assign lack of insurance as the cause of an early death. The study seems to show nothing of the sort.

As I said, lack of effective healthcare - and in the US insurance provides more effective healthcare. I know that uninsured people in the US can sometimes get some basic charity care and are entitled to emergency treatment etc. As I try to point out above, sometimes the causality is easy to note. Thus, risky behaviour doesn't make one male, but males on average show more risky and impulsive behaviour.

If true, we would also expect the smaller number of risk-taking females to have a higher risk of death cf low impulsive females. And that would be a different study (as only the extra risk male-female is accounted for).

So what is it about lacking health insurance that leads to these outcomes? What does health insurance give the normal individual in the US? If I feel a nagging pain in my chest, can I go to the doctor for a check-up readily without fuss? Can the uninsured? Are they more likely to ignore what might seem minor and not be exposed to preventative measures (e.g., find high cholesterol/BP/heart murmur and receive medication and health advice/treatment; have mammogram and treat cancer early) even if they know they have that option (if available)?

If true, we would expect even those with health insurance who fail to report minor health issues and seek preventative care to have a higher risk of death cf. those who use the services more effectively (health checks etc). I'm sure they would be fewer than those who can't even readily seek such help (the uninsured). Again, a different study (as only the extra risk insured vs. uninsured is accounted for).

You're just obfuscating, really. Lack of insurance has consequences such as poor exposure to preventative health measures. Lacking preventative measures doesn't lead to lack of health insurance.

If you really think that health insurance has absolutely no influence on health outcomes, you might as well spend the cash on a new TV or something. Why even bother having the thing?

[edit on 20-9-2009 by melatonin]

reply to post by melatonin

You're just obfuscating

Sigh, I knew I was going to come across that way. However that isn't the case.

The interpetation of the study is clearly bias. It uses the model to try and assign causation to lack of insurance which is misleading to say the least. Forcing people to pay even higher taxes or to support one of the most profitable corporate industries may not produce the outcome this "study" seems to imply.

The bottom line is that root causes need to be assigned to the health care problems. I whole heartedly agree with you that one of the major ones is lack of preventative medicine. I disagree that "insurance" is the solution. And this study certainly does nothing to support that insurance is the solution, as hard as it tries to imply that it is.

The solution that needs to be identified, in my opinion, is how can effective health care be affordable to all. Before I can support the purposed health care reform bill I would need to see a study that indicates that involving a wasteful, inefficient government or a bloated corporate industry would make health care more affordable.

Originally posted by Eurisko2012
reply to post by metamagic

 

Not a myth. Truth.
Canadians are getting on airplanes and flying down to Texas
for surgery as we speak.
As a matter of fact there are companies in Canada who arrange
it. That's all they do. Arrange the airline tickets, hotel reservations,
the hospital appointments, recovery and the flight back to Canada
where they were told to wait.....wait.....wait.....did you die yet?...
.....wait.....wait.....What?! You flew to Texas for surgery!? Why???

--
Timely Medical Link - Great Waiting Times! - CHS-

-Medical tourism in Canada- Google search will point you toward the
Truth.

Let me get this straight. You are saying that Canadians are flying down to Texas for surgery as we speak and the source of this “truth” is... a website belonging to a company that makes money by flying Canadians to the US for medical treatment. You have heard of “marketing” haven't you? The website is not reporting facts, they are trying to convince people that there are long wait time so they should give them money to... oh never mind.

Instead of using marketing brochures, lets look at a real study where real medical researchers (American, not Canadian) have gone out and looked at the facts. It is called 'Waiting Lists in Canada: Reality or Hype?" by Kao-Ping Chua, AMSA Jack Rutledge Fellow 2005-2006 and is available on the website of the America Medical Student Association. (www.amsa.org)

I will let relevant quotes from the study speak for themselves. First, the idea that there are waiting lists for emergency treatment.

A "waiting list" is a list that patients are enrolled in once they opt to pursue an elective procedure, assuming that they cannot get this procedure performed immediately. In Canada, waiting lists do NOT exist for emergency procedures. It is a myth that Canadians with serious, life-threatening illnesses are enrolled on a waiting list before they can receive life-saving therapies.

But what about all of those Canadians flying down to Texas for surgery that you mentioned?

Opponents of the Canadian healthcare system commonly conjure up the image of hordes of Canadians crossing the border to receive healthcare in the U.S. due to long waiting lists. Yet, the studies that have been done on this issue do not support the legitimacy of this idea.

Hmm.. so what do these studies show?

In sum, the number of Canadians receiving care in the U.S. appears to be extremely low compared to the amount of care that Canadians receive in Canada. There does exist a group of Canadians who come to America 1) To receive therapies not approved in Canada; 2) To avoid long waiting lines; and 3) Because of limited capacity in Canada in certain technologies. However, these Canadians are by far the exception, not the rule.

There is a small minority of Canadians who receive care in the U.S., and even a smaller minority who specifically come to the U.S. to receive care. The idea that hordes of Canadians cross the border to avoid waiting lists is a myth.

[edit on 23-9-2009 by metamagic]

Of course not, but Sarah Palin's new book is. GO GET'EM GIRLS!

I don't understand how people's lives, and well-being, is even a matter of debate.

Yet, when the torture, war, and death starts those people say it was for the good of 2 nations.

God, people are dumb.

reply to post by melatonin


Yes and your arguments make a lot of sense. But let me paint a picture. 30 million more people added to the healthcare roles. Without anymore doctors or nurses and fewer hospitals. An overwhelmed system controlled by the most corrupt and I would say ineffective bureacracies in the world.

Well at least we will receive the exact same crap care, except of course for the government employees and the Elite.........

reply to post by uaocteaou


Bull crap!
I am still waiting for Anyone to tell me that they KNOW someone/Anyone that has Not gotten medical care because they have No insurance. Someone you Know, not a friend of a friend.

No One goes without Medical Care in America, except maybe illegals who only get ER care. I am just about sick of hearing this crap.

reply to post by fraterormus


Every one of the items you mention would be more effectively handled by a true free market system, not the corporatism and government interference we have now.

The government, and thus the people, should not be burdened with:

• Airline safety - this is a private business, the companies should be held responsible
  
• H1N1 - waste of money, it's not deadly as thought
  
• Anti-terrorism - depending on what you believe about 9/11, you might also call this a waste of money
  
• Crime Prevention - should be at the local level, as a nation, we shouldn't be spending as much money on this as we currently do. There is a place for the FBI, but I believe it has too much power now
  
• Drunk Driving - what a joke, if you kill someone, you should be held responsible for it regardless of your state of mind (drunk vs. sober) or the weapon you use (gun vs. car)... if murder laws were applied equally to drunk drivers, then this cost would never have had to happen. It's as equally absurd as hate laws.
  
• Poison Control - Truthfully, I don't have an argument for this one
  
• Firearm Deaths - apply the law, if you accidentally kill someone with a firearm, then you get hit with an involuntary manslaughter suit, waste of money
  
• Drug Use and Abuse -
  biggest Government power grab in the last 50 years, get rid of the draconian drug laws (PROHIBITION) and you would see a drastic reduction in crime (see 18th/21st amendments - speaking of which, I find it interesting that back then, to BAN a substance, it was general knowledge that they need to amend the constitution, guess the gov't doesn't really follow the rules anymore)
  
• Healthcare - it isn't a right, let the free market, charities, and charitable doctors provide a solution, get government out of the whole industry, repeal HIPPA
  

[edit on 10/20/2009 by Finalized]