Slate - "Trumpcare Will Probably Kill Thousands Each Year"

[NRaleighLiberal]

http://www.slate.com/articles/business/moneybox/2017/06/trumpcare_will_probably_kill_thousands_that_s_neither_uncivil_nor_alarmist.html

And it is neither alarmist nor uncivil to say so.

By Harold Pollack

As it is currently written, the Senate’s Better Care Reconciliation Act would increase the ranks of the uninsured by 22 million. At least that is the best estimate of the Congressional Budget Office. Many of those rendered uninsured would be older low-income people in some of America’s poorest states, places among those hit hardest by the opioid epidemic, violence, and other public health problems.

By rendering millions of people uninsured and reducing the quality of insurance coverage for millions of others, BCRA would harm millions of people. An estimated 48 percent of the Affordable Care Act’s Medicaid expansion population reports that they have disabilities, chronic illnesses, or are in fair or poor health. Many of these people need care they will not receive if they go uninsured—or for that matter, if they are placed into a cheap but essentially unusable high-deductible plan.

The famed Oregon health insurance experiment identified some of the benefits of insurance that BCRA would snatch away. Men and women who won a lottery to gain Medicaid coverage experienced reduced depression, less trouble managing personal debts, markedly improved self-assessed health, improved management of diabetes and other chronic illnesses, and improved screenings for cancer and other serious diseases. Not everything got measurably better. The OHIE yielded no statistically significant improvement in blood pressure, cholesterol, or blood sugar levels. Still, the benefits found in OHIE match the personal experience of many doctors and nurses I know. So many have seen patients die or experience horrible health outcomes or be financially devastated because they lacked health coverage.

But OHIE involved too few participants for too short a period to rigorously investigate whether Medicaid prevented people from dying. That’s not because researchers were incompetent. Mortality is a rare outcome that arises from many different causes. The consequences of becoming uninsured depend greatly on your ability to access safety-net care from some other source, too, such as a free community clinic or generous public hospital. The survival benefits of insurance are just really hard to pin down.

snip - much more to read at the link