Must-Read: Ezra Klein: Conservatives believe Medicaid is worthless, so slashing it is harmless. They’re wrong

Must-Read: I don’t think any—statistically literate—conservatives believe Medicaid is worthless. Statistically illiterate ones may, and there may be many people who have taken great care to maintain their statistical illiteracy. But the truest core argument—if, as Thomas Hobbes once translated Thoukydides, “the least in speech”—is not that Medicaid is worthless, but that the lives of those who need Medicaid are worth little, and not worth spending public money on. They may say that they believe the first—that Medicaid is worthless. But that, I believe, is, for the statistically literate and for those who have worked hard to remain statistically illiterate, pretense: what they believe is that the lives of those who need Medicaid are worth little.

Ezra Klein: Conservatives believe Medicaid is worthless, so slashing it is harmless. They’re wrong: “Expanding Medicaid saves lives at a cost of $327,000 to $867,000 per life saved… https://www.vox.com/health-care/2017/6/29/15885796/medicaid-senate-gop-health-bill-benefits-bcra

…it’s worth noting that “other public policies that reduce mortality have been found to average $7.6 million per life saved,” making Medicaid a comparative bargain. Nor are lives saved the only measure by which health insurance improves well-being…. security that you can afford medical treatment… a profound effect on psychological well-being… lift[ing] an elemental fear that hangs over daily life…. Medicaid enrollees really, really like Medicaid. A 2015 Gallup poll found that 75 percent of Medicaid enrollees were satisfied with the system—a satisfaction rate that bested enrollees in employer-sponsored insurance….

We don’t have studies measuring the effect of consistent health insurance over 10 or 20 or 30 years. We don’t know how many lives that kind of access to the medical system saves, nor how much disability it prevents, nor how much pain it eases, nor how much psychological comfort it offers. But the patients who qualify for Medicaid expansions are the patients least likely to have regular, long-term health insurance in the absence of Medicaid coverage, and so they’re the patients most likely to benefit from the payoffs of consistency, whatever those payoffs might be….

I’m very sympathetic to arguments that medical care is overvalued, and that in practice, it does less good than we hope…. But these dynamics affect all of us—Medicaid is just better studied…. The proper response to these arguments is to do a better job assessing which medical treatments work and which don’t, not to simply take health insurance away from poor people….

Let’s say you still think Medicaid is a worthless program…. Then what?… What you wouldn’t do is what the Better Care Reconciliation Act does: offer people making below-poverty wages insurance plans with $6,000 deductibles—insurance that is too expensive for them to actually use—while plowing the savings into a large capital gains tax cut for the richest Americans…

Ph’nglui mglw’nafh Cthulhu R’lyeh wgah’nagl fhtagn! Y’ai’ng’ngah Yog-Sothoth h’ee-l’geb fai throdog aaah!