ALLEN: Insurance crisis is frog in a slowly heating pot

Behold the frog. It sits contentedly in a slowly warming pan of water as the temperature gradually rises to the boiling point, immobile, unresponsive and, in the end, quite dead. Another frog, put suddenly into boiling water, jumps out at once.

Fact or urban legend, it is a metaphor for a proven human characteristic: Any event, good or bad, occurring gradually goes unrecognized or forgotten while the same event, occurring suddenly, will cause immediate attention and great concern — and sometimes a response.

The Newtown, Conn., tragedy was unique in the age and innocence of its victims, and the public response has been enormous. From the nation and the world has come all kinds of sympathy, support, money and more teddy bears than people in Newtown. What, if any, reform of gun ownership results remains to be seen.

Mentioned only in passing or mentioned not at all was the unpleasant fact that on the same day, and every day before and since, an average and equal number of Americans, about 25, die from gunfire (double if we count suicides).

We have learned to live with this. After all, these are drug dealers and gang bangers deservedly killing each other and no big deal. But many of the deaths were from domestic violence or innocent bystanders in the wrong place at the wrong time, and most killings didn't need an assault weapon with a full magazine.

Who weeps for them?

In the December 2009 American Journal of Public Health is an article titled "Health Insurance and Mortality in US Adults." It is a serious, scientifically controlled effort asking a basic question: What effect does health insurance have on death rates? Or, as the mission statement says, "Our objective was to evaluate the relationship between uninsurance and death."

It was carefully crafted to meet the stringent statistical requirements of a well done, scientifically valid study. The people entered were placed into one of two groups equal in gender, age (all were 17-64), initial health status as rated by the person and a physician, race-ethnicity, income, education, body mass index, leisure exercise, smoking and regular alcohol use — with only one difference. Half had some type of medical insurance, and the other half had none.

Average follow-up time was nine years and the measured end point was clear and understandable — comparative death rates in each group.

The results were consistent with numerous previous smaller studies and not surprising: The death rate for the uninsured was statistically and significantly higher than those with insurance.

Using existing demographics and extrapolating forward using the entire nation, the study found that "approximately 44,789 deaths among Americans 16-64 in 2005 were associated with lack of health insurance."

But no one noticed.

If 44,000 Americans died each year in airplane crashes, the Federal Aviation Administration would shut airline travel down in a nanosecond. Perhaps if the American public could witness in one place and at one time the sudden preventable death of 44,000 of their fellow citizens, they would be moved to ask, "Isn't there a better way to provide health care for 300 million Americans?"

Some frog.

Allen is a semi-retired Modesto physician and regular community columnist. Send questions or comments to columns@modbee.com.

In 2011, according to Census data, 90,000 people in Stanislaus County were uninsured. In California, the number was pegged at 7.1 million.