A neat comparison of the evidence over mortality and rates of successful treatment between uninsured patients, Medicaid patients, and those on private insurance plans.

    For instance, uninsured patients who are diagnosed with cancer in our state frequently qualify immediately for Medicaid and are no longer uninsured. This leads to a rather frustrating situation for some of my patients who are uninsured and suspected of having cancer but can’t afford the biopsy necessary to prove it and make them eligible for Medicaid. We have other resources, including limited state funds and charitable funds administered through our cancer center that can fund such biopsies, but it’s very frustrating to cancer doctors that such resources are even necessary, given how great the need is.

    Taken together, from my perspective, the evidence is consistent with a conclusion that having Medicaid results in better health outcomes than not having Medicaid but that those outcomes are not as good as those associated having private insurance (although one study did find a paradoxical result). Most likely this is due to a combination of socioeconomic status and lack of primary care resources, all leading to their presenting at a later stage in their disease, as these studies, which are just a more recent sampling of existing studies, clearly indicate. For some conditions, Medicaid patients do as poorly as the uninsured, and those are the studies cited by legislators like Mr. Colbeck to argue against Medicaid expansion. Sometimes they are intermediate in their outcomes, not as good as patients with private insurance but not as bad as the uninsured. These tend to be the studies ignored by legislators like Mr. Colbeck and the pundits that he cites. However you analyze the evidence, however, it is clear that Medicaid patients do have worse outcomes, sometimes a lot worse, than patients with private insurance, and that the cause is almost certainly multifactorial in such a way that simply getting access to bare-bones health insurance like Medicaid can’t remedy. Many of these studies have unmeasured confounders that resort in worse outcomes in Medicaid patients.

posted by thundara: 1875 days ago