Mortality is a very bad way to measure the performance of a health insurance system.

One reason is that people die from violence and genetic factors and bad habits, which no health insurance system can cure.

Yes, there are poor women who lose a child due to a lack of pre-natal care.
But I do not think this a large statistic in America, or has been since 1960 or was ever a big statistic outside the rural south.

Using mortality as a measure of health insurance has another problem —
we spend many billions in the USA extending the lives of cancer sutterers and dialysis patients, even when they are over 85 to begin with.

Does this make our health insurance system the best in the world? It is not that simple.

Finally I go back to the American Indian reservation culture. They have had a national health service for 100 years, and the death rates are the worst in America. This is tragic for all, and is partly due to discrimination by white society. But health insurance has NOT cured the situation.

Well I haven’t read the study, so maybe it should have stated that being poor brings you closer to death.

Needing a study to understand if everyone needs equitable healthcare or trying to find flaws in a study advocating we all need healthcare seems genuinely American, and, if I might say, “Romneyesk”.

I’ll leave you PHDs to argue the finer points of Studies 101.

I am in no way suggesting that being uninsured has no consequences (and my recent Health Affairs study documents how falling seriously ill while being uninsured has catastrophic consequences for one’s savings). I am merely pointing out that academics should take research methods seriously. There is no excuse in academia for sloppy econometrics even in pursuit of a worthy policy goal.

If you will humor me and promise not to cuss again, I will offer a statistics primer. The authors show there is a correlation between mortality and insurance status and assume they know the direction and magnitude of causality. But there are many reasons besides the lack of access to the healthcare system that could create a correlation between insurance status and mortality. Insurance status could be correlated with (but causal to) living conditions, diet, stress, self-assessed health status, and so forth. Some of these factors increase mortality; others may decrease it. If correlated factors are unobservable to researchers (as seems likely), then regression will suffer from omitted variable bias of unknown direction and magnitude. These issues are covered in any basic econometrics textbook.

“The study purporting to show that being uninsured causes premature death has methodological shortcomings. The authors fail to sort out causality”

I don’t know David, do uninsured people get hit by cars more than the insured.

Exactly how do people die if not by accident, would it be by disease? If you have good access to good care (eliminating poor nutrition and dangerous neighborhood) wouldn’t that prolong your life, unless of course, a frigging tree fell on you?

It is not unusual for social science studies to be published in medical journals. They should be treated with the same caution as one would treat medical studies published in social science journals. Of course, social scientists understand their limitations enough to know not to attempt to become medical researchers. If only certain doctors also understand their own limitations as social science researchers. As to how the paper was published by AJPH, one would have to ask the editors what they were thinking. Rest assured, not every published paper stands up over time.

The PPACA law, when you pull out the details, has many clauses which if enforced will require the stingy players to be more generous.

This is not an intrinsically bad thing to do. We forced Southern states to be at least somewhat decent to black voters from the 1940 to 1970 and it didn’t kill them.

No, the test of forced generosity will be whether it works.

Medicaid is about as cumbersome a program as you can get. The feds want to set more uniform standards, but states pay for (on average) 40% of the cost with their own income taxes, and the voters in that state can and do refuse to pay taxes. The reason that Medicaid is “fiinancially broken” is that it is fiscally inconsistent to begin with.

I have no great sympathy with Southern conservatives, but put yourself in Bobby Jindal’s shoes.

Federal initiatives about ease of enrollment could bring an extra 500,000 persons into Medicaid even under the old eligibility limits. At a modest cost of $2500 per enrollee, that comes to an extra $1.25 billion. If the feds pay 40%, then Bobby must raise taxes by $750 million, or else start cutting back money for schools and roads.

Something is deeply wrong with this picture, Let’s get busy federalizing Medicaid, and using the federal income tax to fund it.

http://dyn.realclearpolitics.com/printpage/?url=http://www.realclearpolitics.com/articles/2012/10/30/obamas_discrediting_victory_115971.html

I have absolutely no respect for hypocrisy and pettiness that ALL the Democrats showed in this legislative assault on America. Reading the garbage from many readers who just echo falsehoods and partisan platitudes at this site for the past two plus years, well, I hope the voters as a majority help you choke on it, and again, NOT expecting Romney to fix the matter, but it will be fun for me to see some incumbents possibly lose their fixtures, and post polling commentary show them that voters, at least in this country for now, still rule government. Oh, and that goes for Republican lame-o’s too!

Hope and change, what a farce that campaign turned out to be! This guy in the White House is beginning to make Nixon look like he had a heart!

Wow, what a choice, in the end it is not about freedom, independence,and choice, but what will amount to brutal survival conditions, and isn’t it ironic, as well as cruel, that nature is giving us a preview now in the East.

Frankly, we are stuck with a one party system of Republocrats, and as long as entrenched incumbents keep their seats, it is irrelevant who occupies the White House for the next 4 to 8 years max.

And how does this relate to health care? Because Romney set the pace with his state program that Obama has basically emulated, but in the end, politicians want to control choice, access, and in the end, who has the right to live or die. Think politics won’t intrude into individual care? Yeah, anyone who answers “No” is as partisan as one could possible be!

It is a shame there is no moderate site to discuss this issue. While THCB gives the illusion it is being balanced with partisan commentary from both ends of the group, it is obvious this site is wedded to PPACA surviving.