Researchers at Johns Hopkins Children’s Center analyzed data from more than 23 million children’s hospitalizations in 37 states from 1988 to 2005. Compared with insured children, uninsured children faced a 60 percent increased risk of dying, the researchers found.

The authors estimated that at least 1,000 hospitalized children died each year simply because they lacked insurance, accounting for 16,787 of some 38,649 children’s deaths nationwide during the period analyzed.

“If you take two kids from the same demographic background — the same race, same gender, same neighborhood income level and same number of co-morbidities or other illnesses — the kid without insurance is 60 percent more likely to die in the hospital than the kid in the bed right next to him or her who is insured,” said David C. Chang, co-director of the pediatric surgery outcomes group at the children’s center and an author of the study, which appeared today in The Journal of Public Health.

Although the research was not set up to identify why uninsured children were more likely to die, it found that they were more likely to gain access to care through the emergency room, suggesting they might have more advanced disease by the time they were hospitalized.

In addition, uninsured children were in the hospital, on average, for less than a day when they died, compared with a full day for insured children. Children without insurance incurred lower hospital charges — $8,058 on average, compared with $20,951 for insured children.

Now the poor, who face more limited options in our society and are more often uninsured, are no better or worse than the rest of us but they are clearly different. The poor have less money. This condition, which is most often glossed over by the insane political correctness of libertarian free market economics, influences all of their economic and personal decisions. It would influence us in the same way if we were in similar circumstances.

When you have lower income the value of a dollar saved increases over the value placed on that same dollar by someone with a higher income. Free market economists, who like to pretend that poverty is alternative lifestyle, most often do not discuss this rather obvious truth.

When we are talking about medical care for children this means that people who pay for their own care out of mainly limited income tend to avoid going to the pediatrician for any little thing because the $100 charge for a doctor office visit is a substantial hit against their income.

In their ignorance and their natural desire to save money they tend to wait until the problem is obvious and it is often too late to save a life. We of the better classes are no less ignorant than the poor. Because we have more income we place a much lower value on the $100 spent on the doctor visit. Often we have insurance that will pay for the visit.

Unlike the rest of us, the uninsured live in a grand laboratory where free market health care is being tested every day. In Wonks Anonymous humble opinion, the experiment is failing and calls for its extension are simply ridiculous.

Now this post is rabidly anti-libertarian but it should not be taken as providing any comfort to the vast cadre of liberal health economists who advocate universal health insurance but seek to bend the cost curve by forcing everyone onto catastrophic health plans. I quote Brad DeLong, an otherwise sensible person but an advocate of this pernicious policy:

Brad would like to see a health insurance plan or plans in which the deductible is very large: 20% of any individual's pre-tax income in the previous year. Insurance would... [be] against catastrophically large medical expenses, as opposed to the present situation, where consumers have no real skin in the game and therefore no incentive to try to drive down prices. Where consumers do pay their own money, Brad notes, as with laser eye surgery, prices have a tendency to come down quite impressively.

Now Wonks Anonymous and most likely Brad DeLong can probably afford to live without 20% of their pre-tax income and still maintain a reasonable lifestyle. For most people with lower incomes and - I lapse into economese here - higher marginal utility of income the prospect of spending up to 20% of their already limited income on medical expenses would be daunting.

These people, when faced with a $100 visit to the pediatrician, would tend to behave like the uninsured. The result of this policy would be pretty much the same as the result of free market health care. That would be more late visits to the emergency room and more dead kids.

Wonks Anonymous would be negligent if he did not point out that free market health care and universal catastrophic coverage do not have their advantages. Remember:

Children without insurance incurred lower hospital charges — $8,058 on average, compared with $20,951 for insured children.

In free market health care the uninsured use fewer resources than the insured. Their final hospital visit is cheaper and of course, being dead, they place no further burdens on society.

These same savings will be found with universal catastrophic care. The average spending on uninsured children is well below the approximately $12,000 standard family deductible for a catastrophic health plan. Neither healthy people paying insurance premiums nor the government, which will pay premiums through subsidies, will be responsible for money spent escorting these unfortunates into a better world.

The full cost will be borne by their families and the hospitals which are legally obliged to provide care.