Does health insurance save lives?

According to one study by Martin Anderson presented at the NBER’s Program on Health Economics meeting May 4, the answer is yes.  Dr. Anderson examines the changes in insurance coverage, health care utilization, and mortality after the expansion of Medicare coverage to all patients with end stage renal disease (ESRD).  The study finds that:

…the expansions increased insurance coverage by between 22 and 30 percentage points…and increased physician visits by 18 to 35 percent. These expansions also decreased mortality due to kidney disease in the under 65 population by between 0.5 and 1.0 deaths per 100,000. Lastly, Andersen provides evidence for two mechanisms that affected mortality: an increase in access to and use of treatment, which may be due to changes in insurance coverage, and an increase in entry of dialysis clinics.

Another question was whether this was a cost-effective health insurance expansion.  He finds that the program saved between 2,000 and 14,000 life years per year, yet this health improvement was not sufficient to offset the program’s cost. At the same time, society typically places a high value on health improvements with patients with significant unmet need, and in the 1970s, patients with ESRD certainly had high unmet need.

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