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Invited Commentary |

Trauma Patients Health Insurance Reform Is Only the Beginning

Jarone Lee, MD, MPH1,2,3
[+] Author Affiliations
1Department of Surgery, Harvard Medical School, Boston, Massachusetts
2Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
3Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston
JAMA Surg. 2015;150(7):616. doi:10.1001/jamasurg.2014.2470.
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With the passing of the Affordable Care Act and the need for policymakers to focus on implementing the individual mandate, the article by Osler et al1 comes at a most needed time. This article adds to the national debate by finding a surprising and interesting result: excessive deaths associated with increased insurance coverage among nonelderly adult trauma patients.

The implications of the study are immediately evident; however, we must interpret the results within the correct context. The study reports an interesting association that is not causation. As a high-level study, with little sensitivity analysis to test for robustness of the findings, there are many epiphenomena that could confound the results.

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