This news should be met with a resounding “NO SHIT”:
Into the maelstrom of debate over whether Medicaid should cover more people comes a new study by Harvard researchers who found that when states expanded their Medicaid programs and gave more poor people health insurance, fewer people died.
The study, published online Wednesday in The New England Journal of Medicine, comes as states are deciding whether to expand Medicaid by 2014 under the Affordable Care Act, the Obama administration’s health care law. The Supreme Court ruling on the law last month effectively gave states the option of accepting or rejecting an expansion of Medicaid that had been expected to add 17 million people to the program’s rolls.
Medicaid expansions are controversial, not just because they cost states money, but also because some critics, primarily conservatives, contend the program does not improve the health of recipients and may even be associated with worse health. Attempts to research that issue have encountered the vexing problem of how to compare people who sign up for Medicaid with those who are eligible but remain uninsured. People who choose to enroll may be sicker, or they may be healthier and simply be more motivated to see doctors.
The ability of Republicans to convince themselves of whatever they want is quite impressive. On what universe would having health coverage cause worse health?
Raven
CNN had a story about a guy who was shot in the head in Aurora. He works “part time” at Wal Mart and he is fucked with no medical coverage.
dubo
Conservatives have long been explaining to us that just like how welfare eliminates any motivation to get a job, free healthcare eliminates any motivation to be healthy
Villago Delenda Est
There go those fucking liberal facts again, getting in the way of the wingtard narrative and reality-free ideology.
the Conster
Every day is bizarro world in greater wingnuttia – paying CEOs more motivates them, while paying teachers less motivates them. Lowering taxes increases revenue. Denying birth control decreases abortions. The Iraq war will pay for itself. They’re all fucking nuts.
BGinCHI
Did all these Republicans read Lord of the Flies and say to themselves, “Now that’s how you run an island!”?
Tom Levenson
But but but Avik Roy at McArdle’s place and his own has been telling us how expanding medicaid will kill the poors!!! Surely that counts for more than a mere bit of actual, you know, research!
Schlemizel
You assume that keeping people alive is a goal that the GOP wants to achieve. Nothing they have done in the last 40 years give any indication this is a valid assumption.
Its a feature not a bug
MattR
@Raven: I hope that he will get donations to cover the costs (he should be able to top what that bullied bus driver got – I think she is close to $750 K at this point). Unfortunately, Republicans will just use that charity as proof that there is no need to fix the system.
Ben Franklin
fewer people died.
There’s your problem. Republicans are concerned about the cost of medical care, not the cost of funerals.
Wasn’t ‘People dying’ their solution to accelerating costs?
AA+ Bonds
The program is positively associated with someone writing down information about the people in it
Raven
@MattR: Wonder if the theater faces any liability for the exit door aspect?
MattR
@John Cole (top) –
If you have health coverage then you don’t have to take as good care of yourself because you can now get medicines to fix things. Why worry about the risks of hypertension and diabetes from obesity when you can get blood pressure medications and insulin?
/wingnut
(Of course this ignores the fact that most people who can’t afford health coverage also can’t afford to live a healthy lifestyle – proper food, rest, shelter, etc)
@Raven: Somone is already suing the theater, the movie studio and the gunman. Not sure if they specifically mentioned the exit doors.
jwb
@MattR: And they’ll keep citing it long after charity fatigue has set in.
General Stuck
I just want to say, as a card carrying neo Druid movement member, them Anglo Saxon assholes can go to hell. Motherfuckers will steal you blind, then send you a bill.
Rachel in Portland
Studies like these are why the House Republicans have proposed to eliminate all research that looks into what counts as effective healthcare:
https://www.aamc.org/newsroom/newsreleases/298612/120717.html
trollhattan
@BGinCHI:
Pretty sure they want to move there, pronto.
Mark S.
@MattR:
The movie studio? I’d be curious what the hell the legal theory is for that.
MattR
@jwb: Yep. And screw the millions who get no publicity so they get no charitable help so they die unnecessarily. Or those who are deemed not “worthy” (to use James Taranto’s word) of people’s charity.
@Mark S.: “He thought he was The Joker” or “The movie was violent” are the only two I can think of (and they are ridiculous)
@Raven: Yeah, that too. I am guessing the guy is hoping the studio will give him some $$ in a settlement. IIRC the plaintiff was not shot or injured but his friend was killed and he is suffering from mental trauma.
Raven
@Mark S.: It’s called the theory of deep pockets.
Waynski
@Schlemizel: This. More people (no abortion) = cheap labor (no unions) = let the peasants die (no healthcare) = conservative Utopia = profit
Howlin Wolfe
Medicaid saves lives, but James Tarantrum will tweet “Are those lives worth it?”
SatanicPanic
@BGinCHI: Conservatives don’t read
MattR
@SatanicPanic: That’s why I hide my money in books (h/t Chris Rock)
VividBlueDotty
Not sure anyone wants to hear one of the prevailing theories among conservatives, and I myself don’t agree with it but will attempt to explain.
If everyone has insurance then everyone can see a doctor. And everyone will see a doctor. Then doctors will get too busy to see anyone and we will all die. Or something like that.
Plus no one will want to be a doctor any more because they can’t get rich doing it. Or something like that.
So everyone has health coverage=no one has good health. The scarcity mentality reigns among these types, and the scarcity of their intellectual ability compounds the problem.
kdaug
Same one that thinks one’s opinion on sexuality/religion/abortion/chicken sandwiches should affect anyone else.
SatanicPanic
@MattR: Books are like kryptonite to a conservative
(I’m embarassed to say how much of that routine I remember, always felt kind of uncomfortable about that one)
bemused
@VividBlueDotty:
I think terror rules their lives on everything.
Carnacki
But what type of kitchen counters do people on Medicaid have, John? Lives aren’t important. Kitchen counters, that’s what matters
AA+ Bonds
@BGinCHI:
To answer seriously: they identified with Roger secretly, and claimed to identify with Jack openly
General Stuck
Along with all the other wars the wingnuts are waging on our national existence, the war on facts is one of the best known and described. And I know that some on the left don’t care much for Dahlia Lithwick, but I think she thinks about shit and writes some nifty nuance of otherwise well accepted memes by liberals and dems.
I think this is a keen observation, that seems to be a stage of wingnut metamorphisis toward creating a right wing Shangri La, that we would all have to live in if Mitt Romney became president. It is well past the point of creating their own reality, into something of a deification that ANY information that doesn’t suit the cause, can just be whisked away under the theme it could possibly be bad news for the white ruling class in this country, and therefore not fit for public consumption.
You can see it with the tax returns, off shore accounts, and about anything whatsoever that could be critical of the GOP candidate. That in itself is not that noteworthy, but the molting of the right wing noise machine to fit this new pair-a-dime for information in a pres election IS noteworthy, as their miscreant hordes follow right along with them.
And after a few errant voices on the right stated Romney should release his tax returns, that is being rapidly supplanted by everything is a lie of the left, so no one can even see the materials to judge for themselves.
In a way, this has been walked into the national mindset, though obscurely for most folks, with the GOP senate minority now filibustering anything they don’t like, from even being submitted for debate.
I think It is the sound of citizens seceding in their own minds, from an ever increasing impulse to no longer accept the basic premise of democracy, that is a gentleman’s agreement to let each side govern the other from time to time.
El Cid
If they’d only die quicker, they wouldn’t hang around all these health statistics as being “ill”.
Litlebritdifrnt
This is good news hospitals will either discount or eliminate medical bills for Aurora shooting victims.
http://hosted.ap.org/dynamic/stories/U/US_COLORADO_SHOOTING_MEDICAL_BILLS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2012-07-25-18-56-36
Villago Delenda Est
@Howlin Wolfe:
Well, if the life in question is Taranto’s the answer is a booming, loud as KISS playing the Astrodome NO.
Patricia Kayden
“Medicaid expansions are controversial, not just because they cost states money, but also because some critics, primarily conservatives, contend the program does not improve the health of recipients and may even be associated with worse health.”
No, medicaid expansions are controversial for Repubs because they help the unworthy poor, who the Repubs don’t care about.
cathyx
@Raven: What do you think bake sales are for?
Halcyan
Gotta wonder how the Pro-Life contingent wil respond, doncha?
TenguPhule
As you approach the Wingnut Event Horizon, time appears to slow and even work in reverse, hence the observation by those who have crossed to the other side that health worsens as the sands of time flow back up Zombie Reagan’s Nose.
rikyrah
next thing you’ll be telling me is that water’s wet.
scottinnj
In other breaking news, some also say that water is wet and salt is salty.
slag
I think kay may have mentioned this study a while back, though I could be wrong, but yeah…it seems like a no-brainer but I think there may have been other studies (probably done by AEI or some such) that indicate the opposite.
Also, too, I love Douglas Holtz-Eakin’s concern trolling here:
So, in other words, Republicans use their underfunding of Medicaid as a reason to explain why Medicaid kills people. Genius!
FlipYrWhig
I think, like Vivid suggested above, the idea is not that getting on Medicaid makes _you_ have worse health, but rather that each new person added to Medicaid stretches the program thinner — ergo the better health of patient N+1 comes at the cost of the worse health of patients 1 through N. And in their eyes, like James Taranto said in another context, that sacrifice just isn’t worth it.
It’s a whole party of selfish, resentful ghouls.
MattR
@slag: So isn’t the logical next step to test out Holtz-Eakin’s concerns by expanding Medicaid in all states? That is what he’s advocating, right?
Maude
Christie cut Medicaid for working poor.
So now Charity Care picks up the ER bill.
Charity Care is paid for by NJ taxpayers.
He is a dumb, incompetent, rude, mean, worthless man.
Calouste
@Mark S.:
The legal theory of “They have a lot of money.”
YellowDog
These are the same people who are convinced that lowering taxes produces more tax revenue. In this case, fewer Medicaid recipients dying means more Democratic voters.
James E. Powell
The ability of Republicans to convince themselves of whatever they want is quite impressive.
No, what’s impressive is their ability to convince more than half the country to agree with them.
slag
@MattR: In truth, he’s advocating that we expand it only in states that underfund it so that we can prove it doesn’t work. But I’ll happily take your interpretation of the situation and then gladly anticipate the roll-out of studies that show that Medicaid works well except in states that underfund it.
Roy G.
I always thought the reason why they don’t want to give everybody health insurance is that deep down, they realize they are selling people crap that is really bad for them, and they don’t want to get stuck with the bill.
A la a conservative friend of mine who once told me that ‘smoking cigarettes = freedom.’
J.W. Hamner
Yeah, there have been some studies that have shown that people on Medicaid have had worse outcomes than the uninsured after controlling for the usual suspects (age, socioeconomic, etc).
However, it just takes such a demented mind to take those counter intuitive findings and go “A-ha! Medicaid kills people!!” So, uhm, what’s your hypothesis there? Oh, the same one as why welfare is bad? Interesting. So being on Medicaid is so depressing it actually destroys your will to live. Choosing to not take advantage of government largess on the other hand will be so life affirming that you might live a thousand years!
Weird that this only applies to poor people, eh?
JPL
@Halcyan: Is it a fetus?
mai naem
I am shocked. Shocked, I said that providing healthcare to poor folks will avoid deaths. Where do people come up with such silly ideas. This is just like those global warming idjits and Al Gore is fat. Also. Too.
Southern Beale
What a wingnut will hear:
“… blah blah .. HARVARD .. blah blah TAXACHUSETTS blah blah LIBERAL ELITES blah blah MAH TAX DOLLAHS blah blah BLACK PEOPLE … “
Donut
@BGinCHI:
Yes. Obviously.
Mnemosyne
@J.W. Hamner:
My random, uneducated guess? Since Medicaid is a chronically underfunded program that primarily serves poor people, most Medicaid providers probably provide substandard care, because it’s hard for them to get more than the basics to people.
My co-worker’s sister is on Medicaid because she has breakthrough seizures and is unable to work. During one seizure, she fell forward and broke two of her front teeth. But Medi-Cal doesn’t cover anything but emergency dental work anymore, so she was SOL when it came to getting them repaired. (My co-worker managed to work the system and scrape together some extra money so her sister didn’t have to be freakin’ toothless, but it took several days and was a giant pain in the ass for everyone.)
So, yes, when Medicaid programs put arbitrary limits on things like injuries that you incurred during your illness, I can see that your outcome might not be so good.
PurpleGirl
Well, people who are uninsured and then get Medicaid tend to be sicker by the time they see a doctor. So much sicker that there may not be much that can be done to help them; therefore, Medicaid can be said to make them sicker because before they didn’t know exactly how bad they were.
Of course, if they had gotten Medicaid earlier then maybe they would have gone to the doctor sooner and they wouldn’t be sicker.
Even with the wingnuts in my family, I find it hard to understand how they think and don’t feel about their fellow humans.
japa21
My sister works for one of the universities in the Wisconsin University system, hardly hotbeds of conservatism. Two years ago she told me of a conversation she had with one of the philosphy professors. His belief is that it wouldn’t do any good to exand coverage because it would be wasted on people who didn’t know how to take care of themselves anyway.
Fortunately, she did not have a loaded weapon with her at the time.
MikeJ
@General Stuck:
Remember “these are things we talk about in quiet rooms”?
James E. Powell
His belief is that it wouldn’t do any good to exand coverage because it would be wasted on people who didn’t know how to take care of themselves anyway.
This is a very widespread belief. No one, and certainly not big shot Democrats, has pushed back against it for decades.
JPL
@James E. Powell: Since I live in GA, I have the opportunity to meet lots of over weight, diabetic white men who feel that way.
Turgidson
In a universe where
GOVERNMENT IS THE PROBLEM
* cue scary music *
OH NO! SOCKULISM!
SiubhanDuinne
@General Stuck:
Not to mention that “Dahlia Lithwick” is simply one of the coolest-sounding names ever.
KJD
@dubo:
And by the same logic paying CEOs obscene salaries leads them to slack off and allow their companies to drift into destruction. Perverse income effects are actually more more plausible at high incomes than low, but never mind. People feel wealthy and act in strange ways when they are poor but income effects go away when every possible need has been met 100 times over. Right.
Yutsano
@SiubhanDuinne: it’s rather like something from Jane Austen. Or terribly British.
muddy
In Vermont, you can get a BC/BS policy through the state if you are too rich for Medicaid, there’s a sliding scale depending on your income. The state pays the difference. You still have $20 copays and wev. Also, if you are on Medicaid they give $575 (I think) a year for dental care. It’s not much, but it’s something. They said it would save money in the long run because people are more readily hired if they have teeth. Bernie Sanders has gotten several dental clinics and health clinics going to keep people from falling through the cracks. It’s all so sensible, but gods forbid they be civilized in red states. And our unemployment is under 5%. So there!
amk
@General Stuck:
If true, the cits are truly fucked. And they deserve to be.
muddy
@Raven: The first thing they ask is on whose property were you injured.
Republicans will want to say it’s an act of god. God is kind of a bitch that way sometimes.
Lurker
@KJD:
William Bernstein covered that in “The Executioner of Excellence” back in 2007. Quote:
muddy
Also too, despite being given way too much healthcare, I just heard some study that found Vermonters had the best diet in the nation, with lots of fruits and veg and local stuff. Jeezum, everything is exactly opposite of the shit they say. Bizarro world. I’d hate to be in one of those skulls, I bet it hurts and that’s why they act shitty all the time.
pseudonymous in nc
“From now on, whenever they make that criticism, we will cite the research that shows they’re lying.”
Right?
pseudonymous in nc
@FlipYrWhig:
i.e. the “lump of healthcare” fallacy. But I think it’s more than that: as Sara Robinson wrote back in 2008, it’s medical Calvinism:
kay
Republicans could solve this (partly) for working poor who are single by raising the minimum wage.
That would take them out of 133% of poverty and into the federally-subsidized exchange (max subsidy amount) under the ACA.
They have rock-bottom minimum wage which is why they have so many single, working adults eligible for Medicaid.
That’s my bipartisan solution for them. They save on Medicaid and working poor get a better wage and affordable health insurance. Win/win!
Yutsano
@kay: Yesbut… That might come from the all-sacred profits. And it just wouldn’t be FAIR if Buffy couldn’t get her second nosejob or that third yacht would have to wait until next summer, now would it? Especially to take care of those poors, who are probably blah as well! Why do you make our Job Creators cry?
What Have The Romans Ever Done for Us?
That’s your party of life right there. Irony will not survive peak wingnut.
kay
@Yutsano:
What I love about it is, it rewards states with minimum wages set higher than the federal minimum, because they won’t have working poor on Medicaid ( partly funded by the state) but will instead have working poor on the (fully) federally-subsidized exchange. That’s a better deal for the state.
It’s an incentive for GOP governors to get low wage employers to raise wages.
Let’s use that word, “incentive”. They love that word.
Xantar
I attended a talk by one of the authors of this study, Katherine Baicker. If you ever have the opportunity, you should absolutely go see her. She’s a very engaging and animated speaker, and she explains the issues that a relatively intelligent layperson can easily understand. And when it’s time to show an econometrics equation with weird Greek symbols, she’ll openly tell you, “If you don’t like numbers, go to sleep for the next five minutes. I’ll be back to speaking English by then, promise.”
Weaselone
They simply apply dime store economic theory to a situation where evidence shows it does not actually fit, e.g. by providing the poor with insurance we lower the cost of living an unhealthy lifestyle which inevitably leads to the poor eating nothing but cheese puffs and potato chips and washing it down with the syrup from the soda machine. It’s the same logic that applies to condoms leading to more babies because they lower the costs of intercourse like getting pregnant and catching deadly STDs.
The reality is that the long term consequences of eating crappy food and screwing do not factor as highly into the decision to eat and screw as conservatives seem to believe. There is obviously some impact, but not enough to offset the positive effects. People are not going to start guzzling a containers of salt and lard just because they can now afford to pay for BP medication and angioplasty, nor are join in wild orgies just because they have a reduced risk of STDs and pregnancy.
Yutsano
@kay: My state has the highest minimumwage in the nation indexed to inflation plus no exceptions for tipped workers. You bet we’ll be setting up an exchange and welcoming the Medicaid expansion. Hell we’ve even sent observers to Vermont to see how they’re setting up their single-payer option. That would rock if it got off the ground here.
danielx
@Raven:
Wingnut reply: Well, what did he think he was doing spending money on recreation instead of saving every dime to pay for a crappy insurance plan with a $5000 deductible? He deserves to suffer for being poor!
danielx
@James E. Powell:
It’s a technique pioneered by a certain middle European, uh, statesman:
Sounds nauseatingly familiar, don’t it now?
VividBlueDotty
@bemused: You are so right about that. I just wish they weren’t able to ruin MINE (and countless others!) with that kind of thinking.
AA+ Bonds
People don’t know who qualifies for Medicaid. They think if you are “poor enough”, you are on Medicaid. They do not understand that if you are poor enough to be on Medicaid in most states, but aren’t on it, the data on you is pretty much nil.
How do you think a family of four lives when they live on around, oh, $4,000 per year?
Would you like to design a study method to test this brazen hypothesis about Medicaid’s effects on health?
First question: how do you plan to keep track of them when they sleep somewhere different every night?
Nunca el Jefe
Forget it, John. It’s Datatown.
Triassic Sands
Whenever I discuss health care with other people, I make a point of emphasizing that Republican policies are killing people. Not imaginary, statistical beings, but real-life, air-breathing mothers, fathers, sons and daughters. The percentages are relatively small, but the numbers are not.
By failing to expand Medicaid, Republican governors and legislators will be intentionally choosing to kill people and subject millions more to financial ruin. They intend that to be the result of their policies. Would they pick up guns and shoot those people? In most cases, no, but they would (and will) allow them to be killed when the means exist to prevent those deaths.
As the opposition to the immorality of Republicans, we have to constantly remind people that the victims of Republican policies really do die, i.e., cease to live, when they could have been saved. Millions more are ruined financially, when a sane, rational society would never allow that to happen.
Jay in Oregon
@Raven:
Hmm, let’s see the GOP’s response to this not-quite-hypothetical issue:
http://www.youtube.com/watch?v=bg7kgO7lFA4
“Are you saying society should just let him die?” “YEAH!”
Rafer Janders
@japa21:
Fortunately?
meander
NPR’s Planet Money had an interesting podcast about a Medicaid study in Oregon, where there was only enough money to cover a portion of the eligible population. So the researchers followed the groups that got into Medicaid and those who didn’t. It was interesting how having access to a doctor made people feel better in general, reduced economic uncertainty, and perhaps even reduced mental illnesses like depression. Thus far, total health care spending has not decreased as some had predicted (e.g., if people can get treated earlier, they won’t go to emergency rooms for sore throats, and so on.). It’s still early in the study, so perhaps those savings will appear later.
A follow-up blog post on the study had this:
{begin quote}
“People reported their health to be much better once they were insured,” Baicker says. “The probability that they reported themselves to be in good, very good or excellent health increased by 25 percent.”
People on Medicaid were far less likely to borrow money or have a medical bill sent to a collection agency. And total health care spending (including what is covered by insurance) increased for people on Medicaid.
{end quote}
Matt McIrvin
I have seen people, honestly and for true, respond to essays about the terrible consequences of being unable to afford regular dental checkups/professional cleanings with “Try brushing your teeth once in a while.”
Yes, people who lost all their teeth or got heart infections from an abscess obviously just weren’t ever brushing their teeth, and if you brush your teeth you will never need to see a dentist for the rest of your life.
This is the way these people think.