Health Insurance and Life Expectancy

Did you know that Hispanic Americans live longer than non-Hispanic whites? If that doesn’t knock your socks off, consider this: American Hispanics are three times as likely to be uninsured as non-Hispanic whites.

If you’re still not blown away, maybe you haven’t been following the twists and turns of the health policy debate. As I wrote at my blog the other day, the Centers for Disease Control (CDC) discovery that Hispanics (one-third of whom are uninsured) have a life expectancy that is 2 1/2 years longer than whites (90% of whom have health insurance) makes mincemeat out of the oft-repeated idea that the uninsured get less health care and die earlier than everyone else.

In support of the conventional wisdom, for example, the Physicians for a National Health Care Program (PNHCP) went so far as to claim that a whopping 45,000 people die every year because they are uninsured. That figure, repeated as though it were unquestioned fact by President Obama and most of the health care media, is almost as large as the number of American soldiers killed in the entire Vietnam War!

Families USA went so far as to make the astounding claim that 6 people die every day in Florida because they are uninsured. Eight die every day in California; and 25 die in New York. In Texas, the report implies that more people die every two months from lack of health insurance than the number killed at the battle of the Alamo (counting only losses on our side, that is). Nationwide, says the PNHCP, an uninsured person dies every 12 minutes.

With all this carnage, you might wonder whether there are any uninsured people left alive.

All of this nonsense is critiqued here. But don’t get me wrong. One of the joys of health economics is that you just don’t get this kind of entertainment in other economic fields. For sheer comedic amusement, health economics is sui generis.

The latest government report also completely blows out of the water a whole slew of international comparisons that cause a lot of commentators to froth at the mouth. Take the 1,000 or so U.S.-health-care-system-bashing studies, essays and opinion pieces (or is it 10,000? I can’t remember) that claim we’re getting short-changed because we spend more and die earlier. Turns out, these comparisons were mainly focused on insured people. Had they looked instead at the U.S. ethnic group most likely to be uninsured they would have had to eat their words. American Hispanics probably spend less on health care than people in other developed countries and they live longer!

As the table below shows, American Hispanics outlive Canadians and the British, to say nothing of Germans, the Irish, the Finns and the Belgians. Overall, Hispanics in the United States live a year and a half longer than the OECD average life expectancy. (All numbers are from 2006, to conform to the CDC study.)

Life-exp Sources: OECD Health Data 2008 and CDC.

It is not known why so many Hispanics are uninsured, but the phenomenon is not explained by lower incomes. Census Bureau statistics show that at every level of income, Hispanics are two to three times as likely to be uninsured as the population as a whole, and the higher the income level, the greater the discrepancy.

Now if we did research at the NCPA the way Families USA does research, we would be claiming that lack of insurance actually makes people live longer! I can see the press release now…..”90,000 People Alive Today because They Didn’t Insure, Says Study”….. An estimated million, billion, trillion extra life years, all because of….. 12 extra people walk the streets of Florida every day….. That’s XXX people who didn’t die every minute…..YYY every second…..ZZZ every nanosecond…..

John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis.  He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system. Dr. Goodman’s Health Policy Blog is considered among the top conservative health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.

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22 replies »

  1. Breaking down those Canadian statistics even further, the average life expectancy for women is 83 years and for men, 78 years.

  2. Being a Canadian, it’s interesting to see that Canadians have a life expectancy of 80.4 years. While Canada has a government health plan in place, many people have a supplemental health insurance plan to fill in the gaps where the government health plan falls short.

  3. I love this analysis. My wife and I will drop Medicare B and our supplemental plan saving us $550/month. (Should I drop dental too at $40/month?) Then we’ll become Hispanic and increase our life expectancy by 3 years. Why didn’t I think of that? Thanks Doc John.

    ” .. Actually Frank, I went to Canada for cataract surgery at 1/3 the cost ..”
    Yup. With research funded by U.S. TAXPAYERS.
    What will Canada and the world do, now that OWE-BAMA has CRIPPLED USA research?
    Die earlier.
    Great job, MESS-iah. You Harvard Law Commie-dupe loser.

  5. All you ever need to know is that every single empirical fact and statistical inference he discovers supports John Goodman’s policy positions. Get that? He will never make a conclusion based on research that contradicts his political commitments. That’s why people create such their very own think tanks with such august names as the National Center For Policy Analysis.

  6. Based on this, I expect John to announce that he and his family have given up all health insurance.

  7. I would argue the data actually shows multicollinearity, where several relevant variables are highly correlated with insurance status but largely unaffected by insurance status. This could include rates of smoking, obesity, low income, poor education, etc. These are all correlated with shorter longevity, poorer health and correlated with lack of insurance. Yet in the Families USA and PNHP 2-variable model, the result is misinterpreted as lack of insurance kills people.
    Arguing that Hispanic longevity is an example of migration of the fittest doesn’t explain why Spaniards also live longer than many other European countries (some of which probably have better health care systems).

  8. John,
    This article reflects the worst form of sophistry, and it should be, but apparently isn’t, beneath you. It should also be beneath THCB.
    As TW points out, this kind of analysis employs highly selective use of data, and completely ignores other important data, such as other Hispanic-specific factors that might account for their success, despite access to good care.
    Putting aside the hyperbole that is inevitably associated with any controversial topic, one would hope that someone of your stature would take the high road and address these issues reasonably. There is certainly a wealth of credible data showing that lack of access to coverage and primary care results in poorer quality care and outcomes. To spend time trying to refute that harsh truth with diatribes like the one above points very clearly to why you shouldn’t be taken seriously within the larger marketplace of health care ideas.

  9. Junk science used to attack supposed junk science. I especially like linking to your own post critiquing somthing as if it was a link to some other credible source of critical analysis. After threatening to do so, but failing so far, I will no longer waste my time reading anything this “expert” has to say.

  10. Actually Frank, I went to Canada for cataract surgery at 1/3 the cost. I see just fine.

  11. FIDEL
    ” .. Hey John, seems most citizens with government run/controlled/single-pay live longer than U.S. citizens. What are we to draw from that – it works at lower cost?”
    Don’t like the USA? Try the “worker’s paradise” managed by OWEbama’s pal Fidel. Most people need to be told what to do — just join them.
    Just don’t get too sick. Only Fidel gets the good MDs.

  12. Wow, this is embarrassing analysis. TW hits some good points, but I’d just reinforce that not being insured could only be one factor in longevity. The claim that being uninsured leads to a shorter life span means that other things being equal, if you are uninsured on average you can expect a somewhat shortened life. The data never supported anything else, and anyone with a modicum of sophistication in interpreting statistical data understood that. Diet, behavior, stress, social connections, genes, environmental harms and other factors play a role.
    So, are “other things equal” when looking at hispanics and whites in the US? Obviously not. Two clear differences are that hispanics in the US are more physically active (more manual or quasi-manual labor) and have a better diet (though the longer they live here the more their diet resembles non-hispanics). A commenter above says that hispanics have less stress (due to strong extended family relationships and support?). Finally, I don’t know if this study controlled for the phenomenon of sick immigrants returning to their home country where they can get cheaper health care. If that happens, this could skew the data quite a lot.
    So, does the CDC data disprove the claim that 45,000 die every year from lack of insurance? Not at all! It could be simultaneously true that with universal coverage 45,000 lives would be saved, and that if everyone lived more like hispanics 90,000 lives a year would be saved. And if you did both? Well, America might even beat Japan in longevity.

  13. Friends, hopefully this will crystallize as the disease has increased, I read an article indicating that it is necessary to temporarily checked for the disease and thus counteract it.
    Josue Parker

  14. Hey John, seems most citizens with government run/controlled/single-pay live longer than U.S. citizens. What are we to draw from that – it works at lower cost?

  15. For the record, the argument that Families USA has been making isn’t refuted by any of this: evidence that things other than health insurance affect mortality doesn’t in any way weaken the argument that having health insurance by itself affects mortality.
    Based on your posts here, of which this one’s a good example, I think you shouldn’t be so sanctimonious about how Families USA uses data. I largely agree with most of their policy positions, yet i’ll readily concede that as advocates they can be guilty of using data selectively & over-interpreting findings that happen to support their policy preferences. But you’re doing the exact same thing here, and do so regularly on this blog. Actually what you’re doing here is worse: you criticize Families USA for over-interpreting research on the insurance-mortality link, in the same post where you’re fundamentally misrepresenting both that research and this new research on the ethnicity-mortality link. You’re free to speak your mind, but you should be among the last of the regular posters on THCB to be lecturing anyone about argumentative misuse of data.

  16. If you read the report, it says a couple things worth noting:
    (1) The authors say that the mortality advantage observed for Hispanics holds up when you adjust for socioeconomic characteristics – they DON”T say that it disproves the relevance of those factors or that they don’t matter. It’s more accurate to say that Hispanic mortality appears lower DESPITE the relative levels of disadvantage (including lack of health insurance) among Hispanics, due to factors that the CDC can’t account for.
    (2) One of those factors they can’t account for is what they call the “migration effect” which basically means that the population of Hispanics for whom they have data on health insurance status may be quite dissimilar from those for whom they have mortality data (e.g. Hispanic immigrants may be more likely to have no health insurance, and also more likely to return to their home country before they die). They say there’s no definitive evidence of that, although to me it seems plausible – one reason to regard the findings of this study with some caution until more research is done. As they say repeatedly in the article, it’s only recently become possible to do analyses like this due to improvements in the collection & coding of ethnicity data, so this whole topic is just beginning to get really rigorous study.

  17. living longer is a matter of having a good lifestyle.socializing with friends and as much as possible staying in the positive outlook in life. and watching what you eat.insured people worry too much about their health and how long they would live. causing them stress which is a sign of early aging.

  18. Happiness is believed to be traversable; this is true to some extent. When a person is happy he has the ability to make others happy too and a person is usually happy when he enjoys good health and has all the required materialistic facilities and company. Well in this article we are going to focus on health of a man which keeps him going and contended. This can make a difference in the environment and create a positive ambience. In order to enjoy such good health and environment there are certain factors explained below.
    Good habits in an individual can help that person to be contended due to his good deeds. If an adult follows good practices it serves as an inspirational factor to younger members who often notice such deeds. Good habits in terms of health, profession, education and social life can help in attaining good status and contended life. It is habits that determine an individual’s character or personality. It is also a matter of fact that habit persists for a long time and it is difficult to ebb them away; hence it is essential to observe good habits which may be beneficial in all aspects.
    Eating Habits:
    A fine eating habit is a healthy manner to live contended life. Good nutritional eatables have less or no alternative. It results in good health conditions, longer life span as well as it teaches the younger generation about good nutritional values too. Some basic values such as keeping the hands hygienic before eating your meal, drinking sufficient water and consuming correct foods are good manners to keep yourself fit and healthy. As an adult it is your duty to make a good environment; hence, fine eating habits is a better lifestyle habit.

  19. This is not news to Americans of Hispanic descent, the reality is that Hispanics have less “Stress”.
    Thank you,
    Rudy Lehder Rivas, President
    Hispanic Insure.com

  20. Or,alternatively…If Hispanic Americans had a lower uninsurance rate, the difference between their life expectancy and that of White Non-Hispanics would be even greater.

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