Here is Megan McArdle on the new Oregon Medicaid study. One implication is that a comprehensive prepayment model of health insurance might not be the most cost effective way to get people health care services. There is no statistically significant evidence that Medicaid improved the health outcomes for those enrolled, but it did increase their financial security and it does seem to have decreased incidence of depression. Avik Roy suggest you can get the same outcome for a lot less money by the government converting Medicaid into a two-part concierge medicine/catastrophic care plan.
My totally non-expert read is that we should try to shift Medicaid (and health insurance generally) in the direction of Health Savings Accounts (maybe with vouchers for preventive care) and catastrophic health insurance. Ross Douthat rightly complained on twitter that the Oregon study showed that the Republicans are wasting an opportunity on health care and that while there are conservative alternatives to Obamacare, there are no Republican alternatives.
That is fair enough, but I would point out that at least one Republican implemented programs that included HSAs and catastrophic coverage for both those with employer-provided and Medicaid-provided health care. That guy was Mitch Daniels. C’mon Republicans. You can do this. Just take a break from trying to pass guest worker programs and middle-class tax increases. There might be some votes in good policy.
