No Insurance, Poor Health (NY Times, Editorial)

The case for providing health coverage for all Americans got even more compelling in the past week when two new studies presented the most comprehensive evidence yet that the lack of health insurance is seriously harmful to a patient's health. The studies found that uninsured people suffer significantly worse outcomes from cardiovascular disease, diabetes and cancer than those who have coverage.

One study by researchers at Harvard Medical School, published in the Journal of the American Medical Association, found that uninsured near-elderly people got sicker at a faster rate than comparable people with insurance. Those disparities were sharply reduced when people turned 65 and became eligible for Medicare. Those who previously had insurance reported no significant change in their health as they transitioned to Medicare, but those with little or no prior coverage reported a substantial slowing of the decline of their health. It was strong proof of the value of Medicare's universal coverage for elderly Americans.

The value was particularly evident for previously uninsured individuals suffering from heart disease, stroke, high blood pressure or diabetes. Once on Medicare, they benefited greatly from medical management of blood pressure, cholesterol and glucose levels and quicker access to effective treatments and prescription drugs. They had 10 percent fewer major cardiac complications, such as heart attacks or heart failure, than would have been expected by age 72 based on their previous health trends.

A second study, by researchers at the American Cancer Society, found substantial evidence that lack of adequate health insurance coverage was associated with less access to care and poorer outcomes for cancer patients. The uninsured were less likely to receive recommended cancer screening tests and more likely to have their cancers diagnosed at a later stage, when they are less curable. They had lower survival rates than those with private insurance for several cancers for which there are screening tests and effective treatments, including breast and colorectal cancer.

The two studies leave little doubt that health improves when people gain insurance coverage. That coverage should be available to all Americans.