In my 20 years of practice as a family physician, I have encountered dozens of cases where the main contributing factor to a person’s death was the lack of health insurance for most of their lives.

The lack of universal health care is a mass killer in this country.

Nearly 45,000 deaths in the United States each year are attributable to the lack of health insurance, according to a Harvard University study released in September.

That astonishing figure, which appears in the American Journal of Public Health, is a big uptick from the Institute of Medicine’s finding seven years ago that 18,000 people die each year because they lack insurance and thus have less access to care.

The Harvard Medical School researchers found that an uninsured person’s risk of death is 40 percent higher than his or her privately insured counterpart. Looked at another way, every 12 minutes a person dies unnecessarily because he or she doesn’t have health coverage.

As startling as this 45,000 figure is, I fear it underestimates the problem.

In my 20 years of practice as a family physician, I have encountered dozens of cases where the main contributing factor to a person’s death was the lack of health insurance for most of their lives.

I recall one family that lost three members this way.

George was 21 when he died of complications of juvenile diabetes that he’d had since the age of 2. Whenever George worked for a while, he lost his Medicaid. This meant he could no longer afford to test his blood sugars, they would get out of control, he would get sick, have to stop working, he would spend down, then qualify for Medicaid again. This went on for the three years I knew him.

His older sister Tina also had juvenile diabetes from the age of 6. Her situation was the same — working, losing insurance, getting sicker, not working, getting Medicaid etc. Tina was pregnant at the time of George’s death. Her poorly controlled diabetes made her a very high risk for complications in pregnancy. The baby was born three months prematurely and died in the intensive care unit one month later. Tina’s health worsened after that and within one year she died in post-op after heart bypass surgery. She was 25.

Then there’s Russell — also a diabetic, also on and off insurance. He died at age 37 of diabetic kidney failure. He was uninsured for years.

Another case — Vivian — had warning signs for cancer for years. She finally qualified for insurance but died two weeks into the workup of a pulmonary embolus (a complication of pelvic cancers).

I am only one clinician, and yet I have witnessed dozens of cases of people who died of preventable illnesses — preventable illnesses that could have been treated had these patients possessed uninterrupted, seamless coverage for needed treatments over their lives.

Take my experiences and multiply them 700,000 times for the number of physicians in this country and you arrive at a lot more than 45,000 deaths a year due to lack of insurance.

It is time that our nation join the rest of the industrialized world and guarantee seamless health care coverage to every man, woman and child in America.

In other words, it’s time to enact single-payer health care — Medicare for All.

Dr. Deb Richter practices family medicine in Montpelier, Vt., and is a past president of Physicians for a National Health Program (www.pnhp.org). She can be reached at pmproj [at] progressive [dot] org.