Malkin distorts study on high mortality rates of uninsured in failed attempt to debunk it
In her October 23 column, Michelle Malkin attacked progressives citing the number of annual deaths due to lack of health insurance, a figure she described as the "bogus death statistic." In doing so, Malkin misrepresented the methodology of the study from which this statistic is gleaned.
Study concluded: "The uninsured are more likely to die than are the privately insured"
Study found lack of insurance was a factor in almost 45,000 deaths each year. The study, "Health Insurance and Mortality in US Adults," concluded that those without insurance had a higher mortality rate than those with insurance. By applying that ratio to 2005 census data, the study concluded that lack of insurance was a factor in almost 45,000 deaths every year. The report concluded that "[u]ninsurance is associated with mortality. The strength of that association appears similar to that from a study that evaluated data from the mid-1980s, despite changes in medical therapeutics and the demography of the uninsured since that time."
Malkin distorted the study's methodology in attempt to debunk statistic
Malkin claimed study counted uninsured who died and "attributed deaths to lack of health insurance." Calling the results of the study "a phantom number," Malkin claimed that in their study, "Drs. [David] Himmelstein, [Steffie] Woolhandler, and company then crunched the numbers and attributed deaths to lack of health insurance for all the participants who initially self-reported that they had no insurance and then died for any reason over the 12-year tracking period." From Malkin's October 23 syndicated column:
Democrat Rep. Alan Grayson of Florida has found his calling: Death demagogue. First, he accused Republicans of wanting sick patients to "DIE QUICKLY." Next, he likened health insurance problems to a "Holocaust in America." Now, he's unveiled a new website entitled "namesofthedead.com" in memory of the "more than 44,000 Americans [who] die simply because they have no health insurance."
Just one problem: The statistic is a phantom number. Grayson's memorial, like the Democrats' government health care takeover plan itself, is full of vapor. It comes from a study published last December in the American Journal of Public Health. But the science is infused with left-wing politics.
[...]
So, how did these political doctors come up with the 44,000 figure? They used data from a health survey conducted between 1988 and 1994. The questionnaires asked a sample of 9,000 participants if they were insured and how they rated their own health. The federal Centers for Disease Control tracked the deaths of people in the sample group through the year 2000. Drs. Himmelstein, Woolhandler, and company then crunched the numbers and attributed deaths to lack of health insurance for all the participants who initially self-reported that they had no insurance and then died for any reason over the 12-year tracking period.
Study compared mortality rates of insured and uninsured, then controlled for risk factors, finding health insurance still predictor of mortality rates
The study used a nationally representative sample to determine comparable mortality rates between insured and uninsured. After determining that insurance status is a predictor of mortality, the researchers compared the mortality rates of the insured and the uninsured by using data from the Center for Disease Control's Third National Health and Nutrition Examination Survey to determine the increase in mortality due to uninsurance. The study found that "[a]mong all participants, 3.1%" died. "The hazard ratio for mortality among the uninsured compared with the insured, with adjustment for age and gender only was 1.80 (95% CI=1.44, 2.26)."
The study then controlled for well-known risk factors to determine whether insurance affected mortality rates. The study controlled for many well-known risk factors such as age, race/ethnicity, smoking habits, alchohol habits, body weight, and poverty. It found: "After additional adjustment for race/ethnicity, income, education, self- and physician-rated health status, body mass index, leisure exercise, smoking, and regular alcohol use, the uninsured were more likely to die (hazard ratio=1.40; 95% CI=1.06, 1.84) than those with insurance."
The study applied hazard ratio to census data to estimate that approximately 45,000 people in 2005 died from lack of health insurance. From the report:
In the model adjusted only for age and gender, lack of health insurance was significantly associated with mortality (hazard ratio [HR]=1.80; 95% CI=1.44, 2.26). In subsequent models adjusted for gender, age, race/ethnicity, poverty income ratio, education, unemployment, smoking, regular alcohol use, self-rated health, physician-rated health, and BMI, lack of health insurance significantly increased the risk of mortality (HR=1.40; 95%CI=1.06,1.84; Table 2). We detected no significant interactions between lack of health insurance and any other variables. Our sensitivity analyses yielded substantially similar estimates.
Replicating the methods of the IOM panel with updated census data and this hazard ratio, we calculated 27424 deaths among Americans aged 25 to 64 years in 2000 associated with lack of health insurance. Applying this hazard ratio to census data from 2005 and including all persons aged 18 to 64 years yields an estimated 35327 deaths annually among the nonelderly associated with lack of health insurance. When we repeated this approach without age stratification, (thought by investigators at the Urban Institute to be an overly conservative approach) we calculated approximately 44789 deaths among Americans aged 18 to 64 years in 2005 associated with lack of health insurance.
Well, I have never known facts to get in the way of a point that Ms. Malkin was trying to make.
Remember, it isn't about the "truth", it is about that persons version of "the truth".
Actually, that is, in and of itself, a rather frightening concept in our country - the lack of understanding of basic science. When more than half the country's citizens didn't believe in evolution and belief in climate change is falling as the evidence is rising, it's time to take a clear hard look at what qualifies for science education in this nation.
The gall of these self important wingnuts knows no bounds. Her credentials are barely better than her co-horts. Hannity, Beck Limbaugh etc. The college drop outs.
For her to suggest that their methodology is bogus is ridiculous, and is just another example of a kneejerk reaction that so many on the right demonstrate.
But then... conservtaives NEVER ask for evidence supporting ludicrous, partisan statements like these.
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If a conservative says it, and it sounds conservative or supports thier agenda, that's evidence enough for them!
Yeah, that has no hint of Left-wing politics.
According to who? Those who don't like the conclusions of the Study? Malkin?
Show me HOW and WHY it is skewed. That it supports "left wing politics" in my mind only justifies the conclusion of left wing politics. It does not mean the data is skewed.
You'll have to demonstrate that independently of ideology.
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And hopefully do a better job that Malkin does here.
This response to a widely cited paper by David Himmelstein and
colleagues challenges the basis of its conclusions.
by David Dranove and Michael L. Millenson
Here's the link;
http://content.healthaffairs.org/cgi/reprint/25/2/w74
One example; The researchers counted anyone having over $1000 in medical debt in a 2-year time period, who filed for bankruptcy, as having gone bankrupt due to medical bills. Other researchers pegged the rate at atbout 20%, not %50.
This past year, the U.S. Department of Justice (DOJ) responded to a request by Sen. Charles Grassley (R-IA) by examining 5,203 bankruptcy cases from the files of the U.S. Trustee Program. The filings occurred between 2000 and 2002, the same time frame as the filings studied by Himmelstein and colleagues. The DOJ reported that 90 percent of filers had medical debt of less than $5,000. Of those reporting medical debts, those debts accounted for only 13 percent of total unsecured debt. The DOJ summarizes the evidence against Himmelstein and colleagues’ thesis as follows: “The conclusion that almost 50 percent of consumer bankruptcies are ‘medical related’ requires a broad definition and generally is not substantiated by the official documents filed by debtors.”
And you still didn't refute the fact that the study was written by a progressive with an agenda.
Your turn
Skewed data should relate to the high mortality rate of the uninsured.
Try staying on topic for once.
What's more, how many people do YOU think are saved from bankrupcy simply because the taxpayer ended up picking up the tab for them ANYWAY? (Again, I have a hard time accepting ANY amount of that happeneing as well, under our current, for profit, system.)
And more to your point... they examined 5,203 cases from 2000 to 2002. The actual estimated NUMBER of cases is around 90,000 per year, now. Now... even if you assume it was HALF that THEN, at best your still using a 3.5% sample of the whole, from 7-10 years ago to support your point.
What was the home forclosure rate then? (probably almost zero - the housing boom was still in it's early stages) What was the credit card default rate then? (Again...) How much have average medical expenses increased since then? How many MORE are uninsured now? What about the cost of everything else? Fuel, housing, education, etc...? All UP. Well, I can tell that WAGES have been almost flat in that time. So whether it's one thing or another, the point still stands: Medical Costs, and lack of coverage are a huge problem. (And what... You think individuals can afford bills that Billion-Dollar insurance comapnies CAN'T? Give me a break! If it was that cheap, no one would ever get dropped or denied, and there wouldn't BE a problem in the first place!)
And as to your last point, I don't need to. Having an agenda only gives you the motivation to go out and do the research. That alone doesn't refute the evidence one finds. The study you cited above does a much better job of refuting, but still... at best it just makes the problem smaller. Which will also make it a CHEAPER problem to solve than the very people who comissioned that study will otherwise claim.
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Public Option / Single payer DONE RIGHT is still the way to go.
Let's say I make $75,000, and my wife doesn't work / raises the kids.
Let's say I have a $170,000 mortgage (secured)
$31,000 in student loan debt (unsercured)
$2000 in Credit Card debt (unsercured)
And $2000 in medical bills that I'm paying over time at zero interest. (unsercured)
(The absolute Numbers have been changed, of course, but proportions are still reasonable.)
Now... If I somehow got $3000 MORE in medical debt, and they wanted the whole $5000 NOW...? I'm bankrupt. I don't HAVE $5000 sitting around to right someone out a check for. The sad reality is that I have very little cushion. (OK, I could raid my IRA's/401-K's etc... but that's hardly a GOOD idea, is it? That only kicks my problems down the road a bit, and hamstrings my ability to deal with anything that happens THEN even more!) And I don't even HAVE a car payment right now! (One more year...! One more year...!) Now that $5000 would only amount 13% of my "overall, unsecured debt" but I would still need to consider bankrupcy, if they wanted it collected now.
Now, in my reality... Would it really break me? No, probably not. I have a good job, good credit and could probably work something out. (As I did with the $2000 in med bills I have now.) But I'm also in a better situation than half to three-quarters of the country, income-wise, and have a few *ahem* other resources. But all the same, the numbers I gave for example of unsevured debt are hardly outrageous.
And remember - $5000 and 13% were cited as AVERAGES! Roughly half would be worse than THAT.
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It must be nice to have thousands of dollars just lying around. I guess you're expecting social security to fund your retirement? Cause I'm sure as hell not!
In my opinion, no health care system that even allows the possibility of someone going bankrupt in order to pay for medical bills is acceptable. So whether it's 45% or not, is imaterial. If it's ONE PERSON, then the system has failed. No one's personal wealth or lack there of should stand between their life being saved or not. Period.
What's more, why do I get the feeling that if it was 99%, that your postion would not also change: You'd still turn your nose up at idea of the gov't doing ANYTHING, and still fall bock opn accusing the data of skewed. (Despite having no data of your own to offer.)
IOW: the 45% figure being accurate or not will not change either of our positions. The only difference is that I want to save LIVES (and my position can and will) and you want to save MONEY (which your position claims to, but actually won't, and hasn't.)
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And why is it that just about every lib/con disagreement seems to split along these lines?
How's that exactly?
How did NiceguyEddie change the subject of the debate?
By confronting your obvious uncaring inhuman nature toward your fellow citizens??
Your point (if you can call it that) is a lame attempt at defending a system that allows for even one person going bankrupt or potentially losing everything for being unlucky in DNA or who happen to live near an uncaring multi-national corporate owned factory that dumps toxic garbage in the nearby drinking water or what not... and you call it 'changing the debate'
Good for you in defending uncaring man-made corporate scum and berating actual real people who lose everything if they get sick!
Study after study going back decades has found the costs of medical care to be closely related to a large percentage of bankruptcies, a percentage that has be growing over time.
Do you have any scholarly research to contradict those findings? Or are your contributions confined to petty carping?
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We let our judgement of the evidence drive our agenda. They let their agends drive the judgement of the evidence.
I still stick to the notion that it's humorous for Malkin to poo poo the findings in a comprehensive study with her, angry and poor attempt to debunk science.
A straw-man by any other name would fall just as effortlessly.
Randy
As long as it serves their agenda, dig the grave.
They infer that is the reason they died. They did exactly what FOX news does, that all you complain about. Use a half-truth and spin into some sort semi-believable story they can fool people with.
You people claim that you're all too smart for that and are such independant thinkers.
Doesn't look that way
Because it comes from Harvard, It's beyond reproach?
Correct me if I'm wrong, but hasn't the mantra from the left always been "Question authority"?
Please tell us how many bodies are required before conservatives will care enough to back the will of the people who overwhelmingly want reform, and a public option, too.
Randy
Factcheck.org says that there are "scores" of other studies that back this study's conclusions. Do you know how many a 'score' is? They say that there's nearly 100 studies, so it's undeniable that virtually every peer-reviewed study has shown this same trend.
So, again, how come you are so undereducated on this topic to not be aware of the Factcheck take on this topic? And how come someone as undereducated as you is trying to educate us on this topic? You could have checked Politifact.com too.
Here's some testimony given to Congress.
Uninsured Americans frequently delay or forgo doctors’ visits, prescription medications, and other effective treatments, even when they have serious disease or life-threatening conditions. … Because uninsured adults seek health care less often than insured adults, they are often unaware of health problems such as high blood pressure, high cholesterol, or early-stage cancer. Uninsured adults are also much less likely to receive vaccinations, cancer screening services such as mammography and colonoscopy, and other effective preventive services.
Hmmm, I don't know, I might have to think about how casting aspersions on her character for no good reason might be a smear....give me a minute or two, okay?
What a tool.
If you actually read my original post, I never said she used skewed data for THIS study, nor did I say that PNPH had anything to do with THIS study. I was just pointing out that her prior work and associations prove that she has an agenda.
If you don't believe that, you're not being realistic.
There are close to 100 other studies that came to the same conclusions that many thousands of people die because they are uninsured.
Your claim that she must have an agenda that affected this work product is bogus, and is a smear of her without justification.
http://www.politifact.com/truth-o-meter/statements/2009/jun/11/chris-dodd/medical-bankruptcy-study-not-clear-cut/
That puts the rate at about 28%, not 62%
Factcheck.org is not exactly non-biased. I would say it has a little left-lean to it. After all they are funded by the Annenberg foundation which Obama served on the board of along with Bill Ayers. Not exactly middle-of-the road figures.
I am also not disputing that these things happen. I am just saying they are exagerrated, which is the same thing you seem to have a problem with from Fox News. Just pointing out the hypocrisy.
You should really be careful when you call someone else uneducated. You end up looking stupid yourself. But I know it's hard for you on the left to be civil when you're wrong about something.
Have a nice day
The 28% figure is for those bankruptcies that are entirely attributable to medical expenses. The 62% number is for those where medical expenses are a large contributing factor. Factcheck simply corrected those couple of people who blamed medical expenses for the entire amount.
The Harvard studies are extremely careful to make those differentiations. You've produced nothing to cast doubt on it.
The Annenbergs have been long-time contributors to republican candidates and conservative causes.
fantagor asked you a question which you have so far refused to answer...
Here is the question I'm talking about...
"Please tell us how many bodies are required before (you) conservatives will care enough to back the will of the people who overwhelmingly want reform, and a public option, too."
Stop defending uncaring profit driven corporate whores... unless you are one of them yourself??
Do they really think that making people afraid of the heath care change is helping the debate? Something tells me that they would rather make people so afraid of it that they don't want to debate it so that they'll win.
Ended up going bankrupt with over 30K in medical expenses (from when I supposedly still had 'great' company paid insurance) in October of that year. Started my own company which did great (until the Bush Depression) and now have (after a 2 year waiting period) a million dollar lifetime benefit with a $5K deductible for $901 per month (plus another $385 for my wife). Of course, they won't pay for any chemo which I've been prescribed, so I'm supposed to pay $800 per month out of pocket (which I can't afford so haven't had it since '05 when COBRA ran out), nor the non-generic drugs I take (because the generic is NOT the same thing and doesn't work near as well).
Tell me how a government run health care plan like Medicare is worse than the corporate accountant run health care plan I have now.
As an aside, I'm a vet. Can't get into the VA because I make too much money (thanks again, Bush)... it's not like they promised me anything when I raised my hand and swore to go kill farmers in rice paddies, right?
What the hells wrong with this country? Especially the so-called conservatives. I have mine and screw everyone else seems to be the Republican mantra... which is why I'm no longer a Republican.
They've run the country into the ground and are peacock proud of it, strutting their stuff. They even hope to make it worse so their past screw ups don't look so bad and we'll vote for them next time. I don't think so.
To correct the Bushism, 'Fool me once, shame on you. Fool me twice, shame on me'. I will not be fooled again by Republicans representing the right wing extremist wacko 20% of the population. You people are toast... I guess we'll have to wait until 2010 to show you how wrong you are. Enjoy the next year damaging America even more than you already have, you'll be as extinct as the dodo bird after that.