An online study estimates nearly 45,000 annual deaths are associated with a lack of health insurance. That figure is about two-and-a-half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The new study, "Health Insurance and Mortality in U.S. Adults," appears in an online edition of the American Journal of Public Health, and is being publicized by Physicians for a National Health Program, (PNHP) a Chicago non-profit research and education organization of 17,000 physicians, medical students and health professionals who support single-payer national health insurance.

The Harvard-based researchers found that uninsured, working-age Americans have a 40% higher risk of death than their privately insured counterparts, up from a 25% excess death rate found in 1993.

The messaging coming out of the Harvard study adds fuel to the fire under the Obama administration to pass health care reforms. Today, Senate Finance Committee Chairman Max Baucus submitted the latest such effort—a 10-year, $856 billion bill, called “America’s Health Future Act of 2009” designed to offer health insurance to tens of millions of uninsured Americans. It also includes a $6 billion annual fee also that would be assessed on some health insurance, pharmaceutical and medical device companies as well as clinical laboratories, considered “seed money” to cover insurance co-op start-up costs and meet insurance solvency requirements. Stakeholders from both sides agree that the bill, as written, is not expected to pass.

The Harvard study will, no doubt, add another element of pressure to the growing tension among Americans with and without insurance. The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.

Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.

Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease, says PNHP.

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