Ezra Klein: Here’s what the Oregon Medicaid study really said

[babylonsister]

Here’s what the Oregon Medicaid study really said

Posted by Ezra Klein on May 2, 2013 at 3:11 pm


The Oregon Medicaid experiment is an academic miracle born out of a human tragedy.

A few years back, Oregon found the money to add 10,000 residents to the state’s Medicaid program. The only problem was that there were 90,000 residents who qualified for the program and desperately wanted in. So the state held a lottery. Welcome to the American health-care system. Greatest in the world, folks.

But 80,000 Oregonians’ loss was science’s gain. The lottery gave researchers an opportunity that’s almost never available in policymaking: They could create a randomized controlled study — the absolute gold-standard of experimental design — comparing the health outcomes of the lucky Oregonians who received Medicaid to those who didn’t. It would be the first time that kind of study had even been used to compare the insured and the uninsured.

The initial batch of results was released in August 2012. The data covered the first year of the Medicaid expansion and found that the folks on Medicaid were getting more care, reporting better health (both physical and mental), and seeing fewer financial problems than the people who weren’t on Medicaid.

The second set of results was released Wednesday. The data now covers two years and, importantly, includes clinical measures of health rather than relying on the reports of the study participants. These results are more mixed, but also more telling.

Here’s what we can say with certainty: Medicaid works as health insurance.


more...

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/02/heres-what-the-oregon-medicaid-study-really-said/

[JaneyVee]

1. So it improves 2 of 3 major problems and keeps one problem the same. Sounds like a win.

Improving Medicaid may be easier than we thought.

[dkf]

3. Did you see that all the care didn't improve health stats except depression?

Exactly what was improved?

[JaneyVee]

5. Mental health and overall economic stability. Those are MAJOR. Nothing unimproved.

[dkf]

13. And if you paid a guy to dig a ditch and fill it up he might be less depressed too.

Even if he accomplished nothing.

[JHB]

14. That assumes you already have all the ditches you need...

...and that nothing else is done, like digging a ditch around a century-old pipe and replacing it with a new one before filling the ditch back in.

Just how marked a deviation were you expecting over two years?

[JaneyVee]

15. Wow, you're really downplaying mental health's effect on our society.

Not to mention the increased economic stability of the program, the enormous costs that mental health problems impose on society by reducing productivity, increasing the incidence of violence and self-destructive behavior, and so on. Also, you're citing inconclusive data, the researchers caution that some health effects might take a longer time to materialize.

So you're against Medicaid expansion?

[zipplewrath]

9. Careful

The data suggests that overall, ANYONE with health insurance, not just medicaid, doesn't particularly show a benefit from their health care in the measures used in this study. That is a problem with our health care system, NOT our medicaid system.

[dkf]

12. That is exactly my point! Treatment didn't work.

People just felt better that they had gone to the doctor and weren't depressed that they needed to use their resources to do so.

Would they be so depressed if we didn't drill into them that they need to check this and that?

[zipplewrath]

16. Well, no depression was where they were so successful.

The people weren't healthy, it just points out that people often aren't healthy because they don't "take care" of themselves.

[dkf]

17. They weren't healthy and they still aren't healthy, but for some reason they are happier.

Hey maybe they are on psychiatric meds and those are the only effective drugs we have. That would be ironic.

[dkf]

2. Geez medicine only works for mental health, not physical health.

But the study didn't see much improvement in the health indicators it was tracking. Blood pressure and cholesterol readings were mostly unchanged. Diagnosis of diabetes went way up, and the use of medicine to control diabetes also went up, but, again, there wasn't much difference on the relevant blood tests. The big exception, surprisingly, was mental health: depression rates fell by 30 percent.

http://m.washingtonpost.com/blogs/wonkblog/wp/2013/05/02/heres-what-the-oregon-medicaid-study-really-said/

What a crazy outcome.

Maybe all we need are fake doctors with placebos. Nuts.

[CTyankee]

4. It seems to me that diagnosis of diabetes would go up. Long undiagnosed symptoms of

diabetes would not be treated and when they finally did get diagnosed, were in full blown stage. That's my sense of what is being said here. My husband is pre-diabetic. He was diagnosed years ago. Since then he has been able to keep from becoming diabetic, through regular medical checkups with his PCP and diet changes.

[JaneyVee]

6. could it be that these people weren't taking the steps needed to help their physical health?

[magellan]

7. Health was no doubt improved and lives saved

...outside of the ailments they bothered to track. I'd find it very curious if out of 10,000 people that weren't the case. Really? Not one cancer caught, not one infection found, not one arrhythmia treated and a life extended?

[ProSense]

8. Here's Krugman

on RW reaction to the study: http://www.democraticunderground.com/10022787503

[s-cubed]

10. Maybe people couldn't afford the medication to treat other problems? nt

[another_liberal]

11. Two years is not enough time for truly valid results.

Check these populations again in five more years and you will see the really great advantages having affordable health care provides, as well as how terrible the consequences of not having any are.

Of course, unless the Republicans have their greedy way, in five years everyone should be covered by Obama care and the point will be moot.