By Joe Conason

When Republican politicians and right-wing talking heads bemoan the fictitious “death panels” that they claim would arise from health care reform, they are concealing a sinister reality from their followers. The ugly fact is that every year we fail to reform the existing system, that failure condemns tens of thousands of people to die—either because they have no insurance or because their insurance companies deny coverage or benefits when they become ill.

The best estimate of the annual death toll among Americans of working age due to lack of insurance or under-insurance is at least 20,000, according to studies conducted over the past decade by medical researchers, and is almost certainly rising as more and more people lose their coverage as costs continue to go up.

They die primarily because they didn’t have the coverage or the money to pay doctors and thus delayed seeking treatment until it was too late. They don’t get checkups, screenings and other preventive care. That is why uninsured adults are far more likely to be diagnosed with a disease, such as cancer or heart disease, at an advanced stage, which severely reduces their chances of survival.

This isn’t news. Seven years ago, the Institute of Medicine found that approximately 18,000 Americans had died in 2000 because they had no insurance. Using the same methodology combined with Census Bureau estimates of health coverage, the Urban Institute concluded that the incidence of death among the uninsured was enormous. Between 2000 and 2006, the last year of that study, the total number of dead was estimated to have reached 137,000—a body count more than double the number of casualties in the Vietnam War.

The Institute of Medicine also found that uninsured adults are 25 percent more likely to die prematurely than adults with private health insurance, and other studies have warned that uninsured adults between the ages of 55 and 64 are even more prone to die prematurely. A lack of health insurance is the third-leading cause of death for that age cohort, following heart disease and cancer.

All those appalling figures, which are real rather than mythical, do not include the casualties of insurance company profiteering—namely, all the people, including small children, who perish because of the anonymous “death panels” that deny or delay coverage to consumers. Perhaps the most notorious case in recent years was that of Nataline Sarkisyan, the 17-year-old leukemia patient whose liver transplant was held up by insurance giant Cigna HealthCare. She died for no reason except to protect Cigna’s profit margin, but her unnecessary and cruel demise was hardly unique.

Research by the American Medical Association found that the nation’s largest insurance companies deny somewhere between 2 and 5 percent of all the claims submitted by doctors. That rough estimate is the best available because private insurers are not required to reveal such statistics (although they certainly maintain them), and the government does not collect them. But in June, a House Energy and Commerce Committee investigation found that three major insurance companies—Golden Rule, Assurant and WellPoint—rescinded the coverage of at least 20,000 people between 2003 and 2007 for minor errors, including typos, on their paperwork; a preexisting condition; or a family member’s medical history.

“They try to find something—anything—so they can say that this individual was not truthful,” said Representative Henry Waxman, the California Democrat who oversaw the committee probe. He warned that insurance companies launch these nitpicking inquisitions whenever a policyholder becomes ill with a certain kind of condition—usually a costly and deadly one, such as ovarian cancer or leukemia. The result is denial and loss of coverage—and we now know that means increased mortality for innocent people.

So who are the members of the death panels?

You can find them among the corporate bureaucrats who concoct excuses to deny coverage and throw the sick off their rolls. You can find them among the politicians and lobbyists who have stalled reform for years while people died. You can find them among the morons who show up to shout slogans at town halls rather than seek solutions. And you can find them among the cable and radio blabbers, who invent scary stories about reform to conceal the sickening truth.

Joe Conason can be reached via email at [email protected].