A Harvard Medical School study released in September 2009 suggests that close to 45,000 people die in the United States each year because they lack health insurance and, as a result, quality care is not available to them. The study authors contend that because uninsured people do not have access to proper care and regular doctor visits, they often die due to complications from diabetes and heart disease, both of which are often preventable and/or treatable. This Harvard study was funded by a federal research grant and released by Physicians for a National Health Program.

Researchers involved in the Harvard study say that American adults aged 64 and younger living without health insurance are faced with a 40 percent higher risk of death than those individuals in the same age group who have health insurance. A similar study was conducted in 1993 and revealed that people without health insurance had a 25 percent greater risk of death. This increased risk of death among the uninsured is growing for a few reasons, according to researchers: (1) the number of uninsured people is growing, and (2) there are fewer facilities available to treat the uninsured. The study documented that public hospitals and clinics in major U.S. cities are closing down altogether or greatly reducing services, leaving the uninsured with few healthcare options.

The U.S. Census Bureau reported in September that 46.3 million people in the U.S. lacked health insurance coverage in 2008, which is an increase from 2007′s rate of 45.7 million uninsured. This statistic is not clear as to what “people” were included in the accounting. Does this accounting include only naturalized U.S. citizens or does it also include undocumented individuals and other categories of non-citizens?

This study was not released without controversy. Washington, D.C. think tank, The National Center for Policy Analysis, who supports a free-market based healthcare system, feel that the Harvard researchers overstated the death risk of the uninsured. Furthermore, the researchers purportedly did not track how long the study subjects were uninsured.

We are all aware of the contentious debate over healthcare reform, which remains ongoing. Is it really healthcare reform that is being discussed, however, or is it health insurance reform? Is a government backed “single-payer” system the answer to getting more Americans insured? Are we even aware of what the true problem is and what exactly needs to change within our highly dysfunctional and extremely expensive system? There are many schools of thought and many theories posited by well-educated individuals laying out what is best for the American people in terms of attainable, affordable, effective healthcare. The question is: who is right? There is so much to consider and every component that makes up our current healthcare system must look out for its own interest.

As the nation with the most expensive healthcare system in the world, we must ask ourselves, “what are we getting?” Certainly not the distinction of being the most healthy nation in the world!

Here are a few local statistics: 13% of all Philadelphians have diabetes and 27% of Philadelphians smoke. As for national statistics: 1 out of every 3 Medicare dollars goes to pay for diabetes care; today, one-third of U.S. children and adolescents are overweight or obese. Could our healthcare system be improved greatly by promoting more preventive care? Wouldn’t health insurance rates decrease if doctors practiced more coordinated care with patients? Were back to asking ourselves what is at the crux of the healthcare problem and, ultimately, “what is the answer?”