The Bogus Death Statistic That Won't Die

Michelle Malkin
Friday, October 23, 2009

Democratic Rep. Alan Grayson of Florida has found his calling: death demagogue. First, he accused Republicans of wanting sick patients to "die quickly." Next, he likened health insurance problems to a "holocaust in America." Now, he's unveiled a new website entitled "namesofthedead.com" in memory of the "more than 44,000 Americans [who] die simply because they have no health insurance."

Just one problem: The statistic is a phantom number. Grayson's memorial, like the Democrats' government health care takeover plan itself, is full of vapor. It comes from a study published this year in the American Journal of Public Health. But the science is infused with left-wing politics.

Two of the co-authors, Drs. David Himmelstein and Steffie Woolhandler, are avowed government-run health care activists. Himmelstein co-founded Physicians for a National Health Program, which bills itself as "the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program." Woolhandler is a co-founder and served as secretary of the group.

Sounding more like a MoveOn.org organizer than a disinterested scientist, Woolhandler assailed the current health reform legislation in Congress for not going far enough: "Politicians are protecting insurance industry profits by sacrificing American lives."

How did these political doctors come up with the 44,000 figure? They used data from a health survey conducted between 1988 and 1994. The questionnaires asked a sample of 9,000 participants whether they were insured and how they rated their own health. The federal Centers for Disease Control tracked the deaths of people in the sample group through the year 2000. Himmelstein, Woolhandler and company then crunched the numbers and attributed deaths to lack of health insurance for all the participants who initially self-reported that they had no insurance and then died for any reason over the 12-year tracking period.

At no time did the original researchers or the single-payer activists who piggy-backed off their data ever verify whether the supposed casualties of America's callous health care system had insurance or not. In fact, here is what the report actually says:

"Our study has several limitations," the authors concede. The survey data they used "assessed health insurance at a single point in time and did not validate self-reported insurance status. We were unable to measure the effect of gaining or losing coverage after the interview." Himmelstein et al. simply assumed that point-in-time uninsurance translates into perpetual uninsurance -- and that any health calamities that result can and must be blamed on being uninsured.

Another caveat you won't see on Grayson's memorial to the dubious dead: The single-payer advocate-authors also conceded in their study limitations section that "earlier population-based surveys that did validate insurance status found that between 7 percent and 11 percent of those initially recorded as being uninsured were misclassified. If present, such misclassification might dilute the true effect of uninsurance in our sample."

To boil it all down in plain English: The single-payer scientists had no way of assessing whether the survey participants received insurance coverage between the time they answered the questionnaires and the time they died. They had no way of assessing whether the deaths could have been averted with health insurance coverage. A significant portion of those classified as "uninsured" may not have been uninsured, based on past studies that actually did verify insurance status. But the Himmelstein team just took the rate of uninsurance from the original study (3.3 percent), applied it to census data and voila: More than 44,000 Americans are dying from lack of insurance.

Next, the political doctors cooked up scary-specific death tolls for all 50 states (California -- 5,302, Texas -- 4,675). Newspapers dutifully cited the fear-mongering factoids. The single-payer lobbying group co-founded by Himmelstein and Woolhandler took it from there. Last month, the group set up its own memorial on the National Mall for the phantom 44,000 casualties of uninsurance.

Himmelstein (who was also the driving force behind another flawed study tying medical debt to personal bankruptcies) eschewed scientific nuance and caveats to take to the airwaves and declare starkly that an American "dies every 12 minutes" because of lack of insurance. And now Grayson has taken the monumentally dishonest concept online to solicit sob stories and put flesh on the weak bones of these dubious death numbers.

Where's the White House health care "reality check" squad when you need it?