Expanded Medicaid decreases mortality

[Ma'ake]

http://www.nejm.org/doi/full/10.1056/NEJMsa1202099

I'd be interested in how conservatives react to this study.

To me, this is just part of a long tapestry of social and moral progress, going back to Teddy Roosevelt's "Square Deal", the 40 hour work week, child labor laws, the EPA driving down lead levels in children's blood by outlawing leaded gasoline, CHIP, etc.

I remember the unleaded gasoline upheaval, how the tyrannical Feds were going to not just destroy Detroit, but deliver a huge blow to American manufacturing, overall. Never materialized, lead in kid's blood went down 93%.

[Indy Coug]

But does it also increase the quality of life? Otherwise, the additional longevity just results in additional time needed to be supported by the state for medical and retirement benefits -- and therefore increases the total costs and the strain on the healthcare system. All of this while the baby boomers hit their twilight years being supported by an undersized workforce cohort who have to support them and their impaired, artificially extended existence.

[lambdacoug]

But does it also increase the quality of life? Otherwise, the additional longevity just results in additional time needed to be supported by the state for medical and retirement benefits -- and therefore increases the total costs and the strain on the healthcare system.

That's pretty cold. So we shouldn't increase longevity, unless we also improve quality of life, because it costs more?

[Ma'ake]

But does it also increase the quality of life? Otherwise, the additional longevity just results in additional time needed to be supported by the state for medical and retirement benefits -- and therefore increases the total costs and the strain on the healthcare system. All of this while the baby boomers hit their twilight years being supported by an undersized workforce cohort who have to support them and their impaired, artificially extended existence.

If people are deferring treatment because they don't have insurance, this could save money. We see it all the time in cancer treatment: people are between insurance or don't have insurance, so they defer treatment. By the time they actually show up, it's Stage IV.

[Moliere]

That's shocking that expanded healthcare increases a persons expected life span. Shocking!!!

Maybe next they'll do a study to see if progressive tax rates provide increased social services to the lower class.

[CardiacCoug]

If people are deferring treatment because they don't have insurance, this could save money. We see it all the time in cancer treatment: people are between insurance or don't have insurance, so they defer treatment. By the time they actually show up, it's Stage IV.

Bad example. It's far cheaper if people ignore cancer until they are Stage IV because then people always (literally 100%) die within a few months instead of being treated and able to survive for a few years and then (often) still dying -- a far more expensive route.

But I think expanding Medicaid probably has its biggest benefits in both extending life and improving quality of life when poor people get treatment for things like diabetes, high blood pressure, and high cholesterol. There you are extending life and improving quality of life, preventing thousands of strokes, heart attacks, cases of renal failure (avoiding dialysis is hugely cost-effective), blindness, neuropathy, amputations, etc.

[CardiacCoug]

I think the study results are valid and make sense. Undoubtedly there are poor people suffering from chronic health problems and not getting care because they can't afford it. And most of the care they need isn't expensive care, it's just getting some basic medications for their blood pressure and cholesterol and this care would undoubtedly be cheaper than caring for them after they have a health crisis.

Interesting though that the lead author is now paid by a branch of the federal government (US Department of Health and Human Services). He works for Obama!!

[Ma'ake]

Bad example. It's far cheaper if people ignore cancer until they are Stage IV because then people always (literally 100%) die within a few months instead of being treated and able to survive for a few years and then (often) still dying -- a far more expensive route.

Depends on the type of cancer. We've had lots of patients that come in with stage four lymphoma or even breast cancer we've treated with chemotherapy and radiation, sometimes surgery that extend their lives 10-20 years. Lance Armstrong is the classic example.

[CardiacCoug]

Depends on the type of cancer. We've had lots of patients that come in with stage four lymphoma or even breast cancer we've treated with chemotherapy and radiation, sometimes surgery that extend their lives 10-20 years. Lance Armstrong is the classic example.

Sure, and cancers like those that can be treated are ultimately far more expensive to the health care system than cancers that are too advanced to be effectively treated. Which is why your example wasn't quite right.

Where your point about prevention is correct is where a medication for hypertension ($100/yr) and a medication for diabetes ($100/yr) can stave off a heart attack ($50,000), a stroke ($100,000 inluding rehab) and dialysis ($40,000/yr)