Earlier I commented on Patrick Ishmael's comments on Medicaid in Missouri posted on Forbes website.  In my previous comments I dealt with several of the issues he raises in that commentary, except the last one.  At the end of his piece he makes this comment:

"Keep in mind that this enrollment conversation doesn’t even touch on the abysmal Medicaid health outcome record that Avik Roy, Michael Cannon and others have talked about for years. That’s no small matter. Combine the outcomes problem with the costs of that poor quality care, and one can hardly call mere enrollment in Medicaid a success in itself. We should be fixing what we have, not spending what we don’t on a broken program…” 

Commentators are making this accusation recently, and it seems to have gathered some momentum, at least among some critics of Medicaid.

But the evidence does not back up this claim.  There is a great deal of evidence to the contrary in fact, much too great to list here.  I will start by listing one nice piece done by the Kaiser Foundation that summarizes the main points, and it can be found at this link.

As Kaiser shows:

  1. Having Medicaid is much better than being uninsured.
  2. Medicaid beneficiaries and the privately insured have comparable access to preventive and primary care;
  3. Specialists are less willing to accept Medicaid patients than privately insured patients. However, studies comparing access to specialist care between Medicaid and private insurance have produced mixed findings – likely a reflection of the difficulty of adjusting for all the factors that may influence access.
  4. Studies examining the causes of higher emergency department (ED) use by Medicaid beneficiaries compared to the privately insured indicate that most of the difference is due to higher rates of symptoms determined by ED triage staff to need urgent attention. Barriers to access to care are also a factor.
  5. New evidence is emerging about the quality of care provided to Medicaid beneficiaries. And, although the evidence is limited to date, the evidence indicates that the care received by people with Medicaid coverage tracks closely with benchmarks for high quality.
The first finding is likely the most important one to focus on here, and in terms of the debate currently underway in Missouri.  Numerous studies show what is indicate in the Kaiser summary, that having Medicaid coverage is much better than being uninsured.  And since the main issue being debated right now is should we move millions nationwide from being uninsured into Medicaid (and in Missouri about 300,000 from being uninsured into Medicaid), isn't that the basic point?