Ezra Klein takes a stand against the new party of death and its bosom pal, Joe Lieberman:
[T]he defeat of health-care reform will cost hundreds of thousands of lives. That’s not a particularly controversial statement. It relies on data from the Institute of Medicine and the Urban Institute, both of which are credible sources …
This is, I believe, the sound of desperation. Health-care reform does not live or die with the particular legislative monstrosity currently under consideration in the Senate. Are there not alternative reforms that would save even more lives? I’m sure Ezra agrees there are. So if the Senate Democrats’ suboptimal proposal is made law, shall we therefore lay the foregone QALYs at the feet of its advocates? Surely decency demands it! I do hope the Senate bill fails, if only to save Ezra from the shame of dirty hands.
I kid. Anyway, it’s hard to believe that this is “not a particularly controversial statement.” I see that my colleague Michael Cannon has compiled a list of studies that controvert it.
For example, a careful study by health economists Amy Finkelstein and Robin McKnight found that in its first 10 years, Medicare had no discernible impact on elderly mortality rates. The authors hypothesize that prior to Medicare, seniors who lacked coverage largely got the care that they needed either by paying out of pocket or relying on public or private charity. Whether Medicare had any impact on elderly mortality after its first 10 years remains an open question.
Or consider a study by Richard Kronick, a professor of family and preventive medicine at U.C.-San Diego and a former health policy adviser to the Clinton administration. Kronick performed the largest-ever study on the health effects of being uninsured and concludes that the IOM estimate “is almost certainly incorrect.” Kronick concludes that “the best available evidence” suggests “there would not be much change in the number of deaths in the United States as a result of universal coverage.”
How can that be, when Ezra Klein finds his own argument so “intuitive“? Kronick admits “it is not clear” why the data produce such a counterintuitive result, but posits that existing channels “may provide ‘good enough’ access to care for the uninsured to keep their mortality rate similar to that of the insured.”
Economists Helen Levy of the University of Michigan and David Meltzer of the University of Chicago surveyed the entire economics literature on the connection between health insurance and health. They conclude, “The central question of how health insurance affects health, for whom it matters, and how much, remains largely unanswered at the level of detail needed to inform policy decisions.”
So there’s that.
Yglesias is flipping out, too.
[Added: Yglesias replies to Cannon. Cannon replies right back. Not particularly controversial, you see. Enjoy.]