Obamacare

Should Taxpayers Pay for Health Coverage that Doesn't Improve Health?

|

whitehouse.gov

I agree with much of what Bloomberg's Josh Barro writes in his response to last week's big Medicaid study, the first experiment to compare individuals randomly selected to get Medicaid with a control group of individuals who were not selected.

Despite finding that Medicaid beneficiaries have lower incidence of depression and reduced likelihood of facing outsized health expenses, Barro says that the study is "bad news for advocates" of Obamacare's Medicaid expansion. That's because "it did not find significant effects on the physical health measures that were tracked." The study did find some physical improvements, but not at the level of statistical significance. As a result, he writes, "even if Medicaid does improve physical health outcomes, this study suggests the effects may not be large." I am even inclined to agree somewhat with Barro's argument that the study should be taken "as an indictment of medical insurance broadly" instead of just Medicaid; the study tells us more about Medicaid in specific than it does about insurance overall, but it does suggest that there may be a fair amount of over-insurance built into the system.

Yet this leads Barro to conclude that conservatives—and presumably most other critics of the president's health law—should have been more engaged in the process of designing the law that became Obamacare.

Still, the "I knew Obamacare was a waste of money" reactions are misplaced. The financial effect is a big deal. Having Medicaid reduces your likelihood of facing medical expenses that exceed 30 percent of your income by 80 percent. 

…All of this makes me wish even more that conservatives had been productive partners in health reform rather than trolls. If conservatives want a consumer-directed redesign of the U.S. health-care system that forces patients to pay at the margin more often for care—in order to reveal what treatments are useful—they could have gotten it as part of the health-care overhaul. They just also had to agree to include the progressive fiscal reforms that liberals wanted: ensuring universal coverage and transferring money toward poor people who can't keep up with the rapidly rising cost of health care.

So it's worth paying for the high(er) health expenses of Medicaid beneficairies even though those additional expenses don't appear to produce better outcomes? The Oregon experiment clearly showed—as previous studies have shown—that individuals who got Medicaid utilized significantly more health care services, and thus had significantly higher health expenses. One effect of Medicaid, then, is to subsidize the purchase of additional health services while insulating individuals from the cost of those services. But why should taxpayers continue to fund increased use of health services if they do not lead to significantly better health?

Nor do I detect a strong case for why Obamacare critics should have worked with Democrats to pass the health law. Barro writes that the study "is yet another argument for 'some health care for all but not too much.'" I am not as confident that a study showing little to no physical health benefits from health insurance is any kind of argument for publicly subsidizing health insurance. (Again, it's clear that health coverage increases health services utilization, but less clear that it improves health).

But even if it is, there's little reason to believe that Democrats would have been willing to go that route with Obamacare. Barro's financial-risk focused "not-too-much" approach would have pushed the law in the general direction of universal catastrophic insurance, or, at the very least, less comprehensive coverage. But Obamacare's Democratic authors made the law's guarantee of certain broadly defined "essential" benefits a key part of the law. And Health and Human Services Secretary Kathleen Sebelius has made it clear that her concept of meaningful health insurance does not include simple protection from catastrophic health expenses. "Some of these folks have very high catastrophic plans that don't pay for anything unless you get hit by a bus," she said recently at a congressional hearing. "They're really mortgage protection, not health insurance." The clear implication is that health insurance should pay for a bunch of health services, not merely protect one from unusually large health expenses. And sure enough, what the Oregon Medicaid study reveals is that Medicaid pays for a lot of health care expenses—but doesn't, in the process, appear to significantly improve one's physical health.

Advertisement

NEXT: Obama Golfs with Republicans

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. HATERZ!

    It’s the government’s money and you greedy fracks need to learn to let government spend it, because they kknow how to spend it best..

    /moonbat off

  2. That’s beside the point, I shouldn’t be forced to pay for any healthcare, even if it improves my health.

    1. It’s not beside the point when so many of the tools making the argument for doing so are using utilitarian-like arguments. “Even on your own terms, your argument fails” is a lot more straightforward than arguing libertarian premises with which they probably won’t agree.

    2. I don’t want to have emergency medical personnel rifling through my pockets looking for a “please treat my massive head wound” card just because you have a stick up your ass about taxes.

      1. Okay, but that’s not something that was on offer. And the data from the Oregon study suggests that it’s extremely unlikely that PPACA or Medicaid will reduce emergency room usage and thus taxpayer subsidizing of such procedures. If the same amount of emergency room costs accrue to people who can’t afford them, it really doesn’t matter the exact method by which they are subsidized, whether it’s the hospitals forgiving the bills and making it up elsewhere with everyone else, or direct taxes.

        1. I guess the only way it matters is in terms of cost savings.

          Because of economies of scale, not to mention an entire planet of evidence, it seems to be the case that the more centralized a healthcare supply scheme, the cheaper per capita.

          1. You do know that Canada’s health system is province by province, right? Apparently they need to be told about your economy of scale argument.

            For your homework, google “diseconomy of scale” where organizations become too large to manage effectively, eg. Los Angeles School District.

            1. Canada, every flaw of whose system is pointed out as an argument against socialized medicine? Maybe they could do better with a national program. The US has uniquely high per capita healthcare costs, and the other unique thing about its system is its nonuniversality. Maybe not a causal argument but it’s definitely not in the other direction either.

      2. Emergencies have been treated for everyone for some times, and there was no chance of that changing, so I’m not sure what your point is. Surely you can’t be still suggesting that PPACA will reduce emergency room usage, rather than simply changing the flow of the subsidies?

        1. I was responding to the specific and direct moral argument presented. nilecroc doesn’t want to be “forced” to pay for healthcare. But that means you can’t treat an unconscious patient out of fear that she’ll have a grievance about it with respect to cost. So either those of us who prefer to be treated in an emergency–always regardless of cost, mind you (some market mechanism there)–have to have some sort of card IDing our preference (of course wasting precious time in an emergency as personnel hunt for it), or we’re shit out of luck because of said tax ass-stick.

          Let’s just treat healthcare as the unique market it is–nobody wants to participate in it, but we all have to. It’s not a crispy chicken salad vs. a basket of riblets at Applebee’s. It’s a basic need in the modern world. Pure market principles don’t apply.

          1. “But that means you can’t treat an unconscious patient out of fear that she’ll have a grievance about it with respect to cost”.

            This could easily be dealt with using an insurance model. The vast majority of unconscious patients will want their injuries treated and will not have a grievance after the fact. There will be a very small but predictable number of people who will have a grievance and will file actions. A certain percentage of those actions will be successful and they’ll have a certain average cost. Seems like a pretty easy thing for an actuary to work with…

            Robert Nozick treats this basic phenomenon on, like, page 1 of “Anarchy, State, and Utopia”…

            1. “Let’s just treat healthcare as the unique market it is–nobody wants to participate in it, but we all have to”.

              I call bullshit. Health care is certainly not a unique market. Food, water, energy, etc – they all are markets that we’re forced to participate in. And what do you mean by “nobody wants to participate”? They don’t want to pay for the goods? Well, I don’t really want to spend my dollars on those other goods, either. I do so because their value to me is higher than that of dollars. I believe that’s the case with health care for most people, as well.

              1. What distinguishes healthcare from markets in other basic needs is the cost of the latter is relatively predictable. (Still we subsidize them purely because they are basic needs.)

                1. The cost of healthcare is quite predictable in aggregate, otherwise it’d be impossible for health insurance to exist. Sure, the cost of healthcare for an individual can vary, which is why insurance exists for it, just like there is insurance for home and car, which are big ticket items which could bankrupt someone if something really bad happened. You’ve just decided that healthcare is some special category because it suits your political objectives.

                2. Tony| 5.6.13 @ 6:59PM |#
                  “What distinguishes healthcare from markets in other basic needs is the cost of the latter is relatively predictable”

                  What distinguishes you from humanity is your IQ.
                  No, shithead, there is no such thing as ‘basic needs’ and if such were predictable, we’d all be rich.

                  1. For those with intellectual honesty, I’d highly recommend Nozick’s “Anarchy, State, and Utopia”. The first chapter is difficult, but it deals with these types of issues in an interesting manner.

      3. Tony, emergency medical personnel are already required to treat your emergent condition regardless of your ability to pay and have been by law since the 1980s when EMTALA was passed. Prior to that, they were treating those conditions anyway, because healthcare people are charitable people. It’s seen as an obligation of the profession. You are arguing about a problem that doesn’t exist.

      4. Shithead posted this:

        …”just because you have a stick up your ass about taxes.”

        No, shithead, it’s about guns.

  3. “No, fuck you, cut spending.”

  4. People in general and liberals especially, being morons think the world always works in a linear fashion. So if you throw 20% more resources at something, you should get a 20% improvement. Of course the world works nothing like that.

    This result shouldn’t surprise anyone who has thought about the issue. Remember, we are talking about poor people here not old people. Old people are covered by medicare. So medicaide recipients are under 65. So what healthcare is the government going to provide to people under 65 that actually improves their health? Most people who are under 65 are healthy. And if they are not, it is more than likely due to some condition that is created by their own behavior like smoking or being too fat. Giving people health insurance is going to get them to stop smoking or eating too much.

    In order for health insurance to improve health, there would have to be some kind of health problem that right now is effecting poor people’s health that is not being treated but would be treated when these people get health insurance.

    Now some say that the preventative healthcare unicorn will magically appear and make us all more healthy. But study after study has showed preventative health care doesn’t do any good. Sure, you will occasionally find the person with some latent health problem that can be treated before it gets worse. But, there are never enough of those cases to justify the expense of providing preventative healthcare to everyone.

    1. But, there are never enough of those cases to justify the expense of providing preventative healthcare to everyone

      Nor are their enough doctors to provide that preventive care. You can enact a law requiring unicorn ownership, but that doesn’t mean unicorns are out there.

      1. Yup. And the obsession with preventative care just takes finite resources and uses them to look up healthy people’s asses instead of actually treating people who are sick.

    2. Perhaps unaware, you’re making the argument for why universal healthcare is good anyway.

      If insurance (private or public) doesn’t improve health outcomes, at least it eliminates unpredictable catastrophic costs. Which is sort of the point of many a government program.

      1. It doesn’t eliminate any costs, unless you plan to stop treating the sick. It just shifts them to the government. And further, catastrophic costs are currently dischargable in bankruptcy. So no one remains in poverty because of medical costs.

        1. We shouldn’t have this government insurance program because we already have this other government insurance program?

          I’m still waiting for the free market to enter the conversation.

          1. What are you even talking about you idiot?

            1. Bankruptcy is a government bailout. If it’s somehow such a good alternative, why would anyone be on private health insurance?

              1. So the government pays the debts of bankrupts? No, bankruptcy is the creditors eating the costs, which happens. It is a cost of doing business.

                The bottom line is the costs remain the same unless you are willing to say the government will step in and stop people from getting care they are currently getting. But death panels are a myth right?

                All the government program does is increase costs by hiring bureaucrats and give the government the power to kill the sick, which is of course the end game of all government run healthcare scheme. Murder is the end game of all leftists schemes.

                1. Except for all available data in the world, you might be right.

                  And for the life of me I can’t figure out why someone seemingly intelligent as you must always take a hard left turn into crazytown. Jesus Christ man, get a grip.

                  1. Except for all available data in the world, you might be right.

                    The data in your head doesn’t count. And the brutal mistress that is math isn’t going to allow you to pretend that cost shifting is the same as cost savings.

                    And yes, Tony, you are an adherent to a murderous ideology. All roads lead to murder for you people.

                    1. Since practically the only thing that factors into my political beliefs is how to reduce death and increase quality of life, that would be quite a tragic irony.

                    2. The road to hell Tony is always paved with good intentions. So that doesn’t surprise me in the least.

                    3. So your intentions are intentionally malicious? It would explain so much! Ah cliches.

                    4. Access to medical care does not always lead to more health. In fact it can do the opposite. Unnecessary procedures, prescribing pills you really don’t need, complications from marginal surgeries, etc.

                    5. Plenty to be reformed in our healthcare system. Incentives are totally out of whack, and it’s not because of liberal reform efforts (but to pro-corporate reform efforts).

                    6. Tony, you are just deliberately dishonest or you really do lack the capacity to understand the implications of the things you say. You want a huge government apparatus to run healthcare because you think it will make everything better, but complain that the current system, which is not nearly as big as the system you want, is rife with corruption. The bigger the government is and the more money flows through it, the more incentive there is for lobbying and corruption to occur. I’m waiting for your explanation as to how this problem will be solved.

              2. Tony| 5.6.13 @ 4:47PM |#
                “Bankruptcy is a government bailout”
                Shithead posted this.

          2. We shouldn’t have an incredibly roundabout inefficient more expensive government program that isn’t about catastrophic costs nor targeted at it instead of a well-designed program.

            Like Josh, I’d be fine with a universal program aimed at catastrophic costs, a universal HSA with a government contribution for the poor. But that’s not what was on offer, and I think that Peter is correct to think that the problem of too many Democrats, especially in the Administration, (as well as ordinary voters) not considering it “real insurance” made it difficult to impossible to achieve.

          3. A free market in health insurance would allow individuals to choose the level of insurance that best suits their means, needs, and appetite for risk. The competition would also give insurance companies an incentive to reduce costs and lower the cost of insurance.

            1. What if people universally underestimate their risk, which seems to be true? I don’t think people are particularly rational actors in any market, and this one perhaps least of all. Why can’t we just assume some amount of the inevitable risk of being a human being and socialize the cost? Seems to be cheaper that way.

              1. Why can’t we just assume some amount of the inevitable risk of being a human being and socialize the cost?

                Because I know my max out of pocket cost in a year and I know how much I have in the bank. I don’t need or want to be part of your bullshit idea.

                1. So you have placed a (socioeconomic-status-based) value on your own life? It would be rude to ask what you value your life at, but what you’re saying is it’s valued at whatever you can afford?

                  1. No, dimwit, I have an insurance policy with a $5,000 deductible which is also a $5,000 maximum out-of-pocket policy. My maximum risk for healthcare costs in a year is $5,000. I have enough in the bank to cover that even if I went into the hospital on 12/31 and had to pay two deductibles for the the same event.

                    To the extent I am not willing to pay more to get a higher lifetime cap than $5,000,000 I’ve put a value on my life, or at least indicated how much I’m willing to spend to save it. How many people incur that much cost?

              2. What if people universally underestimate their risk, which seems to be true?

                Is it? I’ve seen studies indicating that on average people are bad at estimating certain types of risk, but that is far from saying people are universally bad at estimating all risk. But even if you’re right, insurance companies are most certainly good at estimating risk, and the cost of a plan to the individual is a reflection of the risk that individual faces. It is also a strong incentive to lower his/her risk, thus lowering his/her insurance costs

                I don’t think people are particularly rational actors in any market

                I think the awe-inspiring progress made in standards of living over the last couple hundred years refutes your assertion.

                Why can’t we just assume some amount of the inevitable risk of being a human being and socialize the cost?

                Because risk depends a lot on individual circumstances, which are not inevitable and can be changed.

      2. If insurance (private or public) doesn’t improve health outcomes, at least it eliminates unpredictable catastrophic costs.

        Yes. But a program designed to eliminate unpredictable catastrophic costs was not on offer, because too many Democrats were dead set against it.

        1. Exactly. HDHP is exactly the kind of insurance I have, and want, because I don’t need insurance for non-catastrophic costs. But the fuckwit-in-chief and his idiot minion from Kansas want to do away with it. So the one thing insurance is good at is going to be taken away because it isn’t “real” insurance. Fucking retards.

  5. The study did find some physical improvements, but not at the level of statistical significance.

    Then it didn’t find any physical improvements.

    1. ^^THIS^^

      If it is not statistically significant, then it is noise and there is nothing there.

    2. Material failures + immaterial successes = SUCCESS!!!!!

    3. Right. Not significant means not found.

  6. Should tax payers pay for “health coverage”? What the fuck is that anyway?

    1. Why should we pay for any of this crap? It’s not like government does things efficiently or well.

  7. Should taxpayers pay for…?

    No. GFY.

  8. All of this continues to be a debate over which end of the soft-boiled egg to crack.

    Obamacare is designed to fail so that single payer Medicare for all can be put in place. That’s it. The fact that it suckes is a feature–it’s misdirection designed to tire us into compliant weariness once singler payer comes.

    1. I’m not quite convinced that’s the planned endgame, because the political failure of ObamaCarousel doesn’t automatically equal MORE GOVERNMENT INTERVENTION!!!! In fact, the reverse could happen.

      On the other hand, they’ll certainly try to do that when this fails.

  9. It amazes me how stupid people are. It really is a cargo cult. Someone says “state provided healthcare” and all of these idiots think that means people’s health will improve with ever bothering to consider just what health problems the health care is going to treat or how such care is going to make people healthy.

    But the words, the words sound so good. How could giving people free health insurance and care not make them more healthy?

    1. You can legislate a system, but you can’t legislate the personal behavior that’s needed for people to participate in a system.

      And the thing is, we see that happen right now, every day–tons of people don’t sign up for things they’re eligible or don’t do things that are personally helpful. Why would we think they’ll flock to Obamacare? Because the Left is wishing really hard this time?

      1. It is worse than that. Even if people sign up for it, the system has no means of improving their health. Most people don’t need healthcare or to the extent they do it is the result of behavioral factors that heath care isn’t going to treat.

      2. tons of people don’t sign up for things they’re eligible or don’t do things that are personally helpful

        Clearly we need to spend more on advertising campaigns.

        1. That’s part of the reason why food stamp recipient lists have boomed–recruiters.

          My mother-in-law was called by a local senior center employee who said she was eligible, so she signed up. I guess her Fidelity account and paid-up $250,000 condo in a 55+ community doesn’t count against her eligibility.

      3. I can’t find it online, but I was filing testimony at HHS one day about 7 or so years ago and i was flipping through stuff from the late 60s that was being boxed up and sent to some sort of Indiana Jones warehouse … .anyway … found this testimony that essentially said that with enough browbeating, the number of “too prouds” to accept Medicaid was on the decline.

        1. The safety net has become a safety hammock.

    2. John, why do you think that these people think that general health will improve? These are people who can’t understand that today’s poorest live much better than the rich of only a few generations ago. I think it’s based on envy more than anything.

  10. All of this makes me wish even more that conservatives had been productive partners in health reform rather than trolls.

    In other words, it would be convenient for Democrats if the Republicans could share the blame for this fiasco.

    Keep in mind that Josh Barro is one of the idiots who thinks the trillion dollar coin is an awesome idea.

    1. Conservatives are of course knuckle dragging morons, except of course on the subject of healthcare. There they are apparently philosopher kings whose wisdom could have made Obamacare work if only they had decided to be reasonable and not just trolls.

    2. Note there is no blame to the side that said “I won” and did not allow any Republican input. And of course, when the Republicans gained some tiny measure of power with Scott Brown’s election, the dems didn’t stop to negotiate but rammed through what they wanted.

      1. Precisely. Democrats quite blatantly didn’t want any Republican cooperation. That’s why they needed 60 votes in the Senate, because they weren’t willing to come up with something bipartisan, and Republicans were actually smart enough for once to run away from this steaming pile of smeg as fast as they could.

  11. I am even inclined to agree somewhat with Barro’s argument that the study should be taken “as an indictment of medical insurance broadly” instead of just Medicaid

    I remember all the talk about how Americans spend more on healthcare than anyone else but aren’t any healthier. I never understood the confusion, because it seems like a pretty obvious answer – there are lots of fat, unhealthy Americans, and having insurance that pays for your diabetes and high blood pressure treatment doesn’t make you any less fat or unhealthy.

    Health and Human Services Secretary Kathleen Sebelius has made it clear that her concept of meaningful health insurance does not include simple protection from catastrophic health expenses

    Then she doesn’t understand the point of insurance.

    1. I am even inclined to agree somewhat with Barro’s argument that the study should be taken “as an indictment of medical insurance broadly” instead of just Medicaid

      I am inclined to think the writer of that sentence is an idiot. The point of insurance is to protect you against risk. Since when does sending a check to an insurance company make you more healthy? It is like saying having auto insurance makes you a better driver.

      Are people really so retarded that not one but two writers at reputable publications fail to understand the point of insurance? Do they really think you buy insurance to make you healthier rather than protect you from the risks of some day not being healthy?

      1. if it made you healthier, it would be the point. since it does not, it’s not.

      2. I think it is a sign of just how messed up the health insurance system is these days. There is now an expectation that “health insurance” should cover even routine doctor’s visits. I’m not sure why people don’t understand that this is the equivalent of expecting car insurance to cover your routine oil change.

        1. And it also is based on the idiotic assumption that doctor’s visits are some kind of fungible good that will automatically produce a desired result as if everyone visiting the doctor more will make them more healthy.

          It amazes me how stupid people are on these issues.

          1. Excellent point.

            1. I’m not sure that’s what Suderman is getting at. I think he means that the health outcomes obtained through TODAY’S insurance policies are subject to indictment. That is, the fact that insurance companies cover lots of things that shouldn’t be insured doesn’t make anyone healthier. It’s probably true for the same reasons the Medicaid findings are true.

  12. My Liberal leaning friend, who just finished Medical School, sent me an article from Mother Jones stating the study was bunk from the get-go.

    http://m.motherjones.com/kevin…..caid-study

    Thoughts?

    1. The crux of the argument seem to be this breathless assertion that

      The problem is that, for all practical purposes, the game was rigged ahead of time to produce this result. That’s not the fault of the researchers. They were working with the Oregon Medicaid lottery, and they couldn’t change the size of the sample group. What they had was 1,500 people, of whom about 5.1 percent started with elevated GH levels. There was no way to change that.

      Maybe I am dense but I am not seeing at all why that makes the study unreliable and see no explanation in the article why it does. It just asserts it and goes on to explain how if the sample was wrong the whole study was wrong.

      Color me surprised that Mother Jones would produced a weak an unsupported argument.

      1. The point is that with that sample size and the relatively few number of unhealthy people in it, the study was destined not to show a statistically significant increase in health outcomes. There’s nothing wrong with the study as far as I can tell (as far as it goes), just with article headlines that say Medicaid has no effect on health outcomes. It wasn’t really able to address that question, but it did find significant positive benefits apart from that.

        1. The point is that with that sample size and the relatively few number of unhealthy people in it,

          That is because the population of the poor under the age of 65 has relatively few unhealthy people in it. Most young people are healthy.

          Providing health insurance to anyone, let alone young people, is not going to make them healthier. To assume it would is to assume there are significant numbers of people out there with untreated health conditions that would be treated if they had health insurance. And in the day and age of charity hospitals and must give care laws, that is simply not the case.

        2. The point is that with that sample size and the relatively few number of unhealthy people in it, the study was destined not to show a statistically significant increase in health outcomes.

          It was destined only if the size of the effect was always destined to be small. A small size (but real) effect requires a higher sample size to demonstrate statistical significance.

          Plenty of people thought that this study was big enough when the first year results were released, or even right before these results were released. It’s only after they didn’t like the results that everything went down the memory hole.

          There’s a relatively small number of unhealthy people who would have immediate adverse events, but there were plenty of people with significant, well accepted markers and predictors of future problems, like cholesterol, blood pressure, and diabetes indicators. Certainly enough to show a result, if the magnitude of the improvement was at all large.

      2. He is saying that for reasonable expectations about how much of an impact treatment could have, the number of unhealthy people (by the markers used in the study) was too small to ever have any hope of detecting an improvement with statistical significance. Basically, they needed either a larger sample size or a pool with more unhealthy people. I can’t comment on whether or not his expectation of improvement is actually reasonable, but the point he is making does seem well grounded, at least at first glance.

        1. It is only well grounded if you assume that the actual population of medicaide recipients contains a higher percentage of unhealthy people than the sample. That is hardly obvious. This guy just doesn’t want to consider the fact that maybe people really are not that unhealthy and thus his sacred cow is a waste of time and money.

          It also assumes that there would be any positive results for healthy people. Again, an awfully wishful assumption.

          1. Rags like Mother Jones are generally filled with ‘awfully wishful assumptions’ from cover to cover.

    2. A couple of good points are made, but don’t justify calling the study “bunk.”

      I have absolutely no doubt that the same author would be writing about how awesome the study was if the results matched what he wanted. You can see this from how he spins the bits he liked.

    3. This, however, strikes me as pure crap

      One fair thing would be to simply say that it’s inconclusive, full stop. It tells us nothing about the effect of Medicaid access on diabetes, cholesterol levels, or blood pressure maintenance. I’m fine with that interpretation.

      Except that it does tell us something about the effect of Medicaid access on diabetes, cholesterol levels, and blood pressure maintenance. It tells us that, over the course of two years, Medicaid’s effect is smaller than the uncertainty in the study. And that should definitely be disappointing to people who expected a larger effect.

      Another fair thing would be to say that the results were positive, but the study was simply too small to tell us if the results are real.

      If you can’t tell if they are real, then the results aren’t positive.

      1. Or there’s a third fair thing you could say: From a Bayesian perspective, the Oregon results should slightly increase our belief that access to Medicaid produces positive results for diabetes, cholesterol levels, and blood pressure maintenance. It shouldn’t increase our belief much, but if you toss the positive point estimates into the stew of everything we already know, they add slightly to our prior belief that Medicaid is effective.

        I’m not an expert on Bayesian statistics, so I can’t comment too much on this. But it seems to me that, if your prior belief was that Medicaid would have a significant impact on outcomes, then this should actually make you less confident that Medicaid produces largepositive results.

  13. In other words, Barro is living in a fantasy world where Democrats would have been willing to limit their healthcare reform ambitions to:

    (a) Requiring everyone to have catastrophic healthcare coverage, and
    (b) Subsidizing it for people who can’t afford it.

    Okay. I want some of what he’s smoking.

  14. Sounds like one heck of a plan dude.

    http://www.Total-Anon.tk

  15. Reverse mortgage is very helpful for senior citizen who are over 62 years.
    http://www.reversemortgagelend…..formation/
    http://www.reversemortgagelend…..-and-cons/

Please to post comments

Comments are closed.