Category: Chart Of The Day

Kliff relays Gallup’s latest numbers:

The polling firm’s data shows states that set up their own exchanges and expanded Medicaid had their uninsured rate fall by 2.5 percent, compared to a 0.8 percent drop in states that have opted out of at least one of the health law programs. Separate federal data has shown that states expanding Medicaid have had faster growth in the public program than those that have opted not to participate. States that do not expand Medicaid essentially leave those in poverty in a coverage gap because they are too poor to qualify for the private insurance subsidies offered to people above the poverty line.

Cohn adds:

As readers of this space know, the Gallup results are very imprecise, enough that nobody should take specific figures too seriously. And these aggregate totals surely mask all sorts of variation among the states. But the overall pattern—a sharp divergence between the two groups of states—is almost certainly real. It’s also very tragic.

Drum piles on:

These numbers will change a bit over the next couple of months as things settle down and signups are complete, but the relative differences will almost certainly remain huge. Republican governors have been almost unanimously dedicated to sabotaging Obamacare and withholding health care from their own residents, and they’ve been successful. I hope they’re proud of themselves.

Douthat, meanwhile, lays down a marker:

If, in 2023, the uninsured rate is where the C.B.O. currently projects or lower, health inflation’s five-year average is running below the post-World War II norm, and the trend in the age-adjusted mortality rate shows a positive alteration starting right about now, I will write a post (or send out a Singularity-wide transmission, maybe) entitled “I Was Wrong About Obamacare” — or, if he prefers, just “Ezra Klein Was Right.”

A reader close to the issue writes:

Clearly that chart was indirectly demonstrating that having a gun in one’s home is much more likely to be associated with suicide than with actually killing someone in self-defence. It is not by any means a definitive chart on “the overall impact of firearms on health.” Your reader remarked that the positives of guns include deterring an unknown number of murders and violent assaults. He disregards the fact that the negatives are massively underestimated, not overestimated, by the chart.

The negative health effects of guns are not just suicides but also the homicides (11,078 in 2010, according to the CDC), the accidental deaths of children and adults (554 in 2009 – see this excellent NYT piece), and the cost and long-term impact of non-fatal gun injuries (73,505 in 2010 per the CDC). It is estimated to cost over $2 billion per year to treat patients with firearms injuries. That does not count the losses in productivity and the chronic healthcare needs of these patients. As for suicides, 19,392 of the 38,364 suicides in the US in 2010 were from firearms. Using a firearm in a suicide attempt is lethal in 85% of patients, far more lethal than any other method.

I am an emergency physician and a medical toxicologist, so I’ve seen up close the costs of suicide.

I have taken care of many patients who have tried to kill themselves, including a 16-year-old boy who fatally shot himself in the head after his girlfriend broke up with him, as well as many who overdosed on medications but recovered. Guns are so lethal so quickly that even if the impulse to commit suicide is transient, the person is often successful. They don’t get a chance to change their minds. That’s why having access to a gun in the home is a risk factor for suicide. The data from an Army Times article back this up:

Troops overseas must abide by the restrictions of host nations, according to military policy. Accordingly, U.S. troops in South Korea, Germany, Italy and elsewhere are virtually without access to personal firearms. Suicides have been fewer among those troops.

Last year, there were three Army suicides among the 25,000 soldiers posted in Germany, one among 19,200 in South Korea and none in Italy, where 3,900 soldiers are based. Meanwhile, U.S. bases often see double-digit suicides each year. There were a dozen among the 30,000 GIs at Fort Campbell, Ky., last year; 17 at Fort Hood, Texas, which has 46,500 soldiers; and 10 among the 20,000 G.I.s at Fort Stewart, Ga., according to Army statistics.

“The takeaway message is we have to do everything we can to limit access to firearms by someone who is depressed, they’re suicidal, struggling with thoughts of self harm,” said Robert Gebbia, executive director of the American Foundation for Suicide Prevention. “It’s just good common sense.”

The NRA has blocked research on these issues because it is not in their interest for people to know the truth. We don’t have the data on gun deaths and gun injuries because they have blocked funding for the research.

I hope you will not leave your other reader’s comments as the only important points to be made about the chart and about the negative health impact of guns. It is time that our politicians developed some backbone and did what is right for the American people rather than for the gun industry. It is ridiculous that they would oppose Dr. Murthy because of his belief that guns are a public health issue. He would be a very poor physician indeed if he did not see the obvious health costs of guns to our society.

Olga Khazan sticks up for Vivek Murthy, the president’s choice to be the next surgeon general, whose confirmation is being held up based on pressure from the NRA:

One of the NRA’s sticking points … is that Murthy once tweeted, “Guns are a health care issue.” It’s not immediately clear what Murthy means by that. The NRA claims that guns are used more than 2 million times a year for self-defense (though social scientists think it’s closer to 100,000 times.) And it’s healthy to want to defend yourself. Murthy has already said that he plans to use his office to work on obesity, not guns.

But looking at the instances in which firearm use ends in death, it becomes clear that there’s a health case to be made for gun control, too. Guns are far more likely to be used in suicides than in killing assailants.  According to the CDC, 19,392 people committed suicide with a gun in 2010, the latest year for which data are available. That same year, meanwhile, the FBI recorded only 230 justifiable homicides (the legal term) in which a private citizen used a firearm to kill a felon during the commission of a felony.

Update from a reader, who makes some important points:

That chart strikes me as an unjustified comparison for considering the overall impact of firearms on health, as it underestimates the positives and overestimates the negatives.

On the positives of gun ownership, surely we aren’t interested in the number of people justifiably killed by them, but rather the number of murders and violent assaults deterred by them. The answer may not be the 100,000 instances of self-defense estimated my social scientists, but it’s surely a lot higher than the 230 justifiable homicides.

On the negatives, it is impossible to take seriously the notion that all 19,392 people who committed suicide in 2010 wouldn’t have found some other way to end their lives. I am aware of research by Justin Briggs and Alex Tabarrok finding that gun ownership encourages suicide, but if I’m reading their tables correctly, they find that about half of suicides by firearm would have occurred through some other method if a firearm was not available.