Study: Medicaid is Not Worthless
An NBER study by Katherine Baicker and Amy Finkelstein compares Medicaid enrollees with the uninsured:
Those with Medicaid were 35 percent more likely to go to a clinic or see a doctor, 15 percent more likely to use prescription drugs and 30 percent more likely to be admitted to a hospital. Researchers were unable to detect a change in emergency room use.
Women with insurance were 60 percent more likely to have mammograms, and those with insurance were 20 percent more likely to have their cholesterol checked. They were 70 percent more likely to have a particular clinic or office for medical care and 55 percent more likely to have a doctor whom they usually saw.
The insured also felt better: the likelihood that they said their health was good or excellent increased by 25 percent, and they were 40 percent less likely to say that their health had worsened in the past year than those without insurance.
See New York Times story.
Interesting, but I don’t think we see anything like this happening in Massachusetts.
There is probably some self-selection in Medicaid. If you want to consume certain medical services, you would be more likely to seek out and enroll in Medicaid. People who feel their health status is lower would naturally want to enroll in coverage if available. There is some evidence of this. Medicaid enrollees have been shown to be in poorer health than the uninsured.
@Devon
The self-selection may exist in real life, but in this study, the participants were randomly assigned to either Medicaid or no Medicaid. Presumably, this would account for different pre-existing health statuses, and keep the two groups relatively similar in terms of initial health. With this design, if health status was balanced at the baseline, then it could not be a confounder of the results.
Avoiding the “self-selection” problem turns out to be one of the more interesting aspects of the study. The study was made possible because the State of Oregon couldn’t afford to provide the expanded Medicaid program to all eligibles. So, it conducted a lottery. This created scientifically-desirable groups of “haves” and “have-nots.”
The NYT article noted that research community was unable to conduct this study previously because it was considered unethical to offer health care to some while denying it to others. Unethical, apparently, for everyone except government.
Sure, Medicaid benefits vs. uninsured is a better deal. However, for those of us on Medicaid programs, dependent on due to health problems, who are slowly losing their covered services to balance mismanaged state budgets(see Arizona’s AHCCCS). It is more like a nightmare!
Sure, Medicaid benefits vs. uninsured it is a better deal. However, for those of us on Medicaid programs, dependent on due to health problems, who are slowly losing their covered services to balance mismanaged state budgets(see Arizona’s AHCCCS). It is more like a nightmare! It may not be worthless but it’s value is dwindling