Should-Read: Austin Frakt: Don’t Assume That Private Insurance Is Better Than Medicaid: “The RAND study… shows… people are terrible discriminators of what care is needed and what’s not… http://theincidentaleconomist.com/wordpress/dont-assume-that-private-insurance-is-better-than-medicaid/

…Since most people under the age of 65 are healthy, even in the RAND study, that doesn’t matter much. But even if most people are healthy, some are not (and particularly those on Medicaid). In the RAND study, poorer and sicker people—exactly the kind more likely to be on Medicaid—were slightly more likely to die with cost-sharing. Free care also resulted in improvements in vision and blood pressure for those with low income. As an influential 1983 New England Journal of Medicine paper put it: “Free care does make a difference.” One limitation of the RAND study is its age. It took place between 1971 and 1982. There have been no studies of cost-sharing to rival it since….

There are certainly private plans for poor and sick Americans that are better than Medicaid. But plans with very high cost-sharing—which are the ones being offered in Congress as A.C.A. replacements—are not among them…