Regarding “Expansion plan: New Medicaid proposal has some appeal, but the fact remains — Obamacare is a bad idea” (Our Views, May 5): Gov. Mary Fallin recently opted out of the Obamacare-mandated state Medicaid expansion, which led to negative reactions from various political consortiums — all purporting potential adverse effects on patient care. The editorial explained in detail the complexities of this legislation and concluded that the mandate was flawed but failed to address the most important issue of all: Does Medicaid expansion improve the uninsured patient's health?
A study recently published in The New England Journal of Medicine examined this question in Oregon, where a limited number of qualifying recipients were, as a test, randomly enrolled in the state's Medicaid expansion to study the proposal's efficacy. They found in a controlled randomized prospective trial that Medicaid expansion showed no improvement in basic health when compared to the uninsured patients, despite increased expense, use and patient visits. The only benefit the study discovered was patient relief from the potential anguish of catastrophic loss. This basic assurance can, of course, be afforded to patients for much less cost and allows patients greater involvement in and responsibility for their own health care.
The Medicare Payment Advisory Commission offers compelling support by showing that 18 of the top 20 disease expenditures can be prevented or mitigated by aggressive patient self-care. James Freeman Clarke once said, “A politician thinks of the next election. A statesman, of the next generation.” We owe Fallin a debt of gratitude for being a stateswoman for these families as she looks for better, well-reasoned options.
Kyle Toal, Oklahoma City