Well, Halleluiah. The Obamacare website is up and running.
Of course, at only half a million applications processed so far… and accounting for the ones that the system garbled or couldn’t verify or seems to have lost… and anticipating the tens of millions of Americans predicted to lose coverage once the employer mandate kicks in and it turns out to be simpler and cheaper for companies to send workers to the government’s back-up plan (the one paid for by the so-called “fine” that Chief Justice John Roberts correctly identified as a “tax”) than to navigate the troubled waters of Obamacare’s rules and costs… America should achieve the fervently promised universal coverage by — Oh, I don’t know — how about sometime in the next decade. Maybe.
I guess that’s what you call close enough for government work.
To think of it. A scant two months ago, 85 percent of the people in this happy republic had health insurance they liked, valued, and wanted to keep. Period. Now anger, anxiety and disgust fill the land.
But, as they say on the late night commercials, that’s not all. There’s more.
And that “more” amounts to even more serious business.
It is captured in a supposedly suppressed statistic I was told recently on good authority. You have probably heard that Medicaid sign-ups have dominated such early registrations as have actually happened. And you have heard that the problem with this imbalance is that it will bankrupt the system. That’s before it bankrupts the states that, after an early payment holiday ends, will bear an increasing share of the cost. The cost of more Medicaid (which is free to the poor) was to be balanced by the dollars from all those now surprisingly scarce Obamacare sign-ups.
But what you haven’t heard is how surprisingly scarce the regular sign-ups are. As I say, I have it on stellar authority that a week and a half ago one typical state was three quarters of the way to 100,000 Obamacare registrants… of which fewer that two dozen were for regular Obamacare. Fewer than two dozen. The rest were for Medicaid.
I can hear our friends on the left saying, at least those new Medicaid recipients now have some coverage. At least they have Medicaid.
My response? “How callous!”
I have been teasing until now. After all, the whole mess is so Keystone Kops-like, how can you help but laugh? But the move of millions onto Medicaid is something else.
Last week, I talked about The Cure for Obamacare, an Encounter Broadside book by Pacific Research Institute president Sally Pipes (http://amzn.to/1fOpvLG) and linked to a four-and-a-half minute cartoon video (http://bit.ly/1jeZYv3) based on it. Both lay out the widely accepted alternative to the president’s impossible scheme.
This week I want to highlight another Encounter Broadside book, How Medicaid Fails the Poor by Manhattan Institute scholar Avik Roy (http://amzn.to/1bgmMdj). The evidence is overwhelming. At enormous expense – dollars that could go to good use elsewhere — Medicaid either has no impact compared to no coverage or is in fact dangerous to the health of the poor.
Here is a sampling of the evidence Roy presents.
In 2010, University of Virginia researchers evaluated almost 894,000 major surgical operations conducted between 2003 to 2007. “Patients on Medicare who were undergoing surgery,” reports Roy, “were 45 percent more likely to die before leaving the hospital than those with private insurance; the uninsured were 74 percent more likely to die; and Medicaid patients were 93 percent more likely.” To account for differences in the populations served, these figures were what statisticians call “normalized” for age, gender, income, geographic region, the operation performed and the initial health status of the patient.
A University of Pennsylvania study found Medicaid patients 27 percent more likely to die undergoing surgery for colon cancer than uninsured patients.
A Johns Hopkins study of patients with lung transplants “found that Medicaid patients were 8.1 percent less likely to be alive 10 years after their transplant operation, compared with those with private insurance or those without insurance. Medicaid was a statistically significant predictor of death three years after transplantation, even after controlling for clinical factors.”
Then there’s the now famous Oregon study the results of which were published in May this year. It compared new Medicaid recipients with non-recipients for factors across the board, not just major operations and other catastrophic events, where Medicaid appears to be a significant risk factor. Its conclusion: Medicaid “generated no significant improvement in measured physical health outcomes.” Metrics included “death, diabetes, high cholesterol, and high blood pressure.”
Hundreds of billions of dollars spent each year. Nothing to show for it or worse. And now what are we doing. Doubling down. Go figure.
As I said last week, the alternatives are simple and proven. It is time to embrace them.