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 totally
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.
RESULTS
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.3,4 Our results correspond to 2840 deaths
prevented per year in states with Medicaid expansions, in which 500,000 adults
acquired coverage.15 This finding suggests that 176
additional adults would need to be covered by Medicaid in order to prevent 1
death per year.
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