Medicaid: The $7 trillion anti-depression program

Phillip Klein @ The Washington Examiner:

As I reported on Wednesday, a landmark new study in the New England Journal of Medicine found that an expansion of Medicaid in Oregon did not improve physical health care outcomes among enrollees. This bombshell finding in a scientifically rigorous study (which included Obamacare’s intellectual architect Jonathan Gruber among its co-authors) has rocked the health care policy world.

Predictably, defenders of Medicaid have jumped to downplay the results or explain them in a favorable light. The New Republic’s Jonathan Cohn noted that though there was no improvement in the physical health of Medicaid beneficiaries (measured by such factors as cholesterol, blood pressure and blood sugar levels), the results found that Medicaid lessened the financial strain on families and improved mental health. This spin was embraced by the broader media. The Associated Press reported on the study with the headline: “Medicaid improved mental health for uninsured.”

Over at the Daily Beast, Megan McArdle, a long time skeptic of the idea that health insurance dramatically improves health outcomes, reflects on how the debate has shifted:

There’s been a bit of revisionist history going on recently about what, exactly, its supporters were expecting from Obamacare–apparently we always knew it wasn’t going to “bend the cost curve”, or lower health insurance premiums, or necessarily even reduce the deficit, and now it appears that we also weren’t expecting it to produce large, measurable improvements in blood pressure, diabetes, or blood sugar control either.  In fact, maybe what we were always expecting was a $1 trillion program to treat mild depression.

This isn’t to dismiss the seriousness of depression or the importance of mental health. But the pertinent question from a policy perspective isn’t whether, if government throws enough money into a program, it can produce some benefits to some people. (It isn’t surprising, for instance, that giving people free health care will save them money.) The question is whether the benefits justify the costs. And Medicaid is an incredibly expensive program.

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