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People without health insurance, even briefly, more likely to get sick and die

Updated:
WASHINGTON (AP) _ Being uninsured can be bad for your health.

People without health insurance are sick more often and die sooner than the insured, the Institute of Medicine reported Tuesday.

And those experiencing even a relatively short interruption in coverage tend to have a decline in their health, the institute said in a study: ``Care Without Coverage: Too Little, Too Late.''

``If you lack health insurance coverage you're going to have a poor health status, a greater chance of dying early and your quality of life is not going to be as good because of poor health care,'' said Mary Sue Coleman, co-chair of the committee that wrote the report.

``Because we don't see many people dying in the streets in this country, we assume that the uninsured manage to get the care they need, but the evidence refutes that assumption,'' said Coleman, president of the Iowa Health System and University of Iowa, Iowa City.

Overall, the study estimated that there were more than 18,000 excess deaths among uninsured Americans in 2000, compared with people with health insurance.

``When you think about some of the most important conditions _ hypertension, high cholesterol, diabetes _ if you don't care for these people with continuous monitoring and drugs, their health deteriorates very rapidly,'' Coleman said.

This is the second of six planned reports exploring aspects of the lack of health insurance. The Institute is an arm of the National Academy of Sciences, a private organization chartered by Congress to provide scientific advice to the government.

According to the Census Bureau, 38.7 million Americans went without health coverage for all of 2000. At some point, one out of seven Americans lacks coverage for a full year while others do without for shorter periods.

One study included in the report issued Tuesday followed 4,700 Americans for at least 13 years. The death rates were 18.4 percent for those without insurance and 9.6 percent for the insured.

Another study compared California residents who lost health benefits with those who did not and those with benefits only part of the time.

Over two years, 22 percent of people with no coverage experienced a major decline in their health. Sixteen 16 percent of people with benefits part of the time noted a deterioration in health, compared with 8 percent of those who were covered all the time.

Uninsured cancer patients die sooner than people with insurance, primarily because of delayed diagnosis, the report says. The uninsured are less likely to get such screening tests as mammograms, Pap tests and colon exams, and by the time cancer is diagnosed it is more likely to be advanced.

The committee found that uninsured people with traumatic injuries are less likely to be admitted to the hospital, receive fewer services if they are and are more likely to die than insured victims.

It also found that uninsured patients hospitalized for a heart attack have a greater risk of dying during their hospital stay or shortly thereafter than patients with insurance. They also are less likely to go to a hospital that performs angiography and, even if they do, they are less likely to receive such sophisticated procedures.
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