People who have followed my articles regarding Medicaid and Medicaid expansion will recall that five years ago, and early in the game, I sited the “Oregon Medicaid Experiment” as proof that the claims of The Affordable Care ACT (Obama Care), specifically as they were applied to Medicaid and Medicaid expansion, were untrue.
In a series of letters to The Wall Street Journal (WSJ) the Oregon Experiment has again been cited as proof that the claims that continue even today that “you can keep your doctor and you can keep your plan” and that Medicaid and Medicaid expansion will improve health care outcomes—remember access, quality costs(?), are completely unfounded and are today proven to be not true.
As Milton Friedman famously stated, “the road to hell is paved with good intentions”. A recent letter reviewed in the June 17th (WSJ), written by John Cogan of Stanford, California, restated the claims of the “Oregon Experiment”, while proving Dr. Friedman’s claim of “good intentions”.
To refresh the memories of our readers the OREGON MEDICAID EXPERIMENT, Medicaid eligible patients were assigned to Medicaid coverage and no coverage at all. Researchers found little evidence that coverage improved medical outcomes. Recipients in the Oregon study like Idaho legislators valued their coverage at 20-30% of its cost to taxpayers. Subsidizing Medicaid coverage to able bodied adults instead of offering them coverage at their own expense creates economic frictions and a misallocation of state resources. They also found that over 50% of people eligible for enrollment in expansion programs chose not to enroll unless they receive a 100% subsidy. Talk about a disincentive and the creation of dependency.
The most important point brought out in Mr. Cogan’s response is this:
“But the research is more mixed than they suggest. As the paper’s authors point out, their finding of lower mortality among able-bodied adults may have come at the expense of higher mortality among disabled people, as might be expected if states shifted resources in response to the 100% subsidies.”
That quote precisely and accurately points out the case that I presented several years ago. By taking away resources from the people that Medicaid was supposed to help—those living on the margins who through no fault of their own cannot take care of their own or their families health care needs—the ones that Medicaid was originally designed to help, are the ones most placed in jeopardy by Medicaid Expansion.
The only thing Medicaid expansion has done is to make the conscience of progressive liberals and progressive Republicans feel good while they don’t get their own hands dirty. The social contract should be between we the people who see that those on the margins are actually being hurt by Medicaid expansion, and those who need help. The symbiotic collusion between large health care provider networks and legislators and government agency heads serves only the large provider systems—not patients.
