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Ear to the Ground

Uninsured Twice as Likely to Die in ER

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Posted on Nov 16, 2009
Flickr / Rosser321

A new Harvard study has uncovered another disturbing reality of America’s broken health care system: Trauma patients without insurance are almost twice as likely to die in the emergency room. Researchers were unable to determine why, but hospitals’ eagerness to transfer the uninsured could be to blame.  —PZS

AP via MSNBC:

Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.

The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.

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By caravan insurance, November 9, 2011 at 8:53 pm Link to this comment

As much as we want to believe that doctors strive to save lives equally, the truth is that medicine has become a profit maximising business. Less doctors would want to take the risk of operating on a patient without insurance. This might also be a reminder that we should get adequate insurance to protect ourselves.

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By gordonmcinnes, July 27, 2011 at 7:31 pm Link to this comment

Usually ER doctors will only patch up an accident patient to stop the bleeding until insurance or an initial payment of sort is ascertained and/ or settled before the begin the major surgeries. Sad but true.

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By Certified Nursing Assistant, June 5, 2011 at 11:41 pm Link to this comment

I have read some terrible cases associated with our health system. It makes sense that those insured will be treated promptly, but to think that people die due to not being treated is sad and unnecessary.

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By Professional Indemnity Insurance, May 3, 2011 at 2:16 am Link to this comment

That is no surprise. This happens all over the world too. They leave you at the ward until they decide to take you in. It is sad that health care providers are also selling themselves out for the greed of money.

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By KDelphi, November 23, 2009 at 6:05 pm Link to this comment

Dave—What you posted gives me a right to make judgements about what you said.

I am sorry you are sick, but you dont care if anyone else has health care…why didnt you work harder before you got sick and save up, so you wouldnt lose you house?(thats pretty much what you would say to others, as described in your post) Because you were surprised by disease that (I assume) you couldnt control.

People like you puzzle me all the more. If someone has lived a charmed life, maybe they just dont know. But you do.
Sorry if it is hard to empathize with people who cannot generalize their own pain to others.

I worked many years with people whom you called “unsavory”—many are still close friends, some are doing alot better, but some never will.

I resent is and have a right to. If you dont care if others die, I dont care if you do.
So, whats up?

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By DaveZx3, November 22, 2009 at 12:34 am Link to this comment

KDelphi, November 21 at 4:02 pm

“how ignorant of real life you are”
“I hope you get hit by a bus”
“What an asshole you are…you assume so much”
“People like you live in ivory towers”
“Because you are comfortabel who gives a f*ck, right? Psycho boy”.


Thanks for all the kind words.

I did not know that you had the monopoly on understanding real life. 

I lost my right lung to cancer in November, 2006.  I lost my job due to layoffs in January, 2009.  I lost my BC/BS because I could not afford Cobra about 5 months ago.  If things don’t shape up soon, I will probably lose my house.

Just because I write a few paragraphs of opinion does not give you the right to make sweeping judgements about everything in my life.

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By KDelphi, November 21, 2009 at 12:02 pm Link to this comment

Davezx3 says—“I will admit the unfortunate discrimination against people who present themselves in a condition of being unclean, intoxicated or otherwise under the influence, or in some other “unsavory” condition.

If a doctor has two patients with equally life-threatening injuries, one a young girl hit by a car while walking to school, and the other a drugged-up and unwashed addict hit by a car while staggering in the street, would it be a mystery if he chose to work on the young girl first?”

And further:“I guess this is why we all try to become well educated and get good jobs and work hard so we can take care of the responsibilities of life.” 

What an asshole you are…you assume so much , which shows how ignorant of real life you are. I have an MS and worked my ass off—got hit by some rich, drunk driver..I had BC/BS—believe me, the treatment difference is huge. Thats the problem with US “capitalism” you can “play by the rules” (what, is everyone going to get a PhD now??—what is needed is more people educated in the Humanities not more smartasses who convince themselves that theyve gotten where they are by “hard work”) and lose—you cannot say that 45,000 of those people a year are “dirty, drug addicted”...and, if they are, it would never concern you to know why. Because you are comfortabel who gives a f*ck, right? Psycho boy.

You wife must work in a wealthy area—or she’s lying. Maybe they dont trust her with the information, because that is generally what they told me first—but almost all of my patients were on Medicaid.. I have been on medicaid for years now (if I go back to work part time, I lose it—there are millions in my position)and had to have a major surgery done at the much hailed Cleveland Clinic (because I was fortunate enough to have family members who could drive me up there and stay with me). The guy in the next room’s mother told me that he was on Medicaid, too, but, the dr had suggested she “wait until he was 21 and could qualify for medicare and get better care.”..real just.

People like you live in ivory towers and should confine yourselves to “working hard” (I’m sure that whatever you do, you think that you “work hard”) and ingdulging yourself and patting yourself on the back about what a great hard-working guy you are.

I worked with these “unsavory” people for many years. I would much rather be around them than people like you—but that is something you simply will never understand and its pathetic. They were treated like shit—now I am.I hope you get hit by a bus.

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By DaveZx3, November 21, 2009 at 3:20 am Link to this comment

The study is extremely unclear.  My wife works in an emergency room setting and says the caregivers are not briefed as to whether a patient has insurance, and what the quality of the insurance is. 

What causes the caregivers to respond differently?  Is it based on how well dressed the patient is, or how literate?  What is the basis for the difference in treatment?  This is all unclear.  Do they make the uninsured person sit in the waiting area with a sign around their neck, so the doctor will know? 

At a time when I had no health insurance, I had to go to the emergnency room because I accidently split my forhead open and was gushing blood.  I was treated exactly as I would have thought normal.  I did not detect any hesitation to do the required procedures given the circumstances.  I had a big bill to pay and I paid it off over time. 

On another occasion, I was insured, but could not find my card to prove it.  I was still given very good care.  There was no hesitation. 

I will admit the unfortunate discrimination against people who present themselves in a condition of being unclean, intoxicated or otherwise under the influence, or in some other “unsavory” condition.

If a doctor has two patients with equally life-threatening injuries, one a young girl hit by a car while walking to school, and the other a drugged-up and unwashed addict hit by a car while staggering in the street, would it be a mystery if he chose to work on the young girl first? 

It would be probable that the young girl was more likely to be insured than the drug addict, but the doctors decision had nothing to do with insurance.

Maybe big city emergency rooms handle everything differently, given the large numbers of cases they must handle.  Another reason I refuse to live in a big city. 

Matt does have a point that poverty does make one more susceptible to “accidents” because one does not have the resources to take care of the things which provide for a safe life.  Like maintaining the car, home heating system, and similar things.

I guess this is why we all try to become well educated and get good jobs and work hard so we can take care of the responsibilities of life. 

.

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By KDelphi, November 18, 2009 at 9:05 pm Link to this comment

Its triage…rationing, which we have in every facet of ‘merkin life. Poverty equals death, hence capitalism equals death.

Matt—poor people drive golf karts?? Not around here…the statistics do show more accidents among impoverished, but, so what? You think that that is fair? All other things being equal, such as the circumstances that they were born under, and , the type and quality of opportunities avaiable to them? Equal?? Dont think so. This is what the study showed, and it sure doesnt just look like correlation:
http://jnci.oxfordjournals.org/cgi/content/full/94/13/967

“..Uninsured adult patients are hospitalized less frequently than those who have some kind of health insurance. When uninsured patients do receive care in the hospital they have higher in-hospital mortality rates, receive fewer services, and are more likely to experience poor quality care than patients with insurance.

In short, health insurance and health outcomes are intimately linked. “If those adults who are not currently insured were covered on a continuous basis, their health could be expected to be better and their risk of dying prematurely would be reduced,” said Coleman. “But the benefits to health of insurance coverage can be achieved in full only when the health insurance is acquired well before the development of advanced disease. For example, the problem of later diagnosis and higher mortality among uninsured women with breast cancer cannot be solved by insurance that becomes available only when the diagnosis is made.”

Here are the stats , with all things (same injury, etc) “being equal”:
http://www.kaufmanlaw.net/news/new-study-shows-the-uninsured-are-more-likely-to-die-in-er20091117.cfm

“..The study analyzed medical data on 690,000 American emergency room patients seen between 2002 and 2006 at over 900 hospitals. They did not include burn patients, patients who were treated and then released, or patients dead on arrival.
 
The overall death rate was 4.7%. More than 95% of patients survive their injuries. Privately insured patients had a death rate of 3.3%. Uninsured patients had a death rate of 5.7%. This is before the rates were adjusted for other risk factors.
 
When researchers took into account factors such as the severity of the injury, and race, gender and age, the uninsured were still 80% more likely to die than those with insurance, even than low income patients covered by Medicaid.”

The study says that “Harvard scientists were surprised, assuming all traumatic care was ‘equal’” (!!!) Wtf thought that??!!

Stop copping out and just admit you dont give a rat’s ass—I could probably respect you a little more—but not much.

Horatio Alger moved to France. Stop blaming the victims.

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By Matt, November 17, 2009 at 6:02 pm Link to this comment
(Unregistered commenter)

People who get shot are much more likely to be low
income.  People who suffer severe injuries in a car
accident are much more likely to be driving an older
car, and therefore probably are low income.  People
who get severely injured trying to jump a golf kart
over a ravine are incredibly stupid, and likely low
income.

Low income people don’t have health insurance.

Ergo, all other things equal, people who don’t have
health insurance are more likely to suffer injuries
severe enough to make the emergency room wait end
abruptly.

Lets not assume that correlation implies causation;
It makes a good headline, but doesn’t really help
drive us towards the solution.

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By ChaoticGood, November 17, 2009 at 11:54 am Link to this comment

Oh noooo, Mr. Bill

Tell me how can the “Best healthcare system in the World” allow this to happen.

It is a lie put out by the eliteist leftist commie Obama-Loving, homosexual, acorn supporting media.

We have the best healthcare next to all the countries who are lower than us. We are “mericans” and we are proud of our humility.

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Blackspeare's avatar

By Blackspeare, November 17, 2009 at 10:14 am Link to this comment

montanawildhack….do I detect a bit of sarcasm?!

Just the other day new guidelines came out for prescribing mammograms.  From a statistical perspective this is very important because there is much data on breast cancer.  If one is good with statistics and mathematics then using the historical data for breast cancer, it’s cost, the screening costs, the frequency, lives saved, and number of deaths one could figure out the value of a single life used in such calculations——-anyone good with numbers out there?

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By montanawildhack, November 17, 2009 at 4:34 am Link to this comment

So this study surprizes people….why?????  You don’t expect the unwashed masses to get the same quality health care as government employees??..(politicians, teachers, cops, firemen, the military etc)  Hospitals are businesses and they need the green…. And, as for the doctors, the Hippopotamus oath is just so many words written by a dead Greek who didn’t have college loans, boat payments and mistresses…..

This is America baby!!!  All you uninsured pull yourselves up by your bootstraps and quit your whining!!!  Go read some Horatio Alger for Christ’s sake…  When he was caught buggering 2 little boys and couldn’t be a pastor anymore did he give up??? Hell no!!!  His American dream was to sodomize lots of small boys and so he split to New York and started a mission where he took in street boys and gave them the encouragement and advice they needed to succeed in America… Of course, he also sodomized them but, what the hell, this is America and we’re all sodomized to some degree….  The goal is to become the sodomizOR and not the sodomizEE…

So… be like Horatio Alger… Pull up your bootstraps, quit your whining, and go out there and f—k somebody up the a—!!!!  God bless you and God bless America!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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