Rep. Raúl Labrador, people do die from lack of insurance
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Perhaps Rep. Raúl Labrador (R-Idaho) should have had better information before he took the position that "nobody dies" from a lack of healthcare coverage.

According to a recent Time article, a member of the audience at the recent town hall at Lewis-Clark State College in Lewiston, Idaho confronted Labrador with the comment, "You are mandating people on Medicaid accept dying. You are making a mandate that will kill people."

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He replied, "No one wants anybody to die. You know, that line is so indefensible. Nobody dies because they don't have access to healthcare."

 

Interestingly, many of the people who attended the town hall understood that Labrador was mistaken. Time reports, "His comments prompted an immediate outcry from audience members, who began to audibly boo, according to clips shared on social media."

It doesn't take a healthcare professional to understand that, as the Henry J. Kaiser Family Foundation (KFF) web site says, "People without insurance coverage have worse access to care than people who are insured. One in five uninsured adults in 2015 (20 percent) went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases." This includes diagnostic cancer screening.

In fact, a 2009 study published in the American Journal of Public Health found that 45,000 U.S. deaths were related to a lack of health insurance. An article in the Harvard Gazette reported, "The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993."

The KFF web site describes the financial implications of lacking insurance. "The uninsured often face unaffordable medical bills when they do seek care. In 2015, over half of uninsured people (53 percent) said that they or someone in their household had problems paying medical bills in the past 12 months. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings."

When Labrador says that "nobody dies" from a lack of health coverage, he seems to believe that everyone in need can receive treatment from an emergency room regardless of their insurance status. However, what he doesn't understand is that, while an emergency room may save the life of a heart attack patient, it fails to provide the ongoing care that sick people require. That means that an uninsured person with a life threatening condition such as cancer, cystic fibrosis, or diabetes that requires ongoing care will not receive it.

If people don't have health insurance, and they're seriously ill, most doctors won't treat them. If a doctor chooses to see an uninsured person with pain, for example, there will be few affordable treatment options.

Doctors are increasingly unwilling to even provide painkillers for fear of contributing to the opioid problem. If they do provide an opioid, in most instances, it is only for a very limited amount of time. This may be fine, unless patient has a serious chronic pain condition requiring long-term therapy and there is no other way for the patient to obtain relief.

The fear of losing healthcare coverage and facing insurmountable medical bills are stressors that no one needs. The families of people with pain, seniors, and sick children shouldn't have to worry about their loved ones' health insurance. And the most vulnerable members of our society — those who face disease, deal with pain, or struggle with addiction — shouldn't have to worry they might lose their ability to receive treatment.

Comedian Jimmy Kimmel unexpectedly put a human face on the importance of healthcare coverage when he went public with the fact that his newborn son was born with a heart defect. His plea to save the Affordable Care Act and allow people with preexisting conditions to keep their health insurance went viral. Kimmel's position did, however, face criticism from some conservatives, according to CNN.

While people may not agree on all of the facts, one thing is indisputable: people without health insurance may die sooner than they would if they had insurance coverage. Sadly, that outcome will also mean more suffering, because people without health insurance also won’t have palliative care. That just doesn’t seem right.

Lynn R. Webster, MD is Vice President Scientific Affairs for PRA Health Sciences. He is a past President of the American Academy of Pain Medicine. In addition, he is a co-producer of the public television, “The Painful Truth.” Visit him online at www.thepainfultruthdocumentary.com. @LynnRWebsterMD


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