Putting the health back in health care reform

By Emily Hutto


Is it life-threatening to not have health insurance?

Starting in 2014, PPACA will mandate that Americans own health insurance plans; otherwise, they’ll have to pay penalties. Most of the literature about health care reform is politically charged, so I was thrilled to see an article on Psychology Today’s blog in which Author and Ph.D. John C. Goodman discusses health care in relationship to health. Go figure.

Goodman presents information suggesting that health insurance doesn’t exactly affect your health.

He begins by citing claims by the Institute of Medicine and the Physicians for a National Health Program that thousands of people die each year because they don’t have insurance, and then he says that his research proves these claims inaccurate. Here are some of his talking points:
  • A 2008 study by scholars Helen Levy and David Meltzer found that past studies that attempt to find a causal link between health insurance and health status were poorly designed.

  • In a 2009 study, Clinton adviser Richard Kronick found that insurance had virtually no effect on mortality rates.

  • A RAND Corporation study found that there is no difference in the level of care that insured and uninsured individuals receive from doctors. Goodman says, “The doctors and nurses who treat these patients are paid the same, regardless of patients’ enrollment in an insurance plan. Therefore, they tend to be indifferent about who is insured by whom, or if they’re even insured at all.”

  • That same RAND study also found very little difference in care between the types of health coverage, such as Medicaid and fees-for-services.
“The implication,” Goodman concludes, “is that reforming the supply side of the medical marketplace is far more important than getting everyone on the demand side insured.”

What do you think? Do people need health insurance to get good health care?