...........There has been some criticism of this type of research and its ability to find a direct causal link. A 2003 commentary by Richard Kronick in Medical Care Research and Review questioned whether other factors beyond uninsurance would reduce the greater mortality for the uninsured. Kronick recreated the Franks study using more recent data and, after adjusting for various factors, also found a 25 percent greater risk of death for the uninsured. But he said: "It seems likely that if we were able to control for additional factors, such as health-related behaviors (smoking, alcohol consumption, obesity, and risk-taking behaviors more generally), wealth, or value placed on health or health care, the estimated effect of being uninsured would be reduced further. What is uncertain is whether the reduction would bring the estimated hazard ratio all the way down to 1.0 or whether an independent effect of being uninsured would remain." (Other studies, including the Franks study, did adjust for smoking, alcohol consumption, obesity and income.)
Another recent report, written by former Congressional Budget Office Director June O’Neill and her husband, economist Dave O’Neill, said "that lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured — particularly the involuntarily uninsured — have multiple disadvantages that in themselves are associated with poor health." Those disadvantages include education level and income. The O’Neills’ study, published by the conservative Employment Policies Institute, separated those it deemed "voluntarily uninsured" (anyone earning 2.5 times the poverty level) from those considered to be "involuntarily uninsured." The study looked at data on persons aged 51 to 61 from the Health and Retirement Survey and determined the "involuntarily uninsured" had an 11 percent higher probability of dying; the number dropped to 3 percent when controlling for smoking as well as education and income. The “voluntarily uninsured” had a 2 percent to 3 percent greater probability of dying. EPI, the publisher of the study, supports business interests and has said that the “living wage campaign” is “an organized effort to force employees to inject a welfare mentality into the workplace.”
It’s important to remember that all of these studies give estimates based on modeling and data with limits. As the Urban Institute wrote: "At the most basic level, the above estimates are not precise ‘body counts.’ Rather, the reader should view them as reasonable indicators of the general magnitude of excess mortality that results from
uninsurance."...............
http://factcheck.org/2009/09/dying-from-lack-of-insurance/
Another recent report, written by former Congressional Budget Office Director June O’Neill and her husband, economist Dave O’Neill, said "that lack of health insurance is not likely to be the major factor causing higher mortality rates among the uninsured. The uninsured — particularly the involuntarily uninsured — have multiple disadvantages that in themselves are associated with poor health." Those disadvantages include education level and income. The O’Neills’ study, published by the conservative Employment Policies Institute, separated those it deemed "voluntarily uninsured" (anyone earning 2.5 times the poverty level) from those considered to be "involuntarily uninsured." The study looked at data on persons aged 51 to 61 from the Health and Retirement Survey and determined the "involuntarily uninsured" had an 11 percent higher probability of dying; the number dropped to 3 percent when controlling for smoking as well as education and income. The “voluntarily uninsured” had a 2 percent to 3 percent greater probability of dying. EPI, the publisher of the study, supports business interests and has said that the “living wage campaign” is “an organized effort to force employees to inject a welfare mentality into the workplace.”
It’s important to remember that all of these studies give estimates based on modeling and data with limits. As the Urban Institute wrote: "At the most basic level, the above estimates are not precise ‘body counts.’ Rather, the reader should view them as reasonable indicators of the general magnitude of excess mortality that results from
uninsurance."...............
http://factcheck.org/2009/09/dying-from-lack-of-insurance/