Saturday, May 4, 2013

Oregon Medicaid Expansion Has No Measurable Effect

Here in North Carolina, we’ve been debating the expansion of Medicaid.  Liberals and their mouthpieces in the media are vociferous in their outrage that the republican led General Assembly and governor have declined the federal government’s overtures.  They believe it is inhumane not to provide “free healthcare” to those who are in need.
The simple fact is expanding the roll will not improve health care outcomes, and neither the state nor the federal government can afford the expenditures.  A recent Oregon program has validated what we conservatives have known all along.  Here is an I told you so moment by FreedomWorks:

During the battle against the government takeover of health care, conservatives were scorned for questioning the ability of a huge bureaucratic program to meet the medical needs of those without coverage. Conservatives and libertarian policy experts had many concerns about expanding government coverage, especially Medicaid. Not only because of the enormous costs, but also the likelihood that expanding such programs and dumping large numbers of people into an already broken system would only add to the numerous problems providing timely access to quality care. Yesterday, a report proved these naysayers right in many regards.

In 2008 Oregon expanded its Medicaid coverage with a lottery system. The state could not afford to cover everyone who qualified, but they did cover an additional 30,000 of the 90,000 residents in waiting. This new expansion allowed for researchers to contrast specifically designated health care outcomes for over 6,300 low-income adults now covered under the expansion to 5,800 who were not picked in the lottery.

The New England Journal of Medicine published The Oregon Health Insurance Experiment, (OHIE) conducted by the nation's top health policy experts. The study found no measurable effect on any of the measured physical health outcomes studied. Participants spent on average 35% more than those not on the plan, averaging over $1,150 per person.

That's right, even with access to medical care and increased spending, those on the expanded Medicaid program showed no measurable physical health benefits over those not selected. The study states:

“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.”

After reading Avik Roy's take on this study, I spoke with him about the most significant findings and what conservatives should take away from all of it.

"Here's what's most important to note; we're currently spending over $450 billion a year on Medicaid, and we're about to spend over $600 billion a year for a program that does not appear to actually achieve the goal of helping the poor become healthier. I am not opposed to spending money on the poor, I'm opposed to wasting money on the poor. The dominant argument from the Left is that we must spend more to help these people, and we have, but it's not achieving the goals."

As Philip Klein puts it "The landmark study shatters liberal health care claims" stating:

"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 doctor's 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 save money by reducing costly emergency room visits."

As I said in the opening line, it doesn't feel good to be right this time. I think I can speak for all conservatives when I say that we want the poorest and most vulnerable members of society to have access to quality health care. We want the sick and the elderly to be able to access a doctor when needed and have the ability to make decisions for their health that benefit them and that also does not waste the taxpayer's money. Unfortunately, Oregon shows us that pouring more people into an already burdened and broken system is not the answer.
Somebody get a hold of the Charlotte Observer and give them a copy of this study.  It won’t do any good?  I’m afraid you’re right.  This study doesn’t comport with the left’s mantra of republicans are at war on women and the poor.

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