May 9, 2013

HAPPILY, WE KNOW EXACTLY HOW TO PROVIDE THEM WITH A FINANCIAL PRODUCT...:

Obamacare can't fix what was never broken (Robert J. Samuelson, May 9, 2013, Washington Post)

The most overlooked finding is that the uninsured already receive considerable health care. On average, the uninsured annually had 5.5 office visits, used 1.8 prescription drugs and visited an emergency room once. Almost half (46 percent) said that they "had a usual place of care," and 61 percent said that they had "received all needed care" in the past year. About three-quarters (78 percent) who received care judged it "of high quality." Health spending for them averaged $3,257.

True, when people were covered by Medicaid, many of these figures rose. The annual number of office visits went to 8.2; the number of drugs, to 2.5; the share of patients with a usual place of care, to 70 percent; the proportion receiving all needed care, to 72 percent. Preventive care also increased. The share of patients receiving screening for cholesterol moved from 27 percent for the uninsured to 42 percent; the share of women older than 50 having mammograms jumped from 29 percent to 59 percent; the share of men older than 50 getting PSA tests for prostate cancer doubled, from 21 percent to 41 percent. Spending rose to $4,429.

Unfortunately, the added care and cost didn't much improve physical health. The study screened for high blood pressure, high cholesterol, diabetes and the risk of heart attack or stroke. No major differences were detected between the uninsured and Medicaid recipients. There was more treatment for diabetes, although no difference was found between the two groups on a key indicator of the disease.

The only major health gain was psychological. Depression dropped from about 30 percent to 21 percent between the groups. One reason may have been that Medicaid recipients don't fear huge medical bills. Their out-of-pocket health costs were $337. For the uninsured, out-of-pocket costs were 64 percent higher. (Presumably, most non-out-of-pocket costs for the uninsured were covered by free clinics, charity care and uncollected debt.)

"Health insurance is a financial product that is aimed at providing financial security," the study says. On that ground, the expansion succeeded; by most clinical measures, it didn't. 


...that will both result in greater financial security and less health care than they were even receiving before they were insured.
Posted by at May 9, 2013 3:10 PM
  
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