A Skeptical View of the Oregon Health Experiment
So far, the new Oregon Health Insurance Experiment shows that for very poor and sick folks who go out of their way to request medical insurance, giving them such insurance makes them report feeling healthier. Two-thirds of this effect appears immediately on granting their request, and before they actually got more medical treatment. It remains to be seen if these healthy feelings will be reflected in more direct health measures, though that seems plausible, and we’ll probably never see mortality effects. The main results of the RAND experiment, which looked at all sorts of people, suggests doubts about presuming that if medicine helps the very poor and sick, it on average helps everyone.
Full Robin Hanson post worth reading.
I can see how merely being accepted to Medicaid might make the new enrollee feel less apprehensive about the possibility of getting sick and not being able to afford care. However, I wonder how new enrollees feel once they start calling clinics requesting an appointment and find out it’s difficult to obtain one?
I am also skeptical.
I second Devon’s comment. It’s one thing to feel less ill. It’s another to actually receive the treatment that makes the feeling a reality.
If the mere illusion of having “coverage” makes people feel healthier, then Obamacare should be a rip roaring success. Wonder if we can measure the imaginary health benefit effects of O-care prospectively…hmmm
Well clearly we have the best imaginary health in the world:
http://healthblog.ncpathinktank.org/new-report-by-deloitte-center-for-health-solutions/
I think drawing this conclusion is even trickier than this post makes it sound. From reading the Harvard/MIT report’s methodology it looks like the raw data simply says “that for very poor and sick OLDER, WHITE folks IN OREGON who go out of their way to request A CHANCE TO BUY medical insurance, xxxxxxxx SIMPLY WINNING SUCH A LOTTERY GIVING THEM THAT CHANCE (THAT IS, TO “BUY” such insurance) makes them report feeling healthier.”
According to the report, in terms of those receiving the survey, the Harvard/MIT group made the treatment group everyone that “won” the lottery whether or not they actually signed up or even qualified for Oregon’s Medicaid Lite. Similarly they made the control group every nth person (about half) who did not “win” the lottery whether or not they had insurance from another source or would have qualified had they “won” the lottery. In terms of the two groups, the researchers reported that the treatment group had “25 percentage points more” liklihood to have insurance than the control group.
Then the researchers modeled all the responses into insured vs uninsured but the raw data does not do that. I understand the modeling is related to maintaining the randomness of the research and avoidances of bias, etc. but why bother when they say so many times: these findings only apply to a bunch of “lucky” old sick poor white people in Oregon. Why not just publish the raw data?