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Opinion: Medicaid expansion will not save lives

Opinion: Medicaid expansion will not save lives

Wayne Hoffman
October 30, 2015

“Everyday people with good health insurance and ready access to medical care die of preventable diseases,” my friend, John, a retired surgeon, wrote me recently.

My friend was lamenting a recent article appearing in many Idaho newspapers about the tragic death of a woman with asthma. Her death was blamed on lawmakers, who have refused to expand government-run programs like Medicaid to include able-bodied childless adults. The article is but the first, I’m sure, of many that will claim that someone’s death is connected to the unwillingness of lawmakers to put more people on government assistance. That legislators are to blame for people dying is a lie, but it’s one advocates for Medicaid expansion figure will move lawmakers to act.

But John is right. People on private insurance die, just as people on government programs or no program. Furthermore, several studies that have found with great consistency that people on government health programs don’t necessarily do better than people on no program at all. In fact, Medicaid has a horrible track record when it comes to saving lives, improving access to care and reducing costs. Those studies have also routinely noted that people on Medicaid had worse outcomes than those with no insurance at all.

These aren’t reports from pikers. The findings in a report from the University of Pennsylvania, a study from Columbia-Cornell, a report from the University of Pittsburgh and a Johns Hopkins study, just to name a few, all found that Medicaid patients ended up with worse medical outcomes including higher morbidity than those on private insurance or even no insurance. Those reports all found, consistently, that patients would have been better off if they weren’t part of the federal government’s Medicaid system.  

Perhaps that’s because sometimes we forget that being in a program isn’t the same as receiving medical care. If we really want to help people who need help—and I think we all do—then what we really should do is end Idaho’s experiment with single-payer government health care via county government and return to a system where local community clinics, volunteer doctors, charities, churches and neighbors all come together to get people the help they really need, to actually provide medical care, follow up visits and the resources to lift people up from poverty, not just keep them there.

Medicaid expansion doesn’t do any of those things. It doesn’t improve health care. It won’t magically create more doctors and more doctor visits in the state. It won’t solve the underlying problem that causes people to seek out government help in the first place. What it will do, however, and has done consistently in other states, is cost more money than expected, trap people in a cycle of poverty and government aid and drain resources in the existing Medicaid program from people who truly need help. It’s bad for taxpayers, bad for patients and bad for our state.

Thirty states have accepted Medicaid expansion. We should be thanking lawmakers, like Senate President Pro Tem Brent Hill, for steadfastly refusing to believe the “people are going to die” desperation narrative of Medicaid expansion propagandists. Idahoans neither want nor need another Big Government program with great intentions and horrible results.  

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