How Much Should We Value a Health Care Program that Doesn't Provide Significant, Measurable Physical Health Benefits?


Noah Strycker |

If you're so inclined, you can read the second-round results of the Oregon Health Insurance Experiment as justifying Medicaid on the simple basis that it helps people, somehow, even though it doesn't appear to improve objective physical health measures in a statistically significant way. The study showed pretty clearly that Medicaid insulates beneficiaries from financial shocks associated with large health expenses. It also showed that Medicaid beneficiaries screen positive for depression far less than those who aren't enrolled.

But is that really enough to justify the program's existence—or planned expansion under Obamacare?

Medicaid is supposed to be a health care program. It's supposed to make people healthier, physically. And it ought to do so in ways that are clear after careful, rigorous scrutiny. That's the rationale for spending roughly $7 trillion on it over the next decade. But the OHIE results suggest that Medicaid may not do that. 

If that's the case, then you have to ask: What, exactly, is the point of a health program that doesn't obviously provide significant measurable physical health benefits to those who are enrolled? You certainly wouldn't design it from the ground up that way. If what we really want is a program that helps the poor screen positive for depression less often and cushions low-income individuals from health-related financial shocks, then what we probably ought to be doing is developing a program or programs that are primarily intended to do that. We could probably build a program that accomplishes those goals for a lot less than we spend, or are projected to spend, on Medicaid.

On the other hand, if what we actually want is a program that helps achieve statistically significant, measurably better physical health outcomes amongst the poor, then we probably ought to be trying to design a program that does that, and can be shown to do that in a high-quality examination. Instead, the folks who continue to back Obamacare's Medicaid expansion are fighting to expand a program that, in the single best study of Medicaid's effects ever conducted, doesn't meet that standard. 


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  1. I can’t be the only one who sees that picture and wonders why there is a giant dick with Portland written on it.

    1. If your dick is green and covering in light bulbs, you need to go see a doctor.

      1. Or change your name to Dirk Diggler.

      2. It must have been a dream I had. On closer inspection, my dick doesn’t say Portland on it at all. And it is connected at one end to my groin.

        1. My dick does. Where do I go for this kind of problem?

      3. If your dick is green and covering in light bulbs, you need to go see a doctor.
        According to recent studies, that won’t help, especially of the government pays for it.

        1. But you’ll be less depressed about it.

          1. True. Apparently, that is all you need no matter how much it costs.

  2. If you are receiving government assistance for healthcare, you’d better be a vegetable eating, exercise doing mutherfucker. Doing everything you can do keep your costs down.

    1. Incentives! How do they work?!

      Don’t worry. Bloomberg and countless other do-gooding busybodies are working on it.

    2. I wonder where people got the idea that taking a pill or getting a shot was a substitute for that? Even Woody Allen knew better when he wrote “Sleeper.”

  3. If that’s the case, then you have to ask: What, exactly, is the point of a health program that doesn’t obviously provide significant measurable physical health benefits to those who are enrolled?

    You’re presuming that our masters actually give 2 shits about results.

    Once you have publicly emoted your intentions and supposed compassion, all else is moot.

    1. That’s it: Intentions trump all.

  4. You’re missing the entire point. Healthcare is a service like any other. It should not be free unless the person offering it volunteerly gives it away. People should not be forced to provide it, as this theft and slavery. Something progtards can’t seem to get through their miniscule sized brains.

    1. No, YOU are missing the entire point.

      Healthcare would be voluntarily given away (just like it is in Europe), if only it wasn’t for all the corporate greed. If only the opponents of healthy people would get out of the way and ALLOW people to be treated for free, than we can finally overcome all their oppression.

      Afterall, health is not a business, it’s a human right.

      1. Not bad. Needs more flecked spittle.

  5. The evidence just keeps piling up in favor of “showing that you care” theory.

  6. A further amazing (and entirely depressing) point is that Medicaid has been around since 1965, having spent trillions upon trillions of dollars since that time, and this is the first time the government has bothered to do a high-quality study to figure out if all that money achieves the program’s stated goals.

    1. In fairness the govt didn’t commission this one, so they didnt “decide” anything.

      Secondly, random trials like this are hard to come by since they essentially involve human experimentation. The Oregon situation is, I believe, the first time Medicaid benefits were handed out via a lottery system of eligible participants.

      1. I’m not sure how this makes it better.

  7. Look motherfuckers! Do we end Headstart because it doesn’t achieve it sprimary stated goal of helping “under-privaleged” kids suceed academically? No we do not. Do we end DARE because there’s real evidence that kids in the program are *more* likely to do drugs? What the fuck, of course not.

    DEA, agriculture, HUD, Education, I could go on and on about all the programs we don’t end and departments we don’t close despite their not achieving anything close to their stated goals. Stop picking on Medicare like its some sort of anomaly.

    1. Stop picking on Medicare like its some sort of anomaly.

      This story isn’t even about Medicare.

  8. “How Much Should We Value a Health Care Program that Doesn’t Provide Significant, Measurable Physical Health Benefits?”

    If it provides distortions in the marketplace which benefit my political crony supporters, and lines union pockets with gratuitous benefits extorted from the real economy, and it produces the illusion of providing benefits to ‘the poor’ which pleases ignorant young middle-class voters, then it is of GREAT value to politicians.

    Health? Silly lad. Soon you’ll be suggesting the TSA is actually about ‘stopping terrorism’. LOL

  9. Now there is a dude that knows whats going on man, WOw.

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