Mark D. White

Mark D. White

At the New York Times' Economix blog this morning, David Leonhardt reports on a recent NBER study that studied the health outcomes of low-income people who either were or were not granted access to Medicare through a lottery, and good golly gosh, guess what they found: those with health insurance had better health, both because of better care and lower financial burden.

I eagerly await the next study that finds out that giving people free shoes prevents food injury and frees up people's own resources for other things (perhaps more shoes).

Well of course giving people health insurance will in the most cases improve their health and financial situation. But there are other forms of health insurance, and other ways to reform the health care system, including the financial aspects of it, than the Affordable Care Act, which Mr. Leonhardt uses the paper to support. It is as if the only choice were between Obamacare and no care at all, hardly a fair or inclusive comparison. (Hell, listening to Justin Bieber may be preferable to no music at all, but I'll wait for the study results to confirm that.)

The paper itself seems more neutral, at least judging by the abstract:

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides a unique opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.

Again, the results seems obvious, but not necessarily politically motivated–I trust they acknowledge the shortcoming in the available data that limit the interpretation of their results.

I would ask Mr. Leonhardt, given that he supports the expansion of health insurance, if he also supports measures that would make private insurance cheaper and easier to maintain, such as allowing interstate competition (which would likely lower prices) and severing the link between employment and health insurance (that prevents many people from changing jobs for fear of losing their insurance).