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September 19, 2005

Paul Krugman and Times Select.

Matt Yglesias also doesn’t think it’s worth $50 to find out what the column says. Good decision as it includes this.

Paul Krugman uses his first day behind the Times Select barrier to provide us with this little gem:

Lack of health insurance kills many more Americans each year than Katrina and 9/11 combined.

(Courtesy of a buddy with Lexis Nexis.)

Some 3,500 deaths from both catastrophes together is roughly the current estimate is it not? No, I have no idea whether lack of health insurance causes that many deaths each year or not and as Krugman doesn’t provide any source it’s a little difficult to check. I wouldn’t be all that surprised if it were true though.

However, just to be obnoxious, let’s look at a different number, that for iatrogenic mortality.

Drugintel thinks that’s about 39,000 via error and a further 106,000 via adverse drug reactions.

Wrong Diagnosis has some slightly different numbers:

Nevertheless, bearing in mind that about 2.5 million deaths occur annually in the USA, here are some of the statistics and death rate estimates from various reports:

  • 42% of people believed they had personally experienced a medical mistake (NPSF survey)
  • 44,000 to 98,000 deaths annually from medical errors (Institute of Medicine)
  • 225,000 deaths annually from medical errors including 106,000 deaths due to "nonerror adverse events of medications" (Starfield)
  • 180,000 deaths annually from medication errors and adverse reactions (Holland)
  • 20,000 annually to 88,000 deaths annually from nosocomial infections
  • 2.9 to 3.7 percent of hospitalizations leading to adverse medication reactions
  • 7,391 deaths resulted from medication errors (Institute of Medicine)
  • 2.4 to 3.6 percent of hospital admissions were due to (prescription) medication events (Australian study)

Various studies have been performed about medical errors. A phone survey by the National Patient Safety Foundation found that 42% of people believed they had experienced a medical error personally or to a relative or friend. The Institute of Medicine (IOM) reports on two studies estimating the hospital deaths due to medical errors at 44,000 to 98,000 annually, which would place medical errors in the top ten causes of death in the USA. Barbara Starfield's article in JAMA places the estimates even higher, citing a total of 225,000 deaths due to iatrogenic causes, which would place health-caused deaths as the 3rd leading cause of death in the USA. Holland et al (1997) estimates as many as 1 million patients are injured while in the hospital and approximately 180,000 die as a result, with the majority due to medication adverse reactions.

So we’ve got a bit of a spread there, 40,000 odd to a quarter million or so. As Krugman clearly implies, lack of health insurance means no treatment (and thus death). But what have we found? That health care, that thing you only get with insurance, kills huge numbers of people!

Which means that it is equally accurate to state that health insurance kills 10 to 60 times more Americans each year than Katrina and 9/11 combined.


(Yes, I know this is silly, it’s a response to the rhetoric, nothing more.)

September 19, 2005 in Health Care | Permalink

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Comments

Iatrogenic illness/death IS more of a threat than terrorism...

Bush has pulled off a massive con job. The Insurance and Medical Industrial Complexes are ripping us off and killing us off in service to their own profit.

Most of what ails us is due to environment, diet, lack of proper excercise/sleep, and an excess of unhealthy stress (fear of trrorism/paying the bills/educating the kids/ etc etc etc)

Krugman is more than right.

The whole damn system is kind of insane...yet for the very well educated who push for their rights in all situations and the very rich it can work just fine (most of the time). Doctors pay very close attention when treating people with power and money...but even so, allopathic medicine is itself a killer...wholistic/prevention is what really works....and done rightly that's actually CHEAP!!!

Again, the whole sysytem is perverse and insane...we're wasting tons of money to kill ourselves...

Posted by: Nick Lento | Sep 19, 2005 3:03:56 PM

Iatrogenic illness/death IS more of a threat than terrorism...

Bush has pulled off a massive con job. The Insurance and Medical Industrial Complexes are ripping us off and killing us off in service to their own profit.

Most of what ails us is due to environment, diet, lack of proper excercise/sleep, and an excess of unhealthy stress (fear of trrorism/paying the bills/educating the kids/ etc etc etc)

Krugman is more than right.

The whole damn system is kind of insane...yet for the very well educated who push for their rights in all situations and the very rich it can work just fine (most of the time). Doctors pay very close attention when treating people with power and money...but even so, allopathic medicine is itself a killer...wholistic/prevention is what really works....and done rightly that's actually CHEAP!!!

Again, the whole sysytem is perverse and insane...we're wasting tons of money to kill ourselves...

Posted by: Nick Lento | Sep 19, 2005 3:04:48 PM

The "40 million with no health insurance" is the new "jobless recovery". It's the throw-away line in every Bush bashing commentary. Of course once you take out temps (mainly recent graduates) those entitled to government support but not claiming it and those earning over $50k a year and choosing not to have it, the number drops rapidly. But the old line about facts and a good story was never more true.

Posted by: Mark T | Sep 19, 2005 4:51:07 PM

Even worse than what Mr. Lento so ably and thoughtfully describes is the rejection of homeopathy by the moneyed/powerful medical establishment, simply because homeopathy's undeniable benefits are undetectable using the conservative research methodologies that the establishment clings to. Just as with the myth of "objective" journalism, there is no such thing as "objective" science. They find what they're looking for. The whole "double blind" fraud is merely a convenient excuse to reject everything that doesn't fit their model!

As an honest scientist, I understand that when the methodology fails to confirm what I already know to be true, the methodology is flawed and must be discarded in favor of one which produces results that match the subjective reality I experience. Subjectively verified facts — facts with a human face, not cold scientific "data" — are more important than some worn-out old "ideology of science" invented by wealthy and powerful men, and therefore obviously tending to support their interests. And that is the essence of Bush's confidence game.

For two centuries, the cold dead hand of the so-called "scientific method" has held back real scientific progress, denying the necessities of life to billions of innocents, most non-white and all mired in poverty. It is no exaggeration to describe establishment "scientists" as war criminals, directly and knowingly responsible for all the horror and privation of modern life, and all because for reasons of personal gain they cling to a methodology which denies possibilities rather than affirming them, a methodology which defines "truth" without reference to human need. They are no less guilty than the Pope. Science with a human face could never have produced infernal combustion engines, nuclear energy, GM foods, or hurricanes.

Posted by: Professor Froward | Sep 19, 2005 6:30:35 PM

...and fried foods are chemical warfare directed against us by the culinary-industrial complex! I don't want to hear about "choice": I'm all for granting choice to people who have the wisdom to choose wisely, but people do eat fried foods, so clearly they're not competent to be allowed the decision. Prevention has been shown not to work when left to the fallible discretion of individuals. Consider the present state of our health: Q.E.D.

If it saves even one life, it will be worth it.

Posted by: Professor Froward | Sep 19, 2005 6:51:23 PM

Prof,

Well done. Your first couple of sentences had my teeth knashing AND produced mental dissonance; this was so contrary to your normal wise and informed utterings.

Then the penny dropped and I started grinning. You must have studied sociology, or been a Guardian commentator, at some stage to have gotten the wording so accurate.

Posted by: Chris harper | Sep 19, 2005 10:53:49 PM

If you were going to spend $50 on the NYT, I believe that Gary Farber could use it.

Posted by: Backword Dave | Sep 19, 2005 11:25:34 PM

Nonsense, Dave. It's impossible to read TimesSelect pieces without paying $50. I read it on the internets, and in countless blogs today, as herein, so it must be true.

Only a genius could figure out a complex and truly elaborate mechanism to subvert the fiendish Times counter-measures!

Apparently that's what it takes to figure out the incredibly obscure flaw in the system that lets one read the stuff for free.

Posted by: Gary Farber | Sep 20, 2005 12:20:17 AM