Study: Uninsured Don't Get Needed Health Care; Delayed Diagnoses, Premature Deaths Result

The lack of health insurance in America leads to delayed diagnoses, life-threatening complications and, ultimately, 18,000 premature deaths each year, according to a report released Tuesday by the Institute of Medicine. In the first comprehensive study of the medical consequences of going without insurance, researchers commissioned by the National Academy of Sciences found that "being uninsured for even a year appears to diminish a person's general health."

Many of the 30 million working Americans without health insurance belatedly discover serious illnesses such as cancer, diabetes, hypertension and HIV. Others may go their entire lives without receiving treatment for mental illness, high cholesterol, arthritis or asthma, the authors found. The vast majority of uninsured Americans go without health care until an illness becomes too serious to ignore.

After a detailed analysis of 130 studies on the uninsured, the researchers estimated that a lack of insurance translates annually into 360 to 600 premature breast cancer deaths, 1,200 to 1,400 deaths among HIV-infected adults, and 1,400 premature deaths due to under-treated hypertension. Committee member Reed Tuckson, a senior vice president with United Health Group, called the results "a major American problem" and "a tragedy of numbers."

Because uninsured persons are less likely to receive common cancer screening tests such as mammograms, Pap smears and colon exams, they die sooner than people without insurance. And patients without insurance are less likely to be admitted to a hospital and more likely to receive fewer services. "Often one of the first pieces of information obtained" in the emergency room is insurance status, said committee member John Ayanian, a health policy expert at Harvard Medical School. Of the nearly 40 million Americans without insurance, about 30 million are adults ages 18 to 65. Nearly 85 percent of uninsured adults work, or live in a family in which someone works.

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