Commonwealth Club: 78,000 Americans die yearly for lack of "timely and effective" health care

In a much-cited speech asserting the moral imperative for universal health insurance, Rep. Alan Grayson cited a Harvard study, published in the American Journal of Public Health, finding that just short of 45,000 Americans die prematurely every year for lack of health insurance.

A just-released state scorecard from the Commonwealth Club Commission on a High Performance Health System, scoring the relative effectiveness of each state's health care system, uses a somewhat different measure but comes up with an equally startling statistic: that if all states could reach the level of care achieved by top performing states,

Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care.

If this is true, more Americans die every year for want of "timely and effective" care than were killed in Vietnam or than die each year in car accidents. Moreover, even the "highest performing" state, Massachusetts, at the time of study ( when it had just begun to implement its universal health insurance plan) still left 7% of its adult working population uninsured -- and so significantly underperformed every industrialized nation in the world except the U.S. (The state with the highest percentage of working uninsured adults, at 32%, is Texas, where in the mid-90s Governor George W. Bush killed by neglect an attempt to establish a health insurance exchange for small businesses -- at least according to the exchange's chairman at the time of its demise).

The study also includes an incidental but striking congruity with CBO scoring of the Baucus bill. As noted, the study found that Massachusetts left 7% of its working adult population uninsured. Not surprisingly it concluded that if all states reached that level

Twenty-nine million more people would have health insurance - cutting the number of uninsured by more than half.

According to the CBO's estimate, the Baucus bill over ten years would cover 94% of legal U.S. residents and reduce the number of uninsured by...29 million. In other words, once fully implemented (by about 2014) it would achieve nationally the level of coverage that Massachusetts achieved in its first phase of implementation.

The Commonwealth Club report also includes some good news, most notably

that national efforts to measure, benchmark, and publicly report performance had a marked effect on quality improvements at the state level. Following a national effort to track and report hospital treatment data, nearly all states improved on measures of treatment for heart attack, heart failure, pneumonia, and prevention of surgical complications. In some instances, the lowest state rate now exceeds the average three years ago. In addition, most states improved significantly on several measures of the quality of care in nursing homes (reductions in pressure sores, pain, and use of restraints) following a national effort to make that data publicly available.

Those results suggest that measures in the Baucus bill to hold hospitals accountable for outcomes and infection rates could be effective and yield significant savings.