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One would have hoped Obamacare would have caused an increase in longevity, what with the dramatic decrease in the uninsured. Particularly, the expansion of Med

One would have hoped Obamacare would have caused an increase in longevity, what with the dramatic decrease in the uninsured. Particularly, the expansion of Medicaid which allowed the poor to gain treatment for chronic conditions like diabetes which they had not had previous access to. But I suppose for that to show up in death statistics would play out over a much longer time scale.

yummyfajitas 10y ago
The best data we have (an actual randomized control trial) suggests the medicaid expansion did not affect objective measures of health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ It did, however, affect various subjective measures. People feel good about going to the doctor and having an insurance card even if it doesn't help them. It's possible there is a long term, small, hard to measure effect, but we have little evidence of it.
- coldtea 10y ago
  Well, "Medicaid substantially reduced the prevalence of depression", which IS a health effect. It also helped people treat their conditions and illnesses (the increased visits, etc). What it didn't no is have lifestyle-level health effects ("had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk") which I don't see why anyone would expect it to have. For one, they just checked after 2 years -- not a significant time unless somebody starts dedicated and determined lifestyle changes. Those people remained poor and retained their lifestyle habits regarding exercise, food etc (which is what accounts for blood pressure, cholesterol, etc). They just get better access to healthcare. If Medicare gave them leisure time, a private chef or high end restaurant gift cards, and a personal trainer it would be a different story...
  - yummyfajitas 10y ago
    Depression is a subjective measure, not an objective one. It's clear that giving people insurance makes them feel better. Increased visits is a cost (about $1200/recipient), not a benefit. I agree that we should have run the Oregon experiment a lot longer and tied the implementation of Obamacare to the outcome.
- thinkcontext 10y ago
  Thanks, that's quite interesting.
- maxerickson 10y ago
  Does that study examine the impact of access to healthcare or the impact of access to healthcare for a group of people that are relatively healthy? The expansion would have been to people that were earning too much to qualify for Medicaid. That's going to mean they were relatively healthy. I'm also not real sure that increasing quality of life and financial security is fairly described by the doesn't help them in People feel good about going to the doctor and having an insurance card even if it doesn't help them. I realize you are carefully talking about effects on objective measures of health, but maybe that isn't the only goal of such programs?
  - yummyfajitas 10y ago
    It studies the impact on the exact group of people that Obamacare expanded medicaid to. I agree with you that making people healthier was not the real goal of Obamacare. If it was we'd have passed the "Affordable Gym Memberships and Vegetables Act" (aka "Michelle Obamacare") instead.

yummyfajitas 10y ago

The best data we have (an actual randomized control trial) suggests the medicaid expansion did not affect objective measures of health. https://www.nber.org/oregon/ https://www.nber.org/oregon/ It did, however, affect various subjective measures. People feel good about going to the doctor and having an insurance card even if it doesn't help them. It's possible there is a long term, small, hard to measure effect, but we have little evidence of it.

coldtea 10y ago
Well, "Medicaid substantially reduced the prevalence of depression", which IS a health effect. It also helped people treat their conditions and illnesses (the increased visits, etc). What it didn't no is have lifestyle-level health effects ("had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk") which I don't see why anyone would expect it to have. For one, they just checked after 2 years -- not a significant time unless somebody starts dedicated and determined lifestyle changes. Those people remained poor and retained their lifestyle habits regarding exercise, food etc (which is what accounts for blood pressure, cholesterol, etc). They just get better access to healthcare. If Medicare gave them leisure time, a private chef or high end restaurant gift cards, and a personal trainer it would be a different story...
- yummyfajitas 10y ago
  Depression is a subjective measure, not an objective one. It's clear that giving people insurance makes them feel better. Increased visits is a cost (about $1200/recipient), not a benefit. I agree that we should have run the Oregon experiment a lot longer and tied the implementation of Obamacare to the outcome.
thinkcontext 10y ago
Thanks, that's quite interesting.
maxerickson 10y ago
Does that study examine the impact of access to healthcare or the impact of access to healthcare for a group of people that are relatively healthy? The expansion would have been to people that were earning too much to qualify for Medicaid. That's going to mean they were relatively healthy. I'm also not real sure that increasing quality of life and financial security is fairly described by the doesn't help them in People feel good about going to the doctor and having an insurance card even if it doesn't help them. I realize you are carefully talking about effects on objective measures of health, but maybe that isn't the only goal of such programs?
- yummyfajitas 10y ago
  It studies the impact on the exact group of people that Obamacare expanded medicaid to. I agree with you that making people healthier was not the real goal of Obamacare. If it was we'd have passed the "Affordable Gym Memberships and Vegetables Act" (aka "Michelle Obamacare") instead.