We wish to thank Drs White and Zwemer for their letter. We were as concerned as they are about lay authors interpreting our study to prove that being uninsured causes higher mortality. However, we are cognizant as researchers that while we did find a significant association, this does not establish causation. We discussed possible mechanisms for our findings, but we point out that further studies need to be performed to find out why the observed disparity exists.
Rosen H, Saleh F, Lipsitz SR, Rogers SO, Gawande AA. More Bad News for the Uninsured—Reply. Arch Surg. 2010;145(6):604-605. doi:10.1001/archsurg.2010.101