Guess what? Medicaid does work
A new Medicaid study out last week is drawing lots of attention. The New York Times, the Boston Globe, the Wall Street Journal, and others are all writing about it. The authors say it is the first randomized study of its kind in 40 years, and it shows significant and positive benefits from providing public health care services for people who can’t afford them. According to the authors, this is also the first study to look at the financial benefits of having health insurance.
The study was done in Oregon, which offers health insurance to poor adults who don’t qualify for the regular Medicaid program. Because money is tight, enrollment in the Oregon Health Plan is limited, and in 2008, the state held a lottery to fill 10,000 openings. The lottery provided a unique opportunity to researchers to have two large, random samples of people: one group with health insurance and the other without. The working paper that was released this week is based on the results of the first year of the study.
(For those who are interested in reading the study itself—not just news reports about the study—it’s available for $5 through the National Bureau of Economic Research.)
On one hand, the study confirms what seems like common sense. People with health insurance are more likely to see a doctor, get regular check-ups, take prescription drugs—in short, seek medical care when they need it. But what becomes clear from news accounts is that there appear to be plenty of skeptics who question whether poor people benefit from having health insurance.
Pardon my naiveté. I thought the health debate was all about the money: how do we bring health care costs under control so we can afford to provide medical services for everyone who needs them. I didn’t realize that some are arguing—and I can only I assume with a straight face—that poor people would be better off without health insurance than with the publicly funded Medicaid program.
Something tells me this study won’t hold much sway with those who have such little regard for fellow citizens. Let’s hope the policy makers have more compassion.
This is an important and landmark study that I hope will be read widely. As the Director of a free clinic that treats the uninsured, it confirms what we already knew about the profile of the uninsured from our own patients here in Vermont, and studies by the National Association of Free Clinics. However, the direct comparison available for this study should influence policy makers profoundly.