How Half the Newly Insured Are Going To Be Insured
Medicaid patients experience significantly more deaths, longer hospitalizations and more serious complications from major surgery, cancers, heart disease, interventional procedures, transplants and AIDS than equivalent patients with the same illnesses and same health status but with private insurance ― objective data-based conclusions proven by medical scientists in the world’s top peer-reviewed medical journals like Annals of Surgery, Cancer, Journal of Heart and Lung Transplantation and the American Journal of Cardiology. Medicaid outcomes are so shamefully poor that, when comparing patients with the same risk factors and same health status, Medicaid patients at times even fared worse than those with no insurance at all.
“Medicaid patients at times even fared worse than those with no insurance at all.”
Hah, great. So if people were educated they would inflate their income to gain access to the exchanges? Or simply refuse and pay the fines, which I plan to do.
The article mentions that doctors are four times more likely to reject Medicaid patients than those with private insurance. We’ve discussed rationing by waiting, but does the regulation require doctors to accept patients?
I don’t doubt this, but the issue a lot of people have is not that Medicaid or any government-run health care system runs efficiently but that many people cannot afford private insurance or getting treated privately. In that sense, medicaid is the better alternative to no care. So it’s important to ensure access to all levels of income through a privatized system and explain how that is done because this only points out the obvious in my opinion.
I agree with your assessment of the problem, Sam. The problem is that they cannot afford any type of care, not that they can’t get the care.
The fact that more people will be insured under these conditions is troubling, but we have been doing a pretty lousy job in insuring several others all-together, which has led to this new law’s implementation.
The Oregon study really is a great example of a randomized experiment on a large scale.
I like the idea to base reform off the Federal Employees Health Benefits Program
“FEHBP is a successful working model of a premium support benefit, offering financial support for consumer choice among private plans.”
Leadership!
“Instead of illusions, leadership in health care reform should focus on enabling the poor to have a truly substantive health care safety net”
I am scared about the future health our country.
I find that this study is a bit misleading, because the quality of Medicare is not what is causing these people to have higher probability of deaths, serious complications from major surgery (that would be the doctors fault, not Medicare), cancers, heart disease, interventional procedures (again, typically the doctors fault, definitely not Medicare), transplants and AIDS than equivalent patients. Also, you have to consider the demographic of people having to use Medicare. They are typically more impoverished than the average person who has heart disease and has insurance and not on Medicare, which means they almost empirically have a lower quality of health, so they are more inclined to be in a worse position than the average person with the same disease.
True, but what is causing the doctors to perform so poorly? Perhaps they don’t have the same incentives than when operating under private care? Do they have the same resources? I don’t know much about medical practice, so these are simply questions.
I thought we were talking about Medicaid. How is it misleading? Quality care facilities refuse to accept lower reimbursement rates.. so yeah, it sort of encourages complications by forcing people to see subpar physicians.
I have markedly limited new Medicaid patients in my practice. Not because of low reimbursement rates (though I believe this is a sufficient reason) but because of high rates of no shows, missed appointments and non-compliance with recommended treatment along with difficulties in getting patients accepted by other providers for consultation, physical therapy, etc.
The Medicaid population is fundamentally different from the insured population in many respects.
We are really going to be putting everyone on this system? It is already malfunctioning…it will probably collapse under the pressure of increased Medicare users.
My concern is that the same personal problems that led someone to be eligible for Medicaid will lead to worse health outcomes. Eg. perhaps a TB patient on Medicaid is less likely to follow through with their meds because of the lower skills that led them to be on Medicaid to begin with.
This would create a positive correlation between Medicaid and bad outcomes unrelated to the quality of care:
LowEducation -> LowIncome -> Medicaid
LowEducation -> BadDecisions -> BadDiseaseManagement
My impression is that the quality of care under Medicaid is inferior, but can we disentangle the inferior care channel from the poor decisions channel? Controlling for education might help, but this issue probably goes beyond that.
I believe you are absolutely correct in your suspicions- at least for a significant subset of Medicaid patients (see my comment above). Research at the University of Virginia found Medicaid patients had a greater risk of mortality and longer length of stay for major surgery than uninsured patients.