Medicaid Blues

First off, Howard Kurtz has been fired from the Daily Beast. I didn’t know it was possible to be so bad as to be fired from the Daily Beast. How low can you go? Maybe Weekly World News has an opening.

Elsewhere — The Right has seized on a new study that they claim proves that Medicaid doesn’t help anyone and is a big waste of money. As usual, the Right can’t read. Jonathan Cohn and bloggers at the Incidental Economist explain what the study actually says. The Incidental Economist explains,

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 affect the A1C levels of people with diabetes or levels of hypertension or cholesterol.

This has led many to declare (and we’re not linking to them) that the ACA is now a failed promise, that Medicaid is bad, and that anyone who disagrees is a “Medicaid denier”. How many people saying that are ready to give up insurance for themselves or their family? If they are arguing that Medicaid needs to be reformed in some way, we’re open to that. If they’re arguing that insurance coverage shouldn’t be accessible to poor Americans in any form, we don’t agree. Medicaid may not be perfect, but we don’t think being uninsured is better. This new study supports this view, though certainly not as strongly as it might have.

Cohn makes the point that the purpose of health insurance is not to keep you well, but to pay the medical bills.

That may sound obvious—of course people with insurance are less likely to struggle with medical bills. But it’s also the most under-appreciated accomplishment of health insurance: Whatever its effects on health, it promotes economic security. “The primary purpose of health insurance is to protect you financially in event of a catastrophic medical shock,” Finkelstein told me in an interview, “in the same way that the primary purpose of auto insurance or fire insurance is to provide you money in case you’ve lost something of value.”

And, anyway, the study has been following subjects for only two years. The difference in health care outcomes after five or ten years might be more significant, assuming the study continues.

31 thoughts on “Medicaid Blues

  1. Over 1,500 people died when the Titanic sunk. The ship had lifeboats but almost two-thirds of those who sailed perished. This is obvious and unshakable proof that lifeboats are useless and outdated and should not be required on passenger liners.

    If you are a rightie and the logic escapes you – why is this the very same logic that’s applied to opposition to AHC, Medicaid, CHIP, etc?

  2. Yah, I read somewhere today that the key word in “doesn’t significantly improve health outcomes” is the word “significantly” … that don’t mean what people think it mean. People hear it and assume “significant” implies large amount … but really here it is implying large precision. It doesn’t significantly improve health outcomes because they just didn’t have a large enough sample size or a long enough sample period to reach 95th percentile confidence level. The point estimate for all measures has the medicaid group outperforming the non-medicaid group, and the margins of error are large enough that we could be talking about very large increases. Or very small. The best you can really say with confidence is that people with medicare DO have better health outcomes than people without, most likely.

    But as your links say, health outcomes is probably not the best measure of success anyways. For the people without medicare, most of them were managing to get at least some health care throughout the trial period, in many cases by going into awesome amounts of debt. In many cases, the bill for that medical care goes directly to the rest of us via increased charges at hospitals and such, trying to cover the cost of people who can’t pay.

    It was an interesting experiment because you just are not allowed to get that kind of data deliberately, ever, but because it was a fortuitous (for science) accident instead of a purpose-designed study, the data is necessarily going to be a bit murky.


  3. Paul Krugman blogged in response to this rightwing pseudomeme: Newsflash! Frie insurance does not prevent fires.

  4. I really want to echo the point that it takes time. I’m 60. In 2009 I went to the doc (I’m uninsured) and he immediately diagnosed hypertension (BPs like 190 / 110). In 2011, my BPs were more like 130/95. They’re now great, and stable. But it took years (getting used to the medication, getting the body used to operating in new ways, cleaning up the crap that years of hypertension leaves in your body). Two years, it is no surprise they haven’t yet seen statistically significant signs of medical progress, but that doesn’t mean it’s not happening.

  5. Uhm…
    Two years?
    And in a state that’s not exactly one of the most populous?
    Nice length of study, and sample size.

    Also too – what part of “preventative” medicine might have “prevented” some disease(s), that “prevented” them from appearing as statistics in this study, do righties NOT understand?

    You can easily show a study of how many people got sick – physically, as well as mentally.
    How many didn’t, or couldn’t afford to, have treatment.
    And how many still suffer from diseases, died, and/or have financial troubles, up to, and including, bankruptcy, and/or losing their homes.
    But you can’t easily prove how many didn’t – unless you do a study longer than 2 years, and in a state larger than Oregon. And then compare that to studies of comparable length, of a comparable sample size.
    And even then, it’s easier to show how many got sick, than how many didn’t. That’s the very nature of “preventative”medicine. If it works, it “prevents” people from showing up as statistics.

    We have a much longer study – over 40 years – with this whole nation to study from, of the effects of Conservatism on the body politic.
    And based on that study, we should be having teams of oncological surgeons, cutting out all of the cancers, and hordes of psychiatric workers out there trying to help find treatments and cures for sociopathy.

    Also three – as regards to this study, as usual, our Conservatives are left with nothing to do, but to lie, obfuscate, and bend the truth – because lying, obfuscating, and bending the truth is all that they have left.
    They have nothing positive to sell, and so, they are left with nothing, but trying to spread the negative message that is at their very core: that nothing good ever came of change – and that women, minorities, and the poor, need to remember their place, and depend on the Noblesse Oblige of their wealthier white male betters.

    They have to lie, and obfuscate, and bend the truth, because if people ‘knew the truth, they couldn’t handle the truth,’ and Conservatives would never ever again get within a Giant Squid’s reach, of power.

    My hope, is that in Europe, and with our Sequester, Conservatives over-played their hand with their Austerity Agenda, and showed people their inner sociopathic lizard.

    And that people will realize that the only thing that Conservatism has to sell, is the thing that Liberalism is directly oppose to, and has been since The Enlightenment – societal, political, and economic systems that insure that from generation to generation, the rich keep getting richer, at the expense of everyone elses suffering.

    And that Conservative will use any and all of the means that are available to them, to make sure that that status quo that has been around since people first organized themselves into societies, remains the same for generations without end.
    There is a better way – it’s progress through Liberalism. And that it is, was, and ever more shall be, that the path to getting and staying free, and getting and keeping liberty, and social and economic justice, is through Liberalism, and not Conservatism.

    Conservatism’s goal, is to take us back to the caves, and keep us there.
    Liberalism’s goal, is for everyone to share in this world, as equitably as possible. And to keep this world worth sharing, environmentally, since it’s not some dump or landfill, but the only home we know of.

  6. Enjoy your weekend, maha.

    I’ll try to stir up some anarchy and entropy, until you come back to restore order.

    Saturday, I’ll bring the beer and tequila – the rest of you, bring your own hookers and blow! With a little for me, please. 🙂

    Ok, until then, back to Medicaid…

  7. Ok, until then, back to Medicaid…

    No, no, bring on the anarchy and entropy!

    Old man in Omaha sends his first Twitter tweet: “Is this thing on?”

  8. Give him some credit, joan.

    I would have been expecting, ‘Mr. Watson–come here–I want to see you.’

    And no anarchy or entropy, yet.
    I suspect maha’s still lurking, trying to catch us.
    We’ll raid her liquor cabinet and search for her p*rn stash when we’re sure she’s gone.

  9. I suspect maha’s still lurking, trying to catch us.

    Run, run, run, as fast as you can…But you can’t catch me said the Gingerbread man.
    She might be trying to see who conducts themselves as adults in the absence of supervision, but I think she knows already who her problem children are..Right, Gulag?

  10. Joan:
    I just hope Buffett’s lackey in charge of tweets doesn’t jam up the toobs with useless stuff about what the Great One is presently investing his billions on. We get enough of that useless crap already from Lindsay, Snookie,

  11. Why, who could you possibly mean? 😉

    She’ll probably put me in the twit-filter until she comes back, just to make sure.

    If I do get blocked, I’ll try to bypass it by posting as “Honda D. Radar,” or “Otto Site.”
    Sssssshhhhh! Our secret…

  12. Problem child me royal arse, ‘e’s the bloody court jester ‘e is;getting away with almost anything with comedy. And that’s why we love ’em.

  13. Yeah, I guess I could always be described as a court jester. So, thanks, erinyes.

    Having just pooped-out the above word-turd, in retrospect, I think “Anarchy ‘n Entropy” would make a hell of a Punk song.
    It would be like the anti-McCartney & Wonder song.

  14. Honda D. Radar? Well, gulag, if you ever find yourself at an Assembly of God camp meeting and feel pressured to speak in tongues, just repeat Honda D Radar in rapid succession and roll your eyes toward heaven. It works like a charm.

  15. Hmm… my last comment’s still in moderation.

    Let me test out my theory.
    Hey, wouldn’t “Anarchy ‘n Entropy” make a great Punk rock song?
    Poo on “Ebony and Ivory!”

  16. It’s ok, I’m not twit-filtered – yet. I must have put some trigger-word in that earlier one.

  17. Yeah GULAG – It’s like ly that the word O R G Y set it off. BYW, in thee interests of political correctness, we will invite as many gigolos as hookers. This is an equal-opportunity event. Domestic grass over any imported weed – we smoke American.

  18. Doug,
    YES! Absolutely American!
    And, in honor of our Kenyan-born, Hawaii-raise President, maybe we can make it some Maui Zaui.

    And remember, I said “…bring your own hookers,” so, bring over whatever kind of hard-working sex-laborer you want.
    Just remember – “Sharing, is caring.” 😉

    I’ll be back later, with some “Anarchy” in the US.

    Note to local, state, and federial authorities – this is all in jest! No one is actually bringing any hookers, blow, or grass, anywhere.
    This is an imaginary Intertube party, using as little bandwidth as possible, to be as green as possible.

  19. Moderation, again – let me try an *, and see if it works:
    YES! Absolutely American!
    And, in honor of our Kenyan-born, Hawaii-raise President, maybe we can make it some Maui Za*ui.

    And remember, I said “…bring your own hookers,” so, bring over whatever kind of hard-working s*x-laborer you want.
    Just remember – “Sharing, is caring.”

    I’ll be back later, with some “Anarchy” in the US.

    Note to local, state, and federial authorities – this is all in jest! No one is actually bringing any hookers, blow, or grass, anywhere.
    This is an imaginary Intertube party, using as little bandwidth as possible, to be as green as possible.

  20. One health issue that wasn’t measured was “quantity of expensive, but necessary treatments procured”. A person who gets cancer, and doesn’t have insurance, might not be able to be treated – no one will do the surgery/provide the chemotherapy drugs/provide the radiation therapy/etc., without assurance that they’ll get paid.

  21. Well, I had a busy morning. I put new brakes on my wife’s car, and I washed her car also. Not only will I get the good husband of the month award, but my good fortune will increase, sort of a metaphysical thing..seems every time I do things for her I end up getting lucky.

  22. Ok, if this gets through the twit-filter, here’s the “Anarchy in the US” thingie that I promised today:

    In a Farleigh Dickenson University study, 44% of Republicans believe that an armed rebellion may be necessary to protect our liberties.
    And only 31% disagreed!
    Democrats agreed at 18%, and Independents at 27%.

    And, what says “Anarchy in the US,” better than an armed rebellion?

    All of those rubes, with cammo on, lugging their assault weapons, and clips of many bullets – gathering in make-shift militia’s.

    All to duke it out, mano-a-mano combat, with the American government – the one with best trained, best armed, military in the world.
    These fools thinking they’re modern-day Minutemen, taking on the Redcoats and Hessians – who didn’t have planes, helicopters, drones, tanks, personnel carries, air-to-surface missiles, drones, etc.

    They dreaming of gathering their forces by screaming, “WOLVERINES!!!”, like in their favorite movie, “Red Dawn.”
    They’re going to build defense positions, waiting for the US troops to come.

    I hope they’re quick, and their aim is perfect.
    Because when the US Government sends in a drone instead, or a missile, the secesh rebels aim had better be perfect – or else the movie we’ll see about them later won’t be “Red Dawn,” but “Red Puddle,” “Red Mist,” or, “Red, Missed!”

    We need look no further for evidence that these people are nucking futs.

  23. I posted my promised “Anarchy in the US” comment in the wrong post.

    And the same thing happened when I just came here to paste it in the right place – and, not unexpectantly, it got twit-filtered again.

    SH*T! Maha IS on to me!

    Oh well, I’ll try again tomorrow with and an “Entropy” comment.

  24. erinyes,
    Here’s my favorite line:
    “Such a Reaganite policy of military strength and moral clarity may not be fashionable today.”

    You could substitute “Reaganite”, with – Leninite, Stalinite, Hitlerite, Maoite, Potite, etc.
    Hell, with a little work, you could also add Obamaite, to that list – only in a good way.

    Now, since the economy is improving a bit, and unemployment is slowly going down, and he’s had a – minor compared to Reagan – embassy disaster, and continued to erode Civil Liberties – which started under Nixon, if not before, – all Obama needs to do, is find some small island somewhere to invade (and Clint Eastwood to make a movie about it – ), honor a Nazi cemetery, start running massive debt, and start to send arms to Iran, to fund the Contra’s, bringing cocaine back to the US, to be sold in inner-cities, and he’s “Reaganite.”

    That, AND being able to lie about it, by saying he didn’t know, and then forgetting about it, while also forgetting who he is.

    What the righties who signed that PNAC statement hate, is that some Nigrah is over-shadowing their beloved Ronald “Maximus” Reagan, as President.

    Obama is so much better than Reagan, that it’s not even funny – especially for those in the “Reaganite” priesthood who worship, and tend the eternal flame, for their Conservative hero, who catapulted the unraveling of America, begun by Nixon.

    “Maximus,” is being minimized, by a “Blah” man, the President with the unlikely name – Barack Hussein Obama.
    And THAT’S what “may not be fashionable today” – but will be soon!

  25. All true,’Gulag.It just blows me away that the PNAC mission statement is an admission of criminal conspiracy, AND THEY SIGNED THEIR NAMES TO IT! Prosecuting them should be like shooting fish in a barrel.

    On another note, all this noise about how many people think a “violent revolution” in our country may be necessary; I’m wondering if those polled understand what that really means, if THEY would be doing some shooting, and if they realize the US military is part of “the government”.Those polled seem to think the only right that needs defending is the second amendment, I remember the “free speech zones” and the burning of Dixie Chicks cd’s….agree with us or STFU!

    Then there is the current focus on the killing of the diplomats in Benghazi; the right is stirring this pot because they fear Hillary in 2016.

  26. Ok, when maha comes back, you can all see my earlier “Anarchy in the US” comment.

    For now (if I make it past the twit-filter), here’s today’s promised comment on “Entropy” – as briefly defined in the wikipedia:
    “Entropy in statistical mechanics is a measure of the number of specific ways in which a system may be arranged, often taken to be a measure of “disorder”; the higher the entropy, the higher the disorder.”

    “Entropy” may also be defined as, ‘the natural order of things to decay into dis-order,’ until there is nothing but a single energy, for lack of a better word, “goo” – with all energy in that goo, equal.
    That process to getting to that goo stage, isn’t pretty. Eruptions, Super-nova explosions, Black Holes, etc.
    In the Universe, if getting to the universal goo stage does happen, as some predict, it will take a long, long, time.

    To apply entropy to politics, all you have to do, is look at the current Republican Party, and watch as it strains to keep political order, out of its component groups – the Economic powers – who once were the “keepers of order”; the Neocons – the military-first, group; the Jesus-freaks – the ground troops, grown into dominance; the white middle class Plebes, desperate that others don’t get what they have – even as they vote in ways which help them lose what they have; and, the newly welcomed, John Birchers – the ones who thought Ike was a Commie(!!!,) – and are a rising power.

    And, while there is cross-over in the Republican Party, these are fairly distinct groups.

    And the economic power elite, can no longer control the Frankenstein Monster’s they’ve unleashed.
    The Tea Party, which brings out the very worst elements of those groups, is unleashed. The Ego and Super-Ego can no longer control the Id.

    And what we’re seeing will either turn into an explosion, or, and implosion. All of that “energy,” the friction between the component parts, has to go someplace.
    And, I sincerely doubt it will go towards the “Center.”

    Here’s someone who can do a much better job of describing what’s happening, and what might yet happen:
    William Butler Yeats (1865-1939)

    Turning and turning in the widening gyre
    The falcon cannot hear the falconer;
    Things fall apart; the centre cannot hold;
    Mere anarchy is loosed upon the world,
    The blood-dimmed tide is loosed, and everywhere
    The ceremony of innocence is drowned;
    The best lack all conviction, while the worst
    Are full of passionate intensity.

    Surely some revelation is at hand;
    Surely the Second Coming is at hand.
    The Second Coming! Hardly are those words out
    When a vast image out of Spiritus Mundi
    Troubles my sight: a waste of desert sand;
    A shape with lion body and the head of a man,
    A gaze blank and pitiless as the sun,
    Is moving its slow thighs, while all about it
    Wind shadows of the indignant desert birds.

    The darkness drops again but now I know
    That twenty centuries of stony sleep
    Were vexed to nightmare by a rocking cradle,
    And what rough beast, its hour come round at last,
    Slouches towards Bethlehem to be born?

    My question is, after “the turning and turning” is over, who the rough beast will be, that ascends to lead the Republican Party in the future?
    “TedTalks ‘n Talks ‘n Talks” Cruz?

    Or, some rough beast who’s not on our radar screens yet?

  27. What the rightwingnuts fail to realize is, when they start their little revolution, all of their rights, including their precious and mythical right to own firearms will be GONE. Their economy will be gone, their social security will be gone, their money will be gone, and they better hope to hell someone is willing to take their gold (maybe yes, maybe no), because, let’s face it, they aren’t spring chickens any more, and they certainly can’t offer to trade their labor for food or shelter…

  28. If these anti-government-patriots-in-their-own minds really do act it will hasten the slow-motion coup that’s continued unabated since the ’60s. They’ll lose but they’ll also set up the next demagogue waiting in the wings to leverage the chaos and co-opt the fearful who have no solution other than wetting themselves. For the peaceful there’s only one solution to roll back some of the legislative tomfoolery that has come to pass…which is getting active. But can good people with less money get elected???

    I listened to a great talk by my “canary in the coal mine”, Chris Hedges in which he enumerated the ways in which we’ve steadily had our options removed…being the stealthy, non-confrontative path to totalitarianism. He quoted author Sheldon S. Wolin calling it an inverted totalitarianism (which I suppose means bottom up and hardly noticeable) by which we’re guided by virtue of reduced options into accepting what corporate America has in store for us.

    He added that for the first time in our history corporate power has only token resistance by government and that a review of Obama’s Senate voting record represented as big a corporate giveaway as can be imagined. That last one is disappointing and I hope to have time to vet the assertion for myself but it’s not like we haven’t seen this in Obama’s leadership regarding the economy, Wall Street and the mortgage crisis which has left the too-big-to-fail banks even bigger. I resist it but he’s slowly becoming a bad joke in my old mind.

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