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Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

N. Meltem Daysal
Tilburg University, The Netherlands

One of the major challenges confronting policy makers today is the persistently high rate of U.S. residents who do not have health insurance. Any health care reform that aims to tackle this issue requires a solid understanding of the effects of uninsurance on society. In this paper, I examine the impact of uninsured patients on the health outcomes of the insured. I focus on one measure of health outcome, the in-hospital mortality rate of insured heart attack patients, and implement panel data models using patient discharge data from California hospitals for the period 1999-2006. Overall, my results indicate that uninsured patients have an economically significant effect on the health outcomes of insured heart attack patients. I show that these results are not driven by unobserved characteristics of insured heart attack patients or hospitals and that they are robust to a host of specification checks. My results indicate that eliminating uninsurance would reduce the annual number of insured heart attack deaths by 125-200, roughly corresponding to a 3-5% reduction in the total number of deaths. My calculations place the marginal cost of a statistical life year saved from reducing uninsurance between $38,093 and $63,569, implying that reducing uninsurance may be a cost effective way of improving the health outcomes of heart attack patients.

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