On the Oregon Medicaid study: “Keep calm and collect more data”
The New England Journal of Medicine sent out a press release Wednesday evening with the click-bait title of “The Oregon Experiment — Effects of Medicaid on Clinical Outcomes” (abstract here, the full paper is gated). Some background: because of a lack of funding the state of Oregon conducted a lottery system for Medicaid enrollment, and the ensuing results are being studied as a rare randomized controlled trial (RCT). The lottery has allowed healthcare researchers to, essentially, study the effects of Medicaid coverage in a way that people can begin to talk in terms of empirical causality. The first results (see here & here) were promising; for those who ‘won’ the lottery Medicaid appeared to provide increased health benefits and greater income security. This second result, however, is a little bit more mixed:
Let’s review. The good: Medicaid improved rates of diagnosis of depression, increased the use of preventive services, and improved the financial outlook for enrollees. The bad: It did not significantly effect the A1C levels of people with diabetes or levels of hypertension or cholesterol.
There is much, much more on this from folks smarter and more able to suss out the details behind this study than I can. For a wonderfully BS-free version go see Matt Yglesias’ take. I’ve read them all and so should you. For what it’s worth, on matters such as these, at the very least you will should be reading the folks at The Incidental Economist (where the above quote comes from). They’re serious, fair, and do this sort of thing for a living.
Unfortunately it was also an opportunity for some conservatives to, what in some cases I can only describe as gloatingly, declare everything they’ve ever argued negatively about Medicaid as validated. That is, yet another opportunity for them to delegitimize the program. I won’t bother linking to those simply because their arguments are (to be polite) disingenuous at best, or (to be impolite) a massive dollop of conservative derp at worst.