This just in: providing the poor with medical insurance has a positive impact!
This isn’t news, exactly, but the argument for insuring low-income people has gotten a big boost from a groundbreaking new study in Oregon. This is good news for advocates of affordable health insurance, especially at a time when many are fighting state efforts to trim health care services for the poor.
As The New York Times reports, the study became possible because of an unusual situation in Oregon:
In 2008, the state wanted to expand its Medicaid program to include more uninsured people but could afford to add only 10,000 to its rolls. Yet nearly 90,000 applied. Oregon decided to select the 10,000 by lottery.
Economists were electrified. Here was their chance to compare those who got insurance with those who were randomly assigned to go without it. No one had ever done anything like that before, in part because it would be considered unethical to devise a study that would explicitly deny some people coverage while giving it to others.
But this situation was perfect for assessing the impact of Medicaid, said Katherine Baicker, professor of health economics at the Harvard School of Public Health. Dr. Baicker and Amy Finkelstein, professor of economics at M.I.T., are the principal investigators for the study.
Previous studies have examined people with health insurance and those without, but researchers had difficulty controlling for things like high rates of smoking, obesity, and diabetes found in higher rates among people without insurance.
In the Oregon study, researchers discovered a marked difference in the health habits, feelings, and finances of those enrolled in Medicaid and those who were not.
According to numbers highlighted by The New York Times, those who had Medicaid were 35% more likely to visit a doctor than those who were not covered. Women with coverage were 60% more likely to have mammograms and 70% more likely to have a clinic that they regularly visit. The number of people with coverage who reported good or excellent health increased by 25% in 2008, and they were 40% less likely to report deteriorating health than those in the uninsured group.
The remarkable differences extended to the financial realm as well – those who had Medicaid coverage were 25% less likely to have an unpaid bill sent to collections and 40% less likely to borrow money or skip other bill payments to pay for health care costs.
In 2010, Oregon was able to expand coverage to the remaining 80,000 applicants, effectively ending the experiment. Researchers are currently probing their data to discern longer-term health effects of insurance – on weight, blood pressure, and cholesterol, for example. What this will show us remains to be seen. If the current findings are any indication, though, the link between health insurance and well-being will likely be strengthened.