This is a study that should stick a major fork in the the argument that many opposed to Health Care reform like to make, because that argument is done. The discredited argument? "People can always get emergency care they need at the ER, and it's the same quality".
Well, by one metric...a rather important one...it's not.
That metric? Dying.
ETA: Link to actual study, courtesy of commenter :).
From the article:
The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.
"This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist
I'm semi-live blogging the article, since I'm reading and posting at the same time. This leaves me wondering "what's the proposed mechanism of poorer care?"
The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors.
The hospitals that treat them also could have fewer resources.
Alright, so they can't quite pin down the reason. But I rather think the latter is a strong reason. Not far from where I sit right now is an extremely busy ER where most of the uninsured in my city get their emergency care. And, the waits there are far longer than other ER's, to the point where if you have insurance you just plain don't go to that ER.
OK, so they've found that uninsured are more likely to die. What factors did they control for?
The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance — even low-income patients insured by the government's Medicaid program.
Seems like they did a pretty good statistical analysis to me.
Another possible mechanism, courtesy of a researcher who was "surprised" and wasn't involved with the study:
Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research.
"Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."
Ah, patient dumping. Some claim it doesn't happen...but it does. Adhering to the letter of the law while violating the spirit of the law, I see.
And, finally, some study statistics:
In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors.
The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals.
This study should be good ammunition to push Health care reform. It shows that the common "meme" that if you need life-saving care, you can get it, regardless of your insurance status still ends up being wrong, in that you're more likely to die without insurance.
I'm not familiar with the journal it's being published in but it seems reputable. I'm presuming this is a peer-reviewed study and Harvard has few, if any, crap researchers.
Brief aside at the end: I got to be one of the few non-Palin, non-bowing journals today. And this wasn't even the one I was planning on, this came up as soon as I saw the article. I'll have to keep an eye out on the usual suspects to see what other web sites post it.