I think that Mr. Sadow misrepresents the results of the Oregon Health Insurance Experiment. This experiment is very important because its use of a control (nonparticipating group) as a check on the results of a participating group, i.e., the health outcomes of groups receiving Medicaid coverage and not receiving Medicare coverage over a three year period. Sadow's conclusion was that there was no significant improvement in measured physical health outcomes or death risk. The immediate problem that a three-year study is probably too short to draw conclusions about morbidity. But the New England Journal of Medicine (May 2, 2013) gave this conclusion: 

"Despite these limitations, our study provides evidence of the effects of expanding Medicaid to low-income adults on the basis of a randomized design, which is rarely available in the evaluation of social insurance programs. We found that insurance led to increased access to and utilization of health care, substantial improvements in mental health, and reductions in financial strain, but we did not observe reductions in measured blood-pressure, cholesterol, or glycated hemoglobin levels." 

Presuming that Sadow is not a regular reader of medical journals, I went to The Quarterly Journal of Economics, August 2012. Its evaluation of the Oregon Health Insurance noted in its conclusion: "Using a randomized controlled experiment design, we examined the approximately one-year impact of extending access to Medicaid among a low-income, uninsured adult population. We found evidence of increases in hospital, outpatient, and drug utilization; increases in compliance with recommended preventive care; and declines in exposure to substantial out-of-pocket medical expenses and medical debts. We also found evidence of improvement in self-reported mental and physical health measures, perceived access to and quality of care, and overall well-being. Our results suggest that Medicaid provides benefits to this population above and beyond the non-Medicaid alternatives that exist through various safety-net options.".

If we are compiling a list of Medicaid myths, we should include Sadow's column.

Richard Lambert

retired

Mandeville