The Relationship of Health Insurance and Mortality
Authors: Steffie Woolhandler, David U. Himmelstein
Journal: Annals of Internal Medicine (2018)

Letters17 April 2018The Relationship of Health Insurance and MortalitySteffie Woolhandler, MD, MPH and David U. Himmelstein, MDSteffie Woolhandler, MD, MPHThe City University of New York School of Urban Public Health at Hunter College, New York, New York (S.W., D.U.H.) and David U. Himmelstein, MDThe City University of New York School of Urban Public Health at Hunter College, New York, New York (S.W., D.U.H.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0704 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Some health care reforms cost more than expected, others less. Dr. Grey cites the early underestimation of Medicare's costs but omits cases where costs were overestimated. The Congressional Budget Office initially projected that the Patient Protection and Affordable Care Act's provisions to expand coverage would cost $187 billion in 2017 (1); its latest estimate is $66 billion less (2). Medicare's drug benefit has similarly cost 35% less than predicted (3).Experience in nations with national health insurance also indicates that universal, comprehensive coverage need not break the bank. All spend far less than we do yet avoid the ...References1. Elmendorf DW. Letter to Nancy Pelosi. 20 March 2010. Accessed at www.cbo.gov/sites/default/files/111th-congress-2009-2010/costestimate/amendreconprop.pdf on 29 October 2017. Google Scholar2. Congressional Budget Office. Federal subsidies under the Affordable Care Act for health insurance coverage related to the expansion of Medicaid and nongroup health insurance: tables from CBO's January 2017 baseline. 2017. Accessed at www.cbo.gov/sites/default/files/recurringdata/51298-2017-01-healthinsurance.pdf on 29 October 2017. Google Scholar3. Elmendorf D. The Accuracy of CBO's budget projections. 25 March 2013. Accessed at www.cbo.gov/publication/44017 on 29 October 2017. Google Scholar4. Osborn R, Squires D, Doty MM, Sarnak DO, Schneider EC. In new survey of eleven countries, US adults still struggle with access to and affordability of health care. Health Aff (Millwood). 2016;35:2327-36. [PMID: 27856648] CrossrefMedlineGoogle Scholar5. The Commonwealth Fund. 2015 international survey of primary care doctors TOPLINE. 20 November 2015. Accessed at www.commonwealthfund.org/~/media/files/surveys/2015/2015-ihp-survey_topline_11-20-15.pdf on 29 October 2017 Google Scholar Author, Article, and Disclosure InformationAffiliations: The City University of New York School of Urban Public Health at Hunter College, New York, New York (S.W., D.U.H.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0704. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly? Steffie Woolhandler and David U. Himmelstein The Relationship of Health Insurance and Mortality Michael R. Grey Metrics 17 April 2018Volume 168, Issue 8Page: 605KeywordsComplex systemsDisclosureDrug pricesDrugsHealth careHealth insuranceHealth surveysMedicarePatient Protection and Affordable Care ActPrimary care physicians ePublished: 17 April 2018 Issue Published: 17 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...