"If you believe our results in Massachusetts, as I do, it seems pretty clear that expanding insurance coverage will lead to gains in saving lives," says Benjamin Sommers, an assistant professor at the Harvard University School of Public Health, who led the new study. "What I don't think you can argue anymore is that health insurance doesn't matter."Jonathan Cohn:
More Good News for Obamacare: It May Be Saving Lives After AllAdrianna McIntyre:
Health insurance saves lives. That means it improves health, tooHarold Pollack:
Could Obamacare save 24,000 lives a year?Bill Gardner:
Ten years of Romneycare data offer solid evidence that the Affordable Care Act could reduce the nation's mortality rate
Second, is it just to worry about the cost of health insurance only when we are considering insuring the poor? 55% of the US population had employer-based health insurance in 2011. Because this benefit isn’t taxed, this meant that 55% received a large subsidy for their insurance, including many affluent people. (And I’m sure Michael Cannon hates this, probably more than I do!) If you oppose the expansion of Medicaid, you should also favor the taxation of employee health benefits. Otherwise, you are arguing that we can afford to subsidize the health insurance of the rich, but that it costs too much to do it for the poor.More politics and policy below the fold.
My conservative twitterfriend Pradheep Shanker MD:
Health Care Saves Lives, But What’s Next? The Oregon vs Massachusetts ConundrumTom Liu:
Taking the two reports together made me wonder: If we consider deaths from failing to expand Medicaid as “preventable,” where would that fall?Jeffrey Young:
A 2012 Urban Institute report estimated that 15.1 million uninsured adults could gain coverage if every state expanded Medicaid. Using the 830 figure from the Massachusetts study, and acknowledging that the state's coverage wasn't exactly equivalent to Medicaid, that would translate to 18,193 deaths prevented per year.
Obamacare Could Save A Bunch Of Lives: Harvard StudyNY Times:
The death rate in Massachusetts dropped significantly after it adopted mandatory health care coverage in 2006, a study released Monday found, offering evidence that the country’s first experiment with universal coverage — and the model for crucial parts of President Obama’s health care law — has saved lives, health economists say.NPR:
More Health Insurance Equals Fewer Deaths In MassachusettsAnd for a deeper dive into the "how many lives would Medicaid expansion save" question, we have Dan Diamond:
Does expanding coverage improve health care?
Could these new findings could help nudge some holdouts toward the Medicaid expansion?
Sommers and his colleagues are cautious; while understanding that the findings may be used in the political debate, their study doesn't take the Massachusetts findings and project what would happen if every state expanded Medicaid under the ACA.
"Nationally, you have to be careful [when trying] to extrapolate from one state," Sommers said, noting the many differences between Massachusetts and other states—everything from the range in residents' financial situations to whether state officials support the idea of coverage expansion.
At the same time, the improvements that researchers spotted in Massachusetts may be the low bar, given that health coverage was already widespread before 2006. Simply put, there was less opportunity to see mortality rates fall in Massachusetts than in Texas, where more than a quarter of the population is uninsured.
For a sense of scope, here's one hypothetical: if every state that wasn't expanding Medicaid under the ACA saw a similar improvement as Massachusetts, how many lives would be saved? A back-of-the-envelope calculation, drawing on Kaiser Family Foundation estimates, suggests that more than 5,700 premature deaths would be avoided by the year 2018.
Tired of health care? Let's talk housing! Here's The American Conservative that may make your eyes widen (in a good way):
In choosing to give away housing to those who did not earn it by their labor, Utah may appear to be a bastion of “legalized plunder” in which hard-working Utahns are victimized by a powerful state government believing that somebody else deserves what they have earned. But dig deeper and you find a pioneering effort that is, first of all, effective and, if viewed properly, honors the spirit and substance of conservatism.Tired of housing? Let's talk pensions!
The model for Utah’s program took shape years earlier in New York City. Clinical psychologist Sam Tsemberis had grown frustrated with orthodox methods that called for the homeless to overcome addiction, seek treatment for mental illness, and find work before getting housed. Tsemberis realized none of that was possible without housing first. So in 1992 he founded Pathways to Housing, a nonprofit group that has slowly transformed the ways municipalities address homelessness.
“The disengagement between the person wanting a place to live and a system that is offering treatment and sobriety and participation in programing as a condition for housing has failed people like this for years,” Tsemberis said during a 2012 presentation in Providence, R.I.
Tsemberis struck out to change that system. His strategy hinges on getting the homeless into permanent housing in order to establish ties to a community.
The Supreme Court of the United States has agreed to resolve a circuit split about how courts should interpret collective bargaining agreements that provide for health insurance benefits for retired employees in M&G Polymers USA, LLC v. Tackett. The U.S. Court of Appeals for the Sixth Circuit says that such retiree health insurance benefits carry with them an inference that they are vested, or guaranteed to continue for life, while the majority of the other federal appellate courts require specific durational language to find that benefits are vested. Given the high cost of retiree health insurance on many employers’ balance sheets, M&G Polymers USA could represent a game changer for employers’ ability to modify retiree benefits going forward.