Major Medicaid study from Oregon: Program does little to improve people’s health

posted at 11:22 am on May 2, 2013 by Allahpundit

As is always true when the Wrong Outcome is arrived at, there are two angles to this story. One is the study itself, two is the media hackwork in the aftermath to spin the hell out of it before the Wrong Outcome leads to Wrong Policy.

First, the Wrong Outcome via Philip Klein. Oregon expanded its Medicaid program five years ago, then tracked more than 6,000 new participants for a year and a half to see if adding them to the rolls led to major improvements in their health compared to 6,000 people in a control group. Verdict: Nope, not really.

Do note, one of the co-authors of the study is ObamaCare architect Jon Gruber:

Specifically, researchers found that those who received Medicaid increased their annual health care spending by $1,172, or 35 percent more than those who did not receive Medicaid. Those with Medicaid were more likely to be screened for diabetes and use diabetes medication and to make use of other preventive care measures. The study also examined health metrics including blood pressure and cholesterol.

Ultimately, the authors concluded that, “This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured health outcomes in the first two years, but it did increase use of health services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.”

So, the study suggests that expanding Medicaid is one way of reducing financial pressure on low-income groups, but it’s costly and does not improve their health.

Another interesting finding was that though medical spending increased among Medicaid enrollees due to more prescription drug usage and doctors’ visits, the study “did not find significant changes in visits to the emergency department or hospital admissions.” This undercuts another favorite talking point of liberals, which is that expanding insurance actually saves money by reducing costly emergency room visits.

If you want a deeper dive into the findings, wonk out with Megan McArdle (“it’s actually bigger, and more important than Obamacare”) and Avik Roy (“it is positively unethical to take money from [the middle class] in order to fund a broken program that doesn’t improve health outcomes”). The point of Medicaid, needless to say, is to improve the health of the poor by expanding their access to health care; oppose the program as an expensive failure and, as surely as Paul Ryan wants to toss grandma off a cliff, you’re in favor of poor people suffering and dying. What’s a smart, right-thinking liberal to do in the face of a scientific study that cuts the legs out from under that reasoning? It’s goalpost-moving time:

Medicaid fails almost entirely to achieve its objectives, at fantastic cost to taxpayers, but if there’s even a glint of welfare-state success to report, rest assured that the media will find it. And it’s not just the AP: Scroll through Shikha Dalmia’s round-up of lefty reporters doing their best to spin the study as some sort of win for the program. The lamest, per Gabe Malor, is the Times’s headline trumpeting the fact that Medicaid “increases use of care” — as if visiting the doctor, not improved health, is suddenly the yardstick of a successful health insurance program. Even the mental-health finding touted by the AP carries an asterisk. As Peter Suderman noted yesterday, some Medicaid recipients reported improved health after they enrolled even though they hadn’t been treated for anything yet. The reduced depression, in other words, may be due in part simply to the security they felt from gaining coverage … even though the care they eventually received ended up doing little for them. How’s that for a new justification for endless billions in health-care spending? The Medicaid safety net may not provide much safety, but the psychic boost from knowing that it’s there is worth the cost — even though there may be ways to achieve the same gains in mental health and diabetes detection through other means, at less expense.

Read Roy’s post linked above for a five-point response to liberal spin of the study. Righty wonks are treating this like a bombshell insofar as it might halt Democratic efforts to expand Medicaid under ObamaCare, but I don’t know. It might give confidence to Republicans in purple states, but the blue states will plow ahead. If they did ten more studies confirming this result, those would all be spun away too. This is an “identity” issue for Democrats — they’ll fight to protect the welfare state, whether it works or not, whether we can afford it or not — and as with abortion (or guns on the right), they won’t cede an inch on “slippery slope” grounds. Even if they were convinced that Medicaid isn’t worth the expense, they won’t relinquish a key political bludgeon against the right. Celebrate the result as a win for truth, but not because policy’s likely to shift dramatically.


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Really? Never saw that coming…

sandee on May 2, 2013 at 11:24 AM

Little change in emergency room visits, so no cost saving there. Geez, wonder of wonders.

WordsMatter on May 2, 2013 at 11:29 AM

So, the study suggests that expanding Medicaid is one way of reducing financial pressure on low-income groups, but it’s costly and does not improve their health.

Giving them free beer would have the same effect.

BobMbx on May 2, 2013 at 11:34 AM

So Medicaid doesn’t actually improve the health of the people enrolled in it. We still have to do SOMETHING! If we don’t its because we hate sick people. Head Start doesn’t help pre-schoolers either but we have thrown billions at it. Because if we don’t we are h8ters who want children to be illiterate. We have to have background checks which won’t stop any crime because if we don’t we want children shot in the streets.

It almost seems that the metric is that you can’t really show how much you care unless your program is without merit but you do it anyway because you care so much.

Lily on May 2, 2013 at 11:34 AM

This is an “identity” issue for Democrats — they’ll fight to protect the welfare state, whether it works or not, whether we can afford it or not — and as with abortion (or guns on the right), they won’t cede an inch on “slippery slope” grounds. Even if they were convinced that Medicaid isn’t worth the expense, they won’t relinquish a key political bludgeon against the right. Celebrate the result as a win for truth, but not because policy’s likely to shift dramatically.

And that’s the long and short of it. Allahpundit’s assessment is insightful and, sadly, accurate.

thatsafactjack on May 2, 2013 at 11:35 AM

The Left would destroy the world to protect their ideology. It’s their God.

Charlemagne on May 2, 2013 at 11:37 AM

These are policies brought to you by the same folks who believe, to this day, that banning cigarette lighters on airplanes was a much needed policy. But matches are just fine.

Well, they did something.

BobMbx on May 2, 2013 at 11:37 AM

His shining achievement, is a failure?

Oh Noz.

hawkdriver on May 2, 2013 at 11:38 AM

Watching the Dems roll out Obamacare reminds me of a clip from the silent-film archives of transportation inventions in the early 1900s. In particular, I remember seeing a flying contraption with four levels of wings, one on top of the next. The contraption got about a yard off the ground before crashing in a heap.

BuckeyeSam on May 2, 2013 at 11:40 AM

“This randomized, controlled study showed that Medicaid coverage generated no significant improvements in measured health outcomes in the first two years, but it did increase use of health services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.”

Sooo, “increase use of health services” Same number of doctors, more patient visits, no improvements in patient health, and this will somehow lower the cost of medical care. Welcome to bizarro world.

WitchDoctor on May 2, 2013 at 11:41 AM

there may be ways to achieve the same gains in mental health through other means, at less expense.

Two words: Helium balloons

blammm on May 2, 2013 at 11:44 AM

Obviously they asked the wrong questions on the survey…

Should have asked….

Q1. Do you want a green card with your Medicaid?

Q2. Would you like to register to vote?

Q3. Do you want SNAP card along with Medicaid?

Q4. How was your late-term infanticide operation?

txdoc on May 2, 2013 at 11:44 AM

This is an “identity” issue for Democrats — they’ll fight to protect the welfare state, whether it works or not, whether we can afford it or not — and as with abortion (or guns on the right), they won’t cede an inch on “slippery slope” grounds. Even if they were convinced that Medicaid isn’t worth the expense, they won’t relinquish a key political bludgeon against the right. Celebrate the result as a win for truth, but not because policy’s likely to shift dramatically.

Yeppers. See the boondoggle failure that is Head Start.

Resist We Much on May 2, 2013 at 11:44 AM

Two words: Helium balloons

blammm on May 2, 2013 at 11:44 AM

God forbid!

http://www.washingtonpost.com/blogs/post-politics/wp/2013/04/26/rep-hank-johnson-on-helium-debate-imagine-a-world-without-balloons-video/

VegasRick on May 2, 2013 at 11:48 AM

People eat like crap, smoke, take drugs, never exercise and expect the healthcare system to make everything right….

It’s all an illusion – designed to take away the rest of your liberty…..

But I do feel safer when the FBI and the DHS team up. /sarc

redguy on May 2, 2013 at 11:50 AM

It serves its purpose well of being a method of wealth transfer.

tom daschle concerned on May 2, 2013 at 11:51 AM

Giving them free beer would have the same effect.

BobMbx on May 2, 2013 at 11:34 AM

Sign me up for Medicaid!!!

stvnscott on May 2, 2013 at 11:51 AM

I like the results of the study, but 2 years seems to be a very short period of time to see any gains in health for the average group of people.

astonerii on May 2, 2013 at 11:51 AM

It helps with some liberal statistics by killing people off, so they are no longer a “burden” on society.

kirkill on May 2, 2013 at 11:53 AM

Giving them free beer would have the same effect.

BobMbx on May 2, 2013 at 11:34 AM

I’m in Colorado, it’s free weed here.

kirkill on May 2, 2013 at 11:54 AM

His shining achievement, is a failure?

Oh Noz.

Failure!? I dunno….maybe it actually achieved the objective sought.

hawkeye54 on May 2, 2013 at 11:54 AM

Results never matter to libs.

Only intentions.

Which must always be fixed by “more funding” (Reid, et al., Since Forever).

Difficultas_Est_Imperium on May 2, 2013 at 11:55 AM

I’m in Colorado, it’s free weed here.

Hmm…. beer, weed, and Doritos, forming the major food groups of slacker health.

hawkeye54 on May 2, 2013 at 12:00 PM

Water, wet. Film at 11.

CycloneCDB on May 2, 2013 at 12:01 PM

The issue here is the same as educational spending. Money does not equal outcome, because you can’t change the underlying fundamentals of personal accountability.

Government spending is no substitute for good parenting, nor is it substitute for making good life choices. Of course some people suffer health ailments which are not within their control, but many “poor outcomes” can be directly correlated to lifestyle. And there is a demographic which simply does.not.care, no matter how often Michelle Obama tells them to “move!”

And no surprise on the ER utilizations. Those are “free” to folks with Medicaid.

byepartisan on May 2, 2013 at 12:03 PM

Government spending is no substitute for good parenting, nor is it substitute for making good life choices.

byepartisan on May 2, 2013 at 12:03 PM

News today shows that DC has the highest number of out-of-wedlock births in the nation at 50%. I guess they really do have bastards all over the place there.

Seriously though, I heard that statistic and the only thing I could think about is the number of those bastard babies that will start off life on the public dole and never EVER leave it.

Happy Nomad on May 2, 2013 at 12:08 PM

So, in a nutshell, Utopia is spending money that you don’t have, to achieve results that don’t happen.

OhEssYouCowboys on May 2, 2013 at 12:11 PM

Don’t worry everybody. Mika’s is hosting Food Nazi Week on Morning Joe all next week. She will scare and nag all the plebs into eating healthier.

Lance Murdock on May 2, 2013 at 12:18 PM

This result is a REPLICATION of the Rand Study from years ago.

Dr. Drew Foy: “[w]e know from the Rand Study that individuals with ‘low premium’ coverage consumed LESS care than those with comprehensive’ coverage but experienced no difference in outcomes. As this was a relatively short social experiment, the reduction in costs is not likely related to pricing mechanisms related to comprehensive coverage but rather, related to over-consumption of services. This is a critical point in my opinion that consumer-driven or low-premium high-deductible coverage would address.”

http://bit.ly/ziaEkz

goy on May 2, 2013 at 12:18 PM

Obviously more money, that we don’t have, needs to be spent in order to accomplish……nothing.

GarandFan on May 2, 2013 at 12:19 PM

This is an “identity” issue for Democrats — they’ll fight to protect the welfare state, whether it works or not, whether we can afford it or not — and as with abortion (or guns on the rightleft), they won’t cede an inch on “slippery slope” grounds. Even if they were convinced that Medicaid isn’t worth the expense, they won’t relinquish a key political bludgeon against the right. Celebrate the result as a win for truth, but not because policy’s likely to shift dramatically.

The right just wants our guns left alone. The left keeps trying to get us onto the slope so they can gradually make us slip.

cptacek on May 2, 2013 at 12:24 PM

It almost seems that the metric is that you can’t really show how much you care unless your program is without merit but you do it anyway because you care so much.

Lily on May 2, 2013 at 11:34 AM

Well, yeah. How you gonna show you care if there’s no problem? If you fix the problem you can’t show you care.

So, people who actually get things done are heartless, unfeeling Fascists.

You know how you can tell they’re Fascists?

Fascists made the trains run on time.

If Fascists cared, trains would have been unrealiable, and then throwing more govt. money at the train operators- ala Amtrak-would have showed how much they care.

So, efficiency, frugality, and results in govt = Fascism.

questionmark on May 2, 2013 at 12:26 PM

Libs deal in feelings, not facts. Same thing with Head Start. Kids aren’t better off, but lefties want it to be true, so the facts of the matter don’t count. After all it’s our money being being squandered, not theirs.

erp on May 2, 2013 at 12:27 PM

So, in a nutshell, Utopia is spending money that you don’t have, to achieve results that don’t happen.

OhEssYouCowboys on May 2, 2013 at 12:11 PM

Yaaaaayyyyyy! We’re There!

questionmark on May 2, 2013 at 12:28 PM

Major Medicaid study from Oregon: Program does little to improve people’s health

…that’s a really really Red State isn’t it?…who would believe them?

KOOLAID2 on May 2, 2013 at 12:29 PM

So, in a nutshell, Utopia is spending money that you don’t have, to achieve results that don’t happen.

OhEssYouCowboys on May 2, 2013 at 12:11 PM

Detroit, the Utopian paradise.

Lily on May 2, 2013 at 12:34 PM

Meanwhile, check out this spin from former “conservative”, Josh Barro. He pretty much takes the opportunity to bash private insurance instead of Medicaid. Unreal.

http://www.bloomberg.com/news/2013-05-02/what-to-make-of-the-oregon-health-study.html

cdog0613 on May 2, 2013 at 12:34 PM

So, in a nutshell, Utopia is spending money that you don’t have, to achieve results that don’t happen.

Depends on what the real definition of “results” is. Perhaps to some, the results achieved were the results desired.

hawkeye54 on May 2, 2013 at 12:36 PM

I’m not connecting the two. I posted this earlier today and it is interesting…

Eugenics And The Nazis — The California Connection

Resist We Much on May 2, 2013 at 12:36 PM

An person who has an unhealthy lifestyle will be still be unhealthy, even if they have health care.

How hard is this to understand ???

williampeck1958 on May 2, 2013 at 12:44 PM

An person who has an unhealthy lifestyle will be still be unhealthy, even if they have health care.

How hard is this to understand ???

For at least half of the population, unfathomable. And many don’t think about the ramifications nor care. And many will continue on with unhealthy lifestyles oblivious to the eventual physical deterioration of their bodies they will experience.

hawkeye54 on May 2, 2013 at 12:53 PM

Resist We Much on May 2, 2013 at 12:36 PM

Thanks for posting that, RWM.

Sounds like such a Progressive idea…

Now…connect Margaret Sanger to Eugenics.

An small educated unelected self-appointed elite making sure the great unwashed are well taken care of…

Progressivism = fascism.

Can be easily documented if one bothers to search.

Most won’t. Many, many refuse.

coldwarrior on May 2, 2013 at 12:59 PM

How’s that for a new justification for endless billions in health-care spending?

Billions? Sounds like a bargain! Here I figured we’d be talking about trillions!

Kensington on May 2, 2013 at 1:04 PM

This is an “identity” issue for Democrats

Indeed. Next time folks tell you that “access” (a.k.a. ACA) is going to save tens of thousands of lives per year, you might have a talking point to refute that, but you won’t change their opinions.

calbear on May 2, 2013 at 1:06 PM

but it did increase use of health services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.

Getting free money and services lowers the rate of depression? I don’t think these authors know what depression really is. They might mean that it lowered the rate of self-reported dissatisfaction or sadness, but not clinical depression. After all, if their idea of depression is something that giving someone some freebies quickly alleviates then why would anyone ever have any drugs prescribed for that?

As usual, the MediCAID program is a total failure and even in these areas that they try to claim some sort of “WINNING!!” they only serve to undercut normal medicine (not that anyone with a brain ever trusted the psychiatrists, who just make stuff up in order to prescribe drugs and make their field seem more important and relevant than it is).

As to emergency room visits, there are people who like just going to the emergency room when they want to see a doctor and they will not be changed because someone tells them they can make an appointment like a normal person. They are into the whole emergency room thing and will not stop. Anyone with a brain understands this and could have easily predicted the results.

ThePrimordialOrderedPair on May 2, 2013 at 1:15 PM

If it is free….
.
.
.
.
.
.

why waste it?

coldwarrior on May 2, 2013 at 1:45 PM

But, 70,000 more folks have ACCESS. Read the fine print.

Kissmygrits on May 2, 2013 at 1:52 PM

Now…connect Margaret Sanger to Eugenics.

An small educated unelected self-appointed elite making sure the great unwashed are well taken care of…

Progressivism = fascism.

Can be easily documented if one bothers to search.

Most won’t. Many, many refuse.

coldwarrior on May 2, 2013 at 12:59 PM

‘Birth Control: To create a race of thoroughbreds. Unity!’

– Margaret Sanger, Editor, The Birth Control Review, Dedicated to Voluntary Motherhood, November, 1921

Eugenics And The Nazis — The California Connection

The Left’s Lie About Fascism Will Outlive Cockroaches In A Nuclear Winter

Resist We Much on May 2, 2013 at 1:59 PM

Can be easily documented if one bothers to search.

Most won’t. Many, many refuse.

coldwarrior on May 2, 2013 at 12:59 PM

There are none so blind as those who actively refuse to see.

Chaz706 on May 2, 2013 at 2:11 PM

Resist We Much on May 2, 2013 at 1:59 PM

The patron saint of Planned Parenthood…a fascist? Oh, heaven’s how is that possible???

//

coldwarrior on May 2, 2013 at 2:11 PM

Didn’t mean to repost California. Here: Eugenics Links

Resist We Much on May 2, 2013 at 2:17 PM

Well I reckon any health care plan that includes arrest, coercion at the point of a gun isn’t really all that concerned about your health in the first place.

esnap on May 2, 2013 at 5:25 PM