Monday Morning Medicaid Must Reads: May 7th, 2018

Helping you consider differing viewpoints. Before it’s illegal. 


Article 1:  

States Can’t Afford Medicaid Expansion — Neither Can Patients, Sally Pipes, Forbes, April 30th, 2018

Clay’s summary: All that extra spending may be for naught (in terms of healthcare outcomes anyway. For political influence, its gravy).

Key Passage from the Article

Activists in Utah, Idaho, and Nebraska are trying to follow Maine’s lead, by putting expansion to the voters this fall.

Before they cast their ballots — and approve millions of dollars in new spending — residents of the three states ought to consider whether Medicaid actually improves the health of its beneficiaries. Surprisingly, research shows that it doesn’t.

Consider Oregon’s experience. In 2008, the state extended Medicaid coverage to 6,300 uninsured patients chosen at random through a state lottery. Researchers from Harvard, Columbia, and Massachusetts Institute of Technology compared health outcomes for these newly eligible beneficiaries to those for uninsured people who weren’t chosen in the lottery.

They concluded that the new enrollees displayed “no significant improvements in measured physical health outcomes in the first 2 years.”

Read it here 

Article 2:   

Medicaid Is Right to Demand Lower Drug Prices, Peter Bach, Bloomberg, May 1, 2018

Clay’s summary:  Dollars are getting short and docs are getting trigger-happy with the price tags on human life / quality.

Key Passage from the Article

During the board meeting, the Institute for Clinical and Economic Review, a nonprofit that assesses the value of prescription drugs, presented its report on Orkambi. ICER found that the drug’s list price amounts to $1.3 million per additional year of life it provides, or $900,000 if you take into account the improved quality of life Orkambi brings. Those numbers are more than four times the current benchmark for cancer drugs.

Oh, and those prevented hospitalizations? ICER found that the state had to spend about $326,000 on Orkambi to prevent each one of them. (Disclosure: ICER is in part funded by the Laura and John Arnold Foundation. My research is, as well. Our grants are unconnected.)

Read it here




Article 3:   

Higher Ed, Lower Spending, Douglas Webber, Education Next, Summer 2018, Volume 18, No.3

Clay’s summary: Doesn’t this guy know that Medicaid is a sacred cow and we will happily sacrifice college for all to keep it going?

Key Passage from the Article

I find that state and local public-welfare spending is easily the dominant factor driving budget decisions, with a $1 increase per capita associated with a $2.44 decrease in per-student higher-education funding—enough to explain the entire average national decline. In particular, my analysis finds that state Medicaid spending is the single biggest contributor to the decline in higher-education funding at the state and local level.

Read it here