Political Animal


May 02, 2013 4:35 PM Health Care Is Probably Good For Your Health

By Ed Kilgore

Kevin Drum, bless him, won’t let go of the Oregon Medicaid study, which, the more you stare at it, doesn’t much “prove” what conservatives say it proves:

[I]t turns out there were improvements in blood pressure, glycated hemoglobin, and cholesterol, but the size of the study was fairly small, so the results weren’t statistically significant. Specifically, as Sam Richardson tweets, “#Oregon point estimates: Reductions of 30% in depression, 18% in high HbA1c, 17% in high chol, 8% in high BP. Big effects, little power.”

“Proving no positive health outcomes” (even if you ignore the very positive finding about the impact of Medicaid on depression) is a very different thing from finding improved health outcomes in a sample so small that you can’t deem them as “statistically significant.”

But here’s the bigger issue Kevin raises:

The truth is that if you take a narrow view of “outcomes,” it’s hard to find a significant effect from most of our healthcare efforts. Nonetheless, improved access to Medicaid produces plenty of improvement in acute problems; better use of preventive care; and far better financial outcomes. This is all worthwhile stuff even if controlling chronic conditions remains a challenge.
Overall, I’m a little unclear about what the conservatives who are crowing over this study really think. They obviously believe that access to healthcare is a good thing for themselves. (At least, I haven’t heard any of them swearing off doctor visits.) But you can’t have it both ways. If it’s a good thing for us middle-class types, it’s a good thing for poor people too. Conversely, if it’s useless for poor people, then it’s useless for the rest of us too. So which is it?

If something about Medicaid itself is the problem here, then what’s the alternative? Insurance poor people can’t afford for crappy coverage in high-risk pools? Reliance on hospital emergency rooms for expensive acute care the rest of us pay for? Most of those who are using a cartoon version of this study to provide a talking point for screwing up the implementation of Obamacare probably aren’t thinking about alternatives at all.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • Robert Waldmann on May 02, 2013 4:43 PM:

    Is it worth pointing out that national treasure Kevin Drum is your blog brother or at least your blog first cousin as he was political animal before brother Benen ?

    Anyway, the post to which you link is, in my humble opinion, blogging at its best which is also journalism at its best.

  • c u n d gulag on May 02, 2013 4:57 PM:

    Which part of 'preventative medicine' 'prevents' problems, which then CAN'T be tracked, because there ARE NO problems to track, do you NOT understand?

    Most of you understand.
    But you can't deal in facts.
    So, you make sh*t up, or twist things, to mean the opposite of what's meant.

  • Oregonian on May 02, 2013 5:18 PM:

    I looked through The (Portland) Oregonian's website (oregonlive.com) for news of this study and found... nothing.

    Waiting for a response from our state and Gov. Kitzhaber.

  • Daddy Love on May 02, 2013 5:25 PM:

    Of course they've thought about alternatives!

    "Die. And die quickly."

  • Mark Rubin on May 02, 2013 6:47 PM:

    My Wingnut friends have a ready answer for "why isn't preventive care beneficial for poor people?" It goes like "those people will never use it, they just do dumb sh*t and run to the emergency room, they f*ck like rabbits and have abortions, etc." Also, I hear "we can't afford it," as if their care--many of them work for the government, but because they are educated professionals, they see themselves as "other" than gub'mint workers--isn't subsidized. Blah, blah, blah! When you are dealing with a group that cannot empathize, and only wants a world with people just like them in their midst, nothing rational is worthy of consideration. For me, the answer is really simple: One of these underserved people will host a bacterium and somewhere, somehow, the "bug" will find me. Public health is where it's at!!!

  • RaflW on May 03, 2013 12:52 AM:

    The problem, dear Ed, is in the innumeracy of our press and the insincerity of our republicans.

  • alwaysiamcaesar on May 03, 2013 8:14 AM:

    RaflW , an , a , for effort , but you only really began the torturous summary of diffuse and persistent pressures to change the subject , or more importantly refresh the mint in the julapium .