January 23, 2015

Those of us questioning spending $3 billion of North Carolina taxpayers money to add able bodied, childless adults, many of whom don’t work, onto Medicaid’s free health insurance rolls have blood on our hands. That’s the basic conclusion of N. C. Policy Watch, the website funded by WRAL TV owner Jim Goodmon.

N. C. Policy Watch claims “The simple and most powerful truth about expanding Medicaid is that it will save human lives – lots and lots of them. Think about that for a second: the political leaders of our state literally hold the very lives of thousands of their fellow citizens in their hands.”. Wow. If you disagree with them on ObamaCare’s Medicaid expansion, in a mirror image of screaming baby killer, you’re killing people like the grisliest abortion clinic around, right?

As evidence expanding Medicaid saves lives, they cite a study of states that enrolled childless adults in Medicaid between 2000 and 2005 and compared death rates with neighboring states. It’s useful to consider the analysis of Duke University healthcare economist Christopher Conover concerning that evidence. “The higher figures are based on a study that compared three states that substantially expanded adult Medicaid eligibility since 2000; New York, Maine, and Arizona; with neighboring states that didn’t do an expansion. So, this Health Affairs study simply took the average results from all three states and extrapolated them to the entire nation without telling you that in the original study on which this was based, only one state, New York, actually demonstrated a statistically significant decline in mortality attributable to Medicaid.”

So in 2 out of 3 cases, Medicaid expansion had no effect saving lives . Conover explains “This is equivalent to a doctor telling you that the blue pill will reduce your risk of death even though two out of three patients in the clinical trials of that drug showed no benefit whatsoever. It’s worse than that, since New York’s Medicaid program ranks #8 in the country according to Public Citizen. The states where Medicaid had no apparent effect on mortality ranked #13, Maine, and #24, Arizona.

Thus, most states that have not expanded Medicaid are much more likely to get results like Maine’s and Arizona’s than New York’s. That is, their characteristics are more similar to the patients who didn’t benefit from the blue pill than the one in three patients who did.”

Oh well, Medicaid saved lives in New York anyway, didn’t it? The Duke University expert doesn’t believe that flimsy story either. “Moreover, we don’t even have a lot of confidence that the apparent mortality benefit in New York even can be reliably attributed to Medicaid. The study did not measure actual mortality experience of people with and without Medicaid. Instead, it looked at county level non-elderly death rates for all causes before and after Medicaid expansion and then tried to make those counties as statistically comparable as possible.

Taken at face value, the study implies that Medicaid expansion reduces external causes of death; such as injuries, suicides, homicides, substance abuse; by 50%. Now it’s not impossible for health insurance to reduce mortality risk due to such causes, but it seems highly improbable that Medicaid coverage would allow such causes of death to be cut in half, yet that’s what the study implies if you believe the results at face value.”

Isn’t it a little implausible to think Medicaid expansion has something to do with the number of murders?

The idea that government should provide health insurance through Medicaid to more people is a legitimate issue to debate. It’s also legitimate to say free health insurance as a government entitlement for able bodied people who don’t work is undeserved. It’s reasonable to say responsibility ought to go with any government benefit.

As the Foundation for Government Accountability found, a significant portion of the population targeted for Medicaid expansion, 35%, have criminal records according to Justice Department statistics. What’s wrong with requiring some personal responsibility?

What’s wrong is the idea Medicaid expansion is all that stands between people and death. Doctors and hospitals have always provided charity care. In fact, states like Arizona that expanded Medicaid coverage to the able bodied slashed life saving organ transplants to cut costs and keep covering the able bodied when Medicaid expansion needed four times more money than expected.

Cutting help for disabled people who can’t help themselves in order to help able bodied people who aren’t helping themselves is a strange definition of compassion.

Just as Pro-lifers who call their opponents baby killers rarely persuade anyone, the left’s new tactic of portraying Medicaid expansion skeptics as killers won’t advance their cause either.