For reasons no known to any of us Harvard conducted a study to determine if health care outcomes changed when more individuals had Medicaid coverage. Here are the
unexpected, surprising, wholly unanticipated, results.
Into the maelstrom of debate over whether Medicaid should cover more people comes a new study by Harvard researchers who found that when states expanded their Medicaid programs and gave more poor people health insurance, fewer people died.
What does this mean? It means this. When politicians like Florida Gov. Rick Scott and others say they will not implement the Medicaid expansion that is part of the health care reform act they will literally be killing people. Not figuratively, literally.
Here is some statistical jargon from the research.
Medicaid expansions were associated with a significant reduction in adjusted all-cause mortality (by 19.6 deaths per 100,000 adults, for a relative reduction of 6.1%; P=0.001). Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties. Expansions increased Medicaid coverage (by 2.2 percentage points, for a relative increase of 24.7%; P=0.01), decreased rates of uninsurance (by 3.2 percentage points, for a relative reduction of 14.7%; P<0.001), decreased rates of delayed care because of costs (by 2.9 percentage points, for a relative reduction of 21.3%; P=0.002), and increased rates of self-reported health status of “excellent” or “very good” (by 2.2 percentage points, for a relative increase of 3.4%; P=0.04).
So now we have to adjust a familiar saying
“Guns don’t kill people. People don’t kill people. Politicians kill people.”
Too harsh, read the study.
Our estimate of a 6.1% reduction in the relative risk of death among adults is similar to the 8.5% and 5.1% population-level reductions in infant and child mortality, respectively, as estimated in analyses of Medicaid expansions in the 1980s. Our results correspond to 2840 deaths prevented per year in states with Medicaid expansions, in which 500,000 adults acquired coverage. This finding suggests that 176 additional adults would need to be covered by Medicaid in order to prevent 1 death per year.