The uninsured and mortality rates

Over at the Standard’s blog I have a post up linking to Megan McArdle’s recent column about the impact on mortality rates of health insurance. McArdle’s basic point is that it’s hard to say just how mortality rates are affected by insurance, a fact borne out by the wildly different numbers produced when the issue is studied. It’s a question worth asking, as Tyler Cowen points out. This seems to be the key point:

3. I live in a country where the extension of health insurance is a major issue, and a major budgetary issue, yet much of the discussion is in an evidence-free zone.

It’s true. We live in a country where the Washington Post allows their bloggers to accuse United States Senators of aiding and abetting in the deaths of hundreds of thousands of his fellow citizens for what amounts to hurt feelings, yet we have no real idea whether or not those hundreds of thousands of people would have been better off with or without health care. The most damning study — the one that claimed some 45,000 people die each year from lack of insurance — was authored by hardcore single payer activists who McArdle previously busted for their shoddy work studying health-related bankruptcies. A more reasonable number is 20,000, but then there’s a study authored by a member of the Clinton White House that shows coverage has no net effect on mortality.

The point is this: we have no idea, really, what sort of effect health insurance has on mortality. Let’s say that granting universal coverage would save, on net, 5,000 lives a year. Would it then be worth embarking on a multi-trillion dollar new entitlement that ruins the American health care system and stifles innovation in the medical community? I don’t think it would. But you bump that number up to something much higher like 45,000, and maybe the equation changes.