Why All Americans Should Have Health Insurance

As opponents of the Affordable Care and Patient Protection Act continue attempts to overturn, defund, or otherwise derail the law, it’s important to remember that the law addresses a crucial need to provide insurance coverage to all Americans.

The list below is a bit long, but these are just a few of the studies that demonstrate that Americans without health insurance have worse outcomes than those with insurance. It’s worth noting that some studies show Medicaid recipients also have worse outcomes, which some researchers speculate may be due to lapses in coverage. Please browse these excerpts from the articles' abstracts and note that all are from peer-reviewed medical or scientific journals. You may still think the Affordable Care Act is bad legislation, but repealing it without replacing it would cost lives.

Am Surg. 2010 Oct;76(10):1108-11.
Does health care insurance affect outcomes after traumatic brain injury? Analysis of the National Trauma Databank.
Alban RF, Berry C, Ley E, Mirocha J, Margulies DR, Tillou A, Salim A.
Cedars-Sinai Medical Center
Increasing evidence indicates insurance status plays a role in the outcome of trauma patients; however its role on outcomes after traumatic brain injury (TBI) remains unclear. A retrospective review was queried within the National Trauma Data Bank.... However, when controlling for confounding variables, the presence of insurance had a significant protective effect on mortality ... indicating insured severe TBI patients have improved outcomes compared with their uninsured counterparts.

Gynecol Oncol. 2011 Jul;122(1):63-8.
Insurance status and racial differences in uterine cancer survival: a study of patients in the National Cancer Database.
Fedewa SA, Lerro C, Chase D, Ward EM.
American Cancer Society
To examine the impact of race and insurance on survival among a large cohort of uterine cancer patients from the National Cancer Database (NCDB).... Patients without private health insurance had worse uterine cancer survival that may be improved through future health care reform aimed at improving access to preventive services and adequate treatment.

Am J Med. 2010 Aug;123(8):741-7.
Health insurance and cardiovascular disease risk factors.
Brooks EL, Preis SR, Hwang SJ, Murabito JM, Benjamin EJ, Kelly-Hayes M, Sorlie P, Levy D.
The National Heart, Lung, and Blood Institute
Compared with those with health insurance, the uninsured receive less care for chronic conditions, such as hypertension and diabetes, and experience higher mortality.... The treatment and control of hypertension and hypercholesterolemia are lower among uninsured adults. Increasing the proportion of insured individuals may be a means to improve the treatment and control of cardiovascular disease risk factors and to reduce health disparities.

Ann Surg Oncol. 2010 Dec;17(12):3104-11.
Health insurance status affects staging and influences treatment strategies in patients with hepatocellular carcinoma.
Zaydfudim V, Whiteside MA, Griffin MR, Feurer ID, Wright JK, Pinson CW.
Vanderbilt University Medical Center 
Lack of health insurance is associated with poorer outcomes for patients with cancers amenable to early detection. ... Uninsured patients with HCC are more likely to present with late-stage disease. Although insurance status did not affect chemotherapy utilization, Medicaid and uninsured patients were less likely to receive surgical treatment.

Cancer. 2010 Sep 1;116(17):4178-86.
Insurance status and survival disparities among nonelderly rectal cancer patients in the National Cancer Data Base.
Robbins AS, Chen AY, Stewart AK, Staley CA, Virgo KS, Ward EM.
American Cancer Society
Among patients with colorectal cancer, insurance status is associated with disparities in survival as well as differences in stage and treatment. 

Am J Respir Crit Care Med. 2010 May 1;181(9):1003-11.
An official American Thoracic Society systematic review: the association between health insurance status and access, care delivery, and outcomes for patients who are critically ill.
Fowler RA, Noyahr LA, Thornton JD, Pinto R, Kahn JM, Adhikari NK, Dodek PM, Khan NA, Kalb T, Hill A, O'Brien JM, Evans D, Curtis JR
American Thoracic Society
One in three Americans under 65 years of age does not have health insurance during some portion of each year. Patients who are critically ill and lack health insurance may be at particularly high risk of morbidity and mortality due to the high cost of intensive care.... Patients in the United States who are critically ill and do not have health insurance receive fewer critical care services and may experience worse clinical outcomes. Improving preexisting health care coverage, as opposed to solely delivering more critical care services, may be one mechanism to reduce such disparities.

Am J Surg. 2010 Apr;199(4):554-7. 
Insurance status is a potent predictor of outcomes in both blunt and penetrating trauma.
Greene WR, Oyetunji TA, Bowers U, Haider AH, Mellman TA, Cornwell EE, Siram SM, Chang DC.
Howard University College of Medicine
Penetrating trauma patients with insurance still had a greater risk of death than blunt trauma patients without insurance.... Insurance status is a potent predictor of outcome in both penetrating and blunt trauma.

J Trauma. 2010 Jan;68(1):211-6. 
Does insurance status matter at a public, level I trauma center?
Salim A, Ottochian M, DuBose J, Inaba K, Teixeira P, Chan LS, Margulies DR.
Cedars-Sinai Medical Center 
It has previously been demonstrated that a lack of insurance impedes access to health care services and may affect outcome after acute medical events. ... Despite being younger and less severely injured, uninsured trauma patients had a significantly higher mortality rate.

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