From The City University of New York School of Urban Public Health at Hunter College, New York, New York, and Harvard Medical School, Boston, Massachusetts.
Ann Intern Med. 2017 Sep 19;167(6):424-431. doi: 10.7326/M17-1403. Epub 2017 Jun 27.
About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Patient Protection and Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine's conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.
大约有 2800 万美国人目前没有医疗保险，而且在国会提出的政策改革下，可能会有更多的人失去医疗保险。与此同时，越来越多的政策领导人呼吁超越《患者保护与平价医疗法案》，建立一个覆盖每个美国人的单一支付者国家医疗保险制度。这些政策辩论使得评估保险覆盖范围对健康影响的研究特别重要。2002 年，医学研究所的一项审查得出结论，缺乏保险会增加死亡率，但此后出现了几项相关研究。本文总结了目前关于保险与死亡率关系的证据。这些证据增强了对医学研究所的结论的信心，即健康保险可以拯救生命：与没有保险的人相比，有保险的人死亡的几率为 0.71 到 0.97。
