So much for Medicaid or government insurance.

[rcdavis]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

[rcdavis]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

[rcdavis]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

[jmj11]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

 

One of the biggest gripes I have with Medicaid programs is the built in lack of personal responsibility. We have to reduce our numbers of these folks not only because they pay crappy, but worse, 50% no show their appointments and Medicaid rules forbid us from giving them disincentives for missing appointments such as a no-show fee. They should be required to pay no-show fees, and pay a copay even if it is $5. I know medicaid patients who are in such a state of social dysfunction that I honestly believe that going to the ER and/or getting scans is one of their hobbies that makes their lives meaningful. If they even had to pay $5 each time, I think they would rent a movie instead.

[jmj11]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

 

One of the biggest gripes I have with Medicaid programs is the built in lack of personal responsibility. We have to reduce our numbers of these folks not only because they pay crappy, but worse, 50% no show their appointments and Medicaid rules forbid us from giving them disincentives for missing appointments such as a no-show fee. They should be required to pay no-show fees, and pay a copay even if it is $5. I know medicaid patients who are in such a state of social dysfunction that I honestly believe that going to the ER and/or getting scans is one of their hobbies that makes their lives meaningful. If they even had to pay $5 each time, I think they would rent a movie instead.

[jmj11]

New england journal this week reports a 5 year study from Oregon, head to head comparison outcomes of Medicaid versus uninsured cohorts,

Guess what?

 

With exception of diabetes screening ( but not control), and depression improvement, and less worry about finances... Medicaid recipients DID NO BETTER THAN UNINSURED PATIENTS....

 

And the number of ED visits in the Medicaid population went UP, not down.

 

IMHO, this is a sentinel study pretty much disproving most of the hypotheses on which Obama care or even single payer programs are based.

 

Liberal and progressives, of course won't care about outcomes ... They will only point to the intentions of the programs.. " well, we mean well"...., and will be happy only as long as income distribution continues.

 

Summary: free health care leads to increased health care utilization, but no I provement in health outcomes.

 

Maybe we should drop all social insurance except for catastrophic, and let everyone start paying for their own routine care...

 

Whoa.. What a concept.

 

One of the biggest gripes I have with Medicaid programs is the built in lack of personal responsibility. We have to reduce our numbers of these folks not only because they pay crappy, but worse, 50% no show their appointments and Medicaid rules forbid us from giving them disincentives for missing appointments such as a no-show fee. They should be required to pay no-show fees, and pay a copay even if it is $5. I know medicaid patients who are in such a state of social dysfunction that I honestly believe that going to the ER and/or getting scans is one of their hobbies that makes their lives meaningful. If they even had to pay $5 each time, I think they would rent a movie instead.

[rcdavis]

I agree. Medicaid has absolved its clients of all personal responsibility, accountability, or sense of being vested in the game. Johnson and califano in the late 60s intended to do well.. But this system has now for the first time been documented to be what I have long suspected; of absolutely no medical health benefit to anyone that is in it.

 

Walmart's $4 drug list has probably made a bigger impact on the overall health outcomes of Americans than Medicaid.

 

I am bringing to develope an inkling of a radical idea.. Drop/stop all Medicaid and let the free market dictate health care...

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes, the variable then must shift from access to responsibility... Make patient's have skin in the game, make them pay, and let's see what those outcomes are.

 

I of course speak heresey to and liberals or progressives by proposing to take the best data available and use it to scuttle the program.

[rcdavis]

I agree. Medicaid has absolved its clients of all personal responsibility, accountability, or sense of being vested in the game. Johnson and califano in the late 60s intended to do well.. But this system has now for the first time been documented to be what I have long suspected; of absolutely no medical health benefit to anyone that is in it.

 

Walmart's $4 drug list has probably made a bigger impact on the overall health outcomes of Americans than Medicaid.

 

I am bringing to develope an inkling of a radical idea.. Drop/stop all Medicaid and let the free market dictate health care...

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes, the variable then must shift from access to responsibility... Make patient's have skin in the game, make them pay, and let's see what those outcomes are.

 

I of course speak heresey to and liberals or progressives by proposing to take the best data available and use it to scuttle the program.

[rcdavis]

I agree. Medicaid has absolved its clients of all personal responsibility, accountability, or sense of being vested in the game. Johnson and califano in the late 60s intended to do well.. But this system has now for the first time been documented to be what I have long suspected; of absolutely no medical health benefit to anyone that is in it.

 

Walmart's $4 drug list has probably made a bigger impact on the overall health outcomes of Americans than Medicaid.

 

I am bringing to develope an inkling of a radical idea.. Drop/stop all Medicaid and let the free market dictate health care...

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes, the variable then must shift from access to responsibility... Make patient's have skin in the game, make them pay, and let's see what those outcomes are.

 

I of course speak heresey to and liberals or progressives by proposing to take the best data available and use it to scuttle the program.

[68W2PA]

...

 

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes...

 

How can an educated person such as yourself write that sentence with a straight face?

 

1) Nothing has been proven. Not even the authors of the study are making the claim you are here.

 

2) I don't know of any reasonable person who would claim medicaid recipients have "unlimited free access to health care". There are plenty of limitations.

 

3) Even if this study were saying what you just claimed (which it is not), there are still plenty of example of public healthcare systems that do indeed produce better results.

[68W2PA]

...

 

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes...

 

How can an educated person such as yourself write that sentence with a straight face?

 

1) Nothing has been proven. Not even the authors of the study are making the claim you are here.

 

2) I don't know of any reasonable person who would claim medicaid recipients have "unlimited free access to health care". There are plenty of limitations.

 

3) Even if this study were saying what you just claimed (which it is not), there are still plenty of example of public healthcare systems that do indeed produce better results.

[68W2PA]

...

 

As it has now been proven that unlimited free access to health care makes no difference to medical condition outcomes...

 

How can an educated person such as yourself write that sentence with a straight face?

 

1) Nothing has been proven. Not even the authors of the study are making the claim you are here.

 

2) I don't know of any reasonable person who would claim medicaid recipients have "unlimited free access to health care". There are plenty of limitations.

 

3) Even if this study were saying what you just claimed (which it is not), there are still plenty of example of public healthcare systems that do indeed produce better results.

[rcdavis]

Have you read the study?

Looked at the results?

 

The data are there.. The lack of any substantive difference between two matched cohorts, only difference being one covered carte Blanche by the government, the other completely uninsured, sort of speaks volumes, doesn't it.

 

Let's give Medicaid its due: that cohort had significantly less stress over finances, had better improvement of depression, and we're better screened for diabetes..

 

And that was the only way, the.only.ways. That the Medicaid cohort had better out come than the completely uninsured cohort.

 

I am not well educated. But I know a poor deal and a scam when I see one.

 

This study is the first of its kind... Well designed, variable matched.

 

Gonna be hard to sell Medicaid or Obama care to the states after this...

 

In reality, as long as it is your dollars paying for this insurance, I don't care.l but I really do not want to continue throwing my dollars at a program which seems to really have no benefit ( other than some people "feeling good that they are giving money (insurance) to folks").

 

I know a bad deal when I see it.

 

I also am old enough to have lived in the south during several decades PRE-great society.. And frankly, I do not see all that much Improvement since medicaid's inception ( with the exception of initially improved surgery salaries).

 

If it would help, I can post the study

 

We can disagree agreeably.

 

But, to me, I am seeing the light, and in its luminance I am noting that the emperor has on no clothes

 

 

Oh yeah.. Can you name significant hinderences to Medicaid recipients to health care?

 

There are virtually none, with the possible exception of an increasing number of physicians which do not accept it...

 

And they universally have better access than the uninsured.. To whom they were compared...

 

You may WANT to think Medicaid improves OUTCOMES,

 

I WANT to win the literary.

 

But I doubt neither is likely.. And the study certainly seems to confirm my opinion.

 

Which it were not so... But it seems to be so.

 

Of course a lot of folks won't like it...

 

5 years of data..... Authored by one of the major designers of obamacare.... Hmmmmm.

[rcdavis]

Have you read the study?

Looked at the results?

 

The data are there.. The lack of any substantive difference between two matched cohorts, only difference being one covered carte Blanche by the government, the other completely uninsured, sort of speaks volumes, doesn't it.

 

Let's give Medicaid its due: that cohort had significantly less stress over finances, had better improvement of depression, and we're better screened for diabetes..

 

And that was the only way, the.only.ways. That the Medicaid cohort had better out come than the completely uninsured cohort.

 

I am not well educated. But I know a poor deal and a scam when I see one.

 

This study is the first of its kind... Well designed, variable matched.

 

Gonna be hard to sell Medicaid or Obama care to the states after this...

 

In reality, as long as it is your dollars paying for this insurance, I don't care.l but I really do not want to continue throwing my dollars at a program which seems to really have no benefit ( other than some people "feeling good that they are giving money (insurance) to folks").

 

I know a bad deal when I see it.

 

I also am old enough to have lived in the south during several decades PRE-great society.. And frankly, I do not see all that much Improvement since medicaid's inception ( with the exception of initially improved surgery salaries).

 

If it would help, I can post the study

 

We can disagree agreeably.

 

But, to me, I am seeing the light, and in its luminance I am noting that the emperor has on no clothes

 

 

Oh yeah.. Can you name significant hinderences to Medicaid recipients to health care?

 

There are virtually none, with the possible exception of an increasing number of physicians which do not accept it...

 

And they universally have better access than the uninsured.. To whom they were compared...

 

You may WANT to think Medicaid improves OUTCOMES,

 

I WANT to win the literary.

 

But I doubt neither is likely.. And the study certainly seems to confirm my opinion.

 

Which it were not so... But it seems to be so.

 

Of course a lot of folks won't like it...

 

5 years of data..... Authored by one of the major designers of obamacare.... Hmmmmm.

[rcdavis]

Have you read the study?

Looked at the results?

 

The data are there.. The lack of any substantive difference between two matched cohorts, only difference being one covered carte Blanche by the government, the other completely uninsured, sort of speaks volumes, doesn't it.

 

Let's give Medicaid its due: that cohort had significantly less stress over finances, had better improvement of depression, and we're better screened for diabetes..

 

And that was the only way, the.only.ways. That the Medicaid cohort had better out come than the completely uninsured cohort.

 

I am not well educated. But I know a poor deal and a scam when I see one.

 

This study is the first of its kind... Well designed, variable matched.

 

Gonna be hard to sell Medicaid or Obama care to the states after this...

 

In reality, as long as it is your dollars paying for this insurance, I don't care.l but I really do not want to continue throwing my dollars at a program which seems to really have no benefit ( other than some people "feeling good that they are giving money (insurance) to folks").

 

I know a bad deal when I see it.

 

I also am old enough to have lived in the south during several decades PRE-great society.. And frankly, I do not see all that much Improvement since medicaid's inception ( with the exception of initially improved surgery salaries).

 

If it would help, I can post the study

 

We can disagree agreeably.

 

But, to me, I am seeing the light, and in its luminance I am noting that the emperor has on no clothes

 

 

Oh yeah.. Can you name significant hinderences to Medicaid recipients to health care?

 

There are virtually none, with the possible exception of an increasing number of physicians which do not accept it...

 

And they universally have better access than the uninsured.. To whom they were compared...

 

You may WANT to think Medicaid improves OUTCOMES,

 

I WANT to win the literary.

 

But I doubt neither is likely.. And the study certainly seems to confirm my opinion.

 

Which it were not so... But it seems to be so.

 

Of course a lot of folks won't like it...

 

5 years of data..... Authored by one of the major designers of obamacare.... Hmmmmm.

[MedicinePower]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

[MedicinePower]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

[MedicinePower]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

[EMEDPA]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

[EMEDPA]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

[EMEDPA]

It's disingenuous to say that government insurance doesn't help. Remember how everyone 65 or older (and the disabled) all have Medicare. I doubt very much that is we suddenly stop providing them with medical care their outcomes would be the same as if we did provide them with medical care.

 

It's not that Medicaid is so bad as the patients on Medicaid are so compromised.

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

[bradtPA]

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

 

There has to be some limits to stop abuse. In NC, there is a $3 copay for adults (children are still free) and a limit of 22 visits to a doctor's office per year....

[bradtPA]

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

 

There has to be some limits to stop abuse. In NC, there is a $3 copay for adults (children are still free) and a limit of 22 visits to a doctor's office per year....

[bradtPA]

the study Davis is talking about examined MEDICAID, not MEDICARE, which are very different systems and insure very different populations.

MEDICAID is abused. no doubt about it. I see it every day. folks who come to the er for a pregnancy test because going to the dollar store for one would cost a dollar but the govt ends up footing a 250 dollar bill for the test. I agree a minimal copay for medicaid(like 5 dollars) would stop the majority of the frivolous er visits. we have a lady on medicaid who comes into the dept EVERY DAY. if she had to decide between an er visit or her pack of smokes every day we would be seeing her less.

MEDICARE is a program to mostly insure the elderly. much less abuse in this system.

I agree that walmart/target/etc 4 and 5 dollar lists are wonderful. most of us now only prescribe off these lists except for the rare pt with actual real insurance with prescription coverage.

 

There has to be some limits to stop abuse. In NC, there is a $3 copay for adults (children are still free) and a limit of 22 visits to a doctor's office per year....

[EMEDPA]

There has to be some limits to stop abuse. In NC, there is a $3 copay for adults (children are still free) and a limit of 22 visits to a doctor's office per year....

they should limit inappropriate er visits first. around here the pcp who accepts medicaid(yup, there is only 1 in the county) requires a 40 dollar copay. guess what? this defeats the purpose and no one goes to their pcp, they all come to the er because it is "free". some folks who actually just need a very reasonable rx refill for atenolol will still come to the er because they honestly can't afford the 40 dollar copay to see their pcp , as much as they would like to.