Explaining Divergent Levels of Longevity in High-Income Countries by National Research Council of the National Academies

Author:National Research Council of the National Academies
Language: eng
Format: epub
Tags: Behavioral and Social Sciences : Population and Fertility Studies. Health and Medicine : Aging. Health and Medicine : Public Health and Prevention
Publisher: NATIONAL ACADEMIES PRESS
Published: 2011-06-27T00:00:00+00:00

The Institute of Medicine (2002) has estimated that 18,000 people aged 25–64 die each year because they lack health insurance. This calculation assumes a mortality rate for the uninsured that exceeds that of the insured by 25 percent. A recent update of this analysis found that those without health insurance had 40 percent higher mortality than the insured in the age range 17–64 (Wilper et al., 2009). An assumption of 40 percent higher mortality would result in 45,000 excess deaths in this age range attributable to a lack of health insurance. This estimate suggests that only a small number of total deaths over age 50 are likely to result from a lack of insurance: if 13 percent of those aged 50–64 are uninsured, and the excess mortality for this group is 40 percent, the excess mortality among all persons aged 50–64 due to a lack of insurance is about 5 percent.

Access to health care in the United States also is affected by the ability to pay for services not covered by insurance. Even those with insurance can find it difficult to pay the high costs of copayments and uncovered drugs. The percentage of adults in the United States who say that they have had an access problem because of costs is far higher than that in other high-income countries (see Table 7-1). In the United States, for example, 42 percent of chronically ill adults indicate that they have forgone some care because of costs in the past year, while this is true of only 5 percent of chronically ill people in the Netherlands.

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