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Wednesday, March 1, 2017
No, Repealing Obamacare Won’t Kill Off Thousands of Americans
Among the most popular of the potentially looming tragedies cited by proponents of Obamacare is that thousands of Americans will die if Republicans are successful in repealing it.
David Himmelstein and Steffie Woolhandler at the Chicago Tribune, for example, posit that "repealing Obamacare will kill" as many as 43,000 people every year due to a lack of health insurance. Note that they don't just suggest that 43,000 people will die as a result of the repeal. Specifically, their argument is that Republicans, and you that may support the effort toward repeal, will kill them. It's hard to miss the political currency they're aiming for with the shocking headline.
Their argument is utterly insane. There's absolutely no way to quantify or verify the number claimed. After all, in order for this to be remotely plausible, one would have to be able to prove that there are 43,000 people (or some number relative to population growth) who annually died in the years leading to Obamacare's passage, who, but for their having Obamacare-designed health insurance, would have otherwise lived.
Since that would be unprovable, disseminators of this argument tend to lean on apples and oranges comparisons between mortality rates and health insurance coverage data.
Glenn Kessler at the Washington Postgave Bernie Sanders "four Pinocchios" for his claim that the much lower number of 36,000 Americans would die annually due to the repeal of Obamacare. Those numbers, Kessler notes, were based upon assumptions drawn from a study about the impact of Massachusetts' healthcare law, which preceded Obamacare. The study that Sanders used in his calculation "compared mortality rates for adults from 2001-2005 to the rates in 2007-2010, after the law was implemented. The research indicated that for every 830 adults who gained insurance, there was one fewer death per year."
"But the study clearly noted," Kessler says, "that "we do not have individual-level insurance information and thus cannot directly link mortality changes to persons gaining insurance coverage." Furthermore, Massachusetts is something of a microcosm in the scope of Americans' healthcare, given "lower mortality, higher income and baseline insurance coverage rates, fewer minorities, and the most per capita physicians in the country."
So the study is worthless when appraising the effects of Obamacare. But more to the point, can it be assumed that mortality rates in a given period are the factor which most closely aligns with the success of federal healthcare policy? We can assume that is the logic being employed across the board with these silly assertions. Even in the study cited by Chicago Tribune article, mortality rates are addressed in correlation to expanded Medicaid coverage under Obamacare, and assumes that reduction in mortality rates in the years since Obamacare was implemented must obviously signify the success of Obamacare.
The facts, however, are that mortality rates have been generally decreasingover the last century, which correlates (as one might imagine) with a steadily increasing life expectancy.
In 1950, for example, life expectancy was 68.2 while the mortality rate was 9.6 (per 1,000 Americans). In 1980, life expectancy was 73.7 with a mortality rate of 8.7. In 2010, life expectancy was 78.7 set against a mortality rate of 8.0.
The point is, the generally decreasing trend in mortality rates long preceded Obamacare's massive expansion of subsidized health insurance. This should not signify that Obamacare is the cause of recent decreases in mortality rates, nor should any sane person expect that we'll see a massive reversal of the trend if Obamacare is repealed.
But since the left seems wedded to this argument, accusing its opponents of advocating murder and whatnot, it's worth reversing the lens with some recent alternative data to see what shakes out.
The crude data from 2015 show a mortality rate of roughly 8.4 per 1,000 Americans. Why the uptick from 2010 mortality rates? The number of Americans covered by Medicare and Medicaid has gone from 87.8 million in 2008 to 117.4 million in 2015 (data available via census.gov). This is a 38% increase in federally subsidized health insurance, versus a 5.2% increase (304 to 320 million) in the population. Shouldn't this massively increased subsidization of health insurance correlate to a lowermortality rate, given the logic we've been fed?
The death rate rose in the United States rose last year  for the first time in a decade… a rare increase that was driven in part by more people dying from drug overdoses, suicide and Alzheimer's disease. The death rate from heart disease, long in decline, edged up slightly.
Doesn't this just exemplify the fluidity with which the left chooses the data to support its talking points? You'll note that this sort of trend in the mortality rate data has nothing to do with Obamacare or health insurance coverage in this estimation. How is it that Obamacare's increasing subsidization of health insurance could not prevent this shocking uptick in mortality rates, but repealing Obamacare, and thus decreasing the massive subsidization of health insurance via free market alternatives as conservatives have been arguing, is tantamount to murder on the part of Republicans and their supporters?
It's all utter nonsense. There are myriad reasons for fluctuations in mortality rates that have nothing to do with the level at which health insurance is subsidized, as the Times seems to be aware if one considers the above excerpt.
All the hysteria about how repealing Obamacare will kill however many more thousands of people that the left will arbitrarily try to tack onto the effort is yet another example of a calculated attempt to make the data fit the theory rather than shaping a theory upon observed data.