One of the arguments against an individual mandate is that people should be able to make the choice if they want to contract with any health insurance company, whether that company is a public one or a private one. The younger healthier Americans are the ones being held up as the people who would be unfairly put upon by this requirement. However that assumes these folks are making an informed decision about what it means to be without insurance. Just because you are relatively healthy in your 20’s does not equate to not needing insurance.
"Originally posted at Squarestate.net"
We know that younger citizens are more likely to be in major car crashes than older citizens are. Younger people also are more likely to take risks older folks would shy away from. Part of this is the nature of maturing, but it also makes them less able to evaluate the actual risks of being without health coverage. The choice (if they get a chance to make a choice) is far more important than if they can see a doctor for that rash they developed.
A new study in the Archives of Surgery,studied the survival rates of trauma patients looking to see if there was a difference between insured and uninsured patients. To reduce the instance of outside factors causing death, the study looked specifically at patients 18 to 30 years of age. Since this group is healthier than older folks it makes for a good control. The findings were pretty shocking.
First off, we need to talk about the fact that when someone comes to a trauma center it does not matter if they are insured or not. The Emergency Medical Treatment And Active Labor Act of 1986 requires all trauma patients regardless of any other status (citizenship, immigration status, insurance, ability to pay) to be treated when they are in risk of dying. This Act was put in place in response to the dumping of uninsured patients on inferior hospitals or on the street.
In theory, this means if you are uninsured and you have a car accident or are shot, then you will get the treatment you need to stay alive. The practice shows there are problems with this system. Uninsured trauma patients 18 to 30 years of age die at a rate that is 89% higher than their insured counter parts. Let that sink in for a minute. If you are a healthy 20 something, without insurance, you have nearly a ninety percent higher chance of dying than if you had insurance.
To be clear the issue is not the trauma nurses and doctors. They get someone in dire straights in the ER, they go to work and do the work. But once someone is stabilized and not in immediate danger of dying the care seems to taper off as costs rise. The study finds that uninsured patients are significantly less likely to be admitted to a hospital and they received far less radiological (MRI, CT, X-ray) studies than insured patients.
Uninsured trauma patients are also far less likely to be admitted to a rehabilitation facility (long-term care for those who are not ready to go home but are not sick enough to need full hospitalization). In addition, the uninsured tend to be less medically literate than their insured counterparts are. This leads to communication issues with the doctors. It also makes it less likely for them to request specific treatment for symptoms and problems with their care.
All of this is just more in the mountain of evidence for universal coverage for all citizens. It is clear from the data in this study and others that insurance is not something you should choose to purchase, it is something which is required for any kind of reasonable life in a modern nation. There is no time in your life where you are "safe" from needing insurance. While many diseases develop midlife there is nothing to prevent early onset from happing. There is no way to know when you will be hit by a truck or fall off your bike or be the victim of violent crime and require hundreds of thousands of dollars of care to become healthy (if you ever do get back to where you were). Asking anyone to evaluate these risks compared to cost is insane, especially for Americans.
We are not the best people at evaluating risk. We are by nature an optimistic people and so when comparing cost of something we might need with the risks of not having it, we are far more likely to underplay the consequences and risks in favor of more money in our pockets today. This is especially true for young adults who do not, in general, have enough experience to make even half-assed evaluations.
This leads us to the lesson we should know from every other industrialized nation in the world, the only way to cover all your people and do it cost effectively is to have a single payer system of one stripe or another. To the Dog Medicaid for all is the way to go. This argument about "socialization" is bullshit. It ignores the cost of 45,000 lives a year. Just to give you a feel for where this falls in the causes of death, lack of insurance kills more people than Leukemia, Cervical Cancer and Prostate Cancer. It kills more people than Hepatitis C, Melanoma, drug abuse and alcohol abuse combined every year.
The trend is should have always been clear, without insurance and the access to quality care it provides at all levels, your chances of death are significantly higher. The Republicans were willing to take our nation into war for the deaths of 3,000 of our citizens but they are completely unwilling to do what it takes to help prevent the death of 45,000 citizens a year. What is truly sad is there are Democrats who are also unwilling to act for the best interest of their citizens.
The time to redouble our efforts is now. We are going to get a reform bill. It is gonging to suck in many of its particulars. We need to keep the pressure on to do as much of the right thing as possible and to be ready to push to fix what is enacted. This fight has been going on for far too long, far too many needless deaths have happened, and more will happen until we get to the final goal of single payer. We should never lose sight of the human cost of failing, or failing to do our best. Today, while you have been reading this, someone without insurance will be in a trauma center, they are far less likely to recover than those who are insured. Are we really willing to live with that? Are we really willing to say, "at least it is not me"? The Dog is not.
The floor is yours.