THIS TIME ON CODE WACK!
This time on Code WACK!
The strong reactions to the tragic murder of United Healthcare CEO Brian Thompson by alleged killer Luigi Mangione are bringing renewed attention to the abuses of for-profit health insurance. How does our complex, costly, and callous for-profit healthcare system contribute to America’s high mortality rate and how many people are believed to die each year as a result?
To find out, we interviewed Dr. James G. Kahn, an expert in health policy and economics, and advisor to Code WACK! and editor and primary blogger of Health Justice Monitor, a health policy blog.
Check out the Transcript and Show Notes for more!
SHOW NOTES
WE DISCUSS
How does the United States overall mortality rate compare to that of other wealthy nations? What about the mortality rate from our health insurance system?
“… sadly, [the U.S.] mortality rate is much higher than other wealthy nations.
“Another way to think about it is, our longevity or lifespan is substantially lower than other wealthy nations.
“This is a trend which has been growing over time – this difference between the US and other countries. It got even bigger during COVID because our management of the epidemic was not as effective, but remains very large. And the best estimate is that if the U.S. had mortality rates similar to other wealthy countries, we would have 620,000 fewer deaths each year.
“ [Of that] about 420,000 can be accounted for by higher risk factors and higher disease prevalence.
“That leaves nearly 200,000 deaths per year, not explained by higher disease rates…” – James G. Kahn, MD, MPH
Are you saying that about 200,000 deaths EACH YEAR in the U.S. are related to health insurance and access to care issues?
“… some of those [deaths] are due to complete lack of insurance, but some of them are due to financial barriers among people who do have insurance, under insurance like high deductibles and as you mentioned earlier, denials of care when requesting care that needs prior authorization.
“So the estimate is about 200,000 deaths per year attributable to insurance problems.” – James G. Kahn, MD, MPH
That’s shocking. What are your thoughts on this?
“… to try to get a sense for how many people this is, it’s equivalent to the entire population of Rochester, New York or Reno, Nevada. This is a lot of people and I think we lose track.
“What struck me about the unfortunate assassination of the CEO of United Healthcare is, that was one unnecessary, sad, devastating death, and yet the amount of deaths attributable to the way we do insurance is literally 200,000 times greater per year. I’m not the only one who noticed this contrast.
“There was a widespread social media reaction from both sides of the political aisle about just how horrendous the insurance situation is and just how responsible private insurers are for denying care and for other issues and how our insurance functions or fails to function properly.” – James G. Kahn, MD, MPH
Helpful Links
Health Justice Monitor, James G. Kahn, MD, MPH
Estimated US Deaths Associated with Health Insurance / Access to Care, Health Justice Monitor
The UnitedHealthcare CEO Shooting Should Be a Turning Point for Corporate America, Harvard Business Review
The Financial Burden of Inadequate Health Insurance Coverage, American Journal of Kidney Diseases/National Kidney Foundation
‘It’s a death sentence’: US health insurance system is failing, say doctors, The Guardian
Episode Transcript
Read the full episode transcript.
Biography: James G. Kahn MD, MPH
James (Jim) G. Kahn, MD/MPH, is an emeritus professor of health policy at University of California San Francisco. He has 30 years of experience conducting economic analysis of health programs in the U.S. and in low and middle income countries around the world. He has published widely on the economics of health insurance and single payer reform in the U.S. His funders include the National Institutes of Health, the World Health Organization, and many foundations. He has more than 200 academic publications.
In 2005 he quantified U.S. healthcare administration costs. This work found that billing and insurance-related administration represents nearly one quarter of the costs of physician and hospital care funded through private insurance. He presented on administrative costs to the U.S. Institute of Medicine, of the National Academy of Sciences. In 2014, Dr. Kahn led a team that estimated potential savings of at least $400 billion per year from simplifying billing and insurance-related administration in the U.S. healthcare system.
In 2020, Dr. Kahn and colleagues found that 21 of 22 existing studies of the cost of single payer estimated savings in the first year, and all did over time. The main source of savings was simplified administration. This was published in the prominent journal PLoS Medicine.
Dr. Kahn served for two years as President of the California chapter of Physicians for a National Health Program. Currently, he is health policy analyst for the podcast Code WACK! and editor and primary blogger for Health Justice Monitor.
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