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The Uninsured Are Sicker And Die Sooner

Health care coverage should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient centered, and equitable.

Health insurance is the key to obtaining needed health care services, and those who lack insurance are less likely to get timely and appropriate care than their insured counterparts. Evidence from the scientific literature overwhelmingly shows that those without insurance, children as well as adults, suffer worse health and die sooner than those who have coverage.

Insurance is more important than ever, given the array of effective new medical interventions, technologies, and pharmaceuticals. Without insurance, people have less access to state-of-the-art services and drugs which often improve health and longevity.

Thus the gap between insured and uninsured persons widens, raising questions of justice and equity. The uninsured use less health care.

On average, uninsured persons use one-half to two-thirds the number and value of services compared with their privately insured counterparts and are more likely to use no health services at all.

In the last year, 43 percent of working-age adults without health insurance reported that they did not seek a physician’s care when they had a medical problem, compared to 10 percent of those who had coverage all year. Lack of health insurance undermines health on multiple levels.

Uninsured people are more likely to receive too little medical care and receive it too late; as a result, they are sicker and die sooner.

Uninsured adults have a 25 percent greater mortality risk than adults with coverage. About 18,000 excess deaths among people younger than 65 are attributed to lack of coverage every year. This mortality figure is similar to the 17,500 deaths from diabetes and 19,000 deaths from stroke within the same age group in 2001.

Uninsured women with breast cancer have a risk of dying that is between 30 percent and 50 percent higher than for insured women.

Uninsured car crash victims were found to receive less care in the hospital and had a 37 percent higher mortality rate than privately insured patients.

Uninsured individuals with diabetes, cardiovascular disease, end-stage renal disease, HIV infection, and mental illness have consistently less access to preventive care and have worse clinical outcomes than do insured patients.

Drawn from: Coverage Matters, 2001; Care Without Coverage, 2002; Health Insurance Is a Family Matter, 2002; Hidden Costs, Value Lost, 2003; Insuring America’s Health, 2004; Institute of Medicine, Washington, D.C.: National Academies Press.
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