Three researchers, Benjamin D. Sommers, M.D., Ph.D., Atul A. Gawande, M.D., M.P.H., and Katherine Baicker, Ph.D. have reviewed the past ten years of research on the effect of insurance on mortality and financial stability in the New England Journal of Medicine.
Here are the highlights:
Overall, the study identified a “number needed to treat” of 830 adults gaining coverage to prevent one death a year. The comparable estimate in a more recent analysis of Medicaid’s mortality effects was one life saved for every 239 to 316 adults gaining coverage.29
Are the benefits of publicly subsidized coverage worth the cost? An analysis of mortality changes after Medicaid expansion suggests that expanding Medicaid saves lives at a societal cost of $327,000 to $867,000 per life saved.29 By comparison, other public policies that reduce mortality have been found to average $7.6 million per life saved, suggesting that expanding health insurance is a more cost-effective investment than many others we currently make in areas such as workplace safety and environmental protections.29,54
It seems that Medicaid is extremely cost efficient in buying longer lives. I speculate that part of the resistance is that the cost of Medicaid is extremely explicit while regulations can be more easily hidden off budget. I also speculate that there is a sympathetic beneficiary differential.
Medicaid versus private payer
there is no large quasi-experimental or randomized trial demonstrating unique health benefits of private insurance. One head-to-head quasi-experimental study of Medicaid versus private insurance, based on Arkansas’s decision to use ACA dollars to buy private coverage for low-income adults, found minimal differences.11,19 Overall, the evidence indicates that having health insurance is quite beneficial, but from patients’ perspectives it does not seem to matter much whether it is public or private.47
This is telling me that if we are to expand cost efficiently, we should expand Medicaid as much as possible.
Go read this article. It is only eight, double columned, pages that is easily accessible and clearly written.
And then go call the Senate.