Former
Massachusetts governor Mitt Romney delivers his address on health-care
reform May 12, 2011, at the Cardiovascular Center on the campus of the
University of Michigan in Ann Arbor, Mich.
(J.D. Pooley - Getty Images)
In newly released research, Charles Courtemanche and Daniela Zapata ask perhaps the most important question about the Massachusetts health-care reforms: Did they improve health outcomes in Massachusetts?
The answer, which relies on self-reported health data, suggests they did. The authors document improvements in ?physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity.? The gains were greatest for ?women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law?s subsidies.?
Some of those results are a bit odd. Although it?s possible to tell yourself a story about how the Massachusetts health reforms affected the body mass indexes of the newly insured, you have to stretch a bit.
But most of them make perfect sense. The reforms led to more people having insurance, which is to say more people having more opportunities to see a doctor and get early and/or regular treatment for ailments. That led to improvements in health. If that hadn?t led to improvements in health, it would be the worth of going to the doctor and getting timely medical care that would be called into question. And if going to the doctor and getting timely medical care isn?t worth doing, the Massachusetts reforms are pretty far down the list of practices and policies we need to rethink.
The researchers end by asking whether the Massachusetts reforms provide a good guide to what will happen under the Affordable Care Act. ?The general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar,? they write. ?However, the federal legislation included additional costcutting measures such as Medicare cuts that could potentially mitigate the gains in health from the coverage expansions. On the other hand, baseline uninsured rates were unusually low in Massachusetts, so the coverage expansions ? and corresponding health improvements ? from the Affordable Care Act could potentially be greater.?
I?d add one point to their discussion: The national reforms, unlike the Massachusetts reforms, included major investments in comparative-effectiveness research, electronic health records, accountable care organizations and pay-for-quality pilots. If any or all of those initiatives pay off, they could dramatically improve our understanding of which treatments work and force the health-care system to integrate that new knowledge into everyday treatment decisions very quickly.
If that happens, medical care could become substantially more effective than it is now, which should also improve health outcomes. Quality improvements like that could, for the already insured, be the largest payoff from the Affordable Care Act.
(Thanks to Tyler Cowen for pointing me to the paper.)
Re: Study: Romneycare making Mass residents healthier.
Above Us Only Sky
My home DCP moved back to Mass. for the free health care to take care of her issues. She is healthy now. True story.
All this tells me is that I want to see more research on this, and research that is not based on self-report data. There's too much potential for error involved with self-report data collection. /end research geek
I'm not sure that self-reported health data can be used by itself, but I would certainly love to see a further study done. It absolutely makes sense that when people have access to free health care, they will utilize it and thus treat their problems sooner, rather than later.
I think this is great, even if it's self reported. I would love if other states followed the lead and started building healthcare/insurance systems for their states. Can you imagine how awesome it would be to have states building systems that suit the needs of their citizens?
<a href="http://www.thenest.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Home D
Baked ham vs hotdish. You have to attack the heart disease differently.
First off, I think we can all agree that there are going to be kinks to work out in any health care plan at this point. From that perspective, I think we're better off, in the long run, to let states be our testing ground, rather than the entire country. Smaller samples are more likely to find issues faster, and certainly can respond faster to those problems (unlike our govt at the natl level, where they can't even agree on what to have for lunch).
There's no one idea out there that solves our healthcare issues. So let's have the states take a crack at fixing it to see what works. Vermont's taking a run at single-payer. Maybe Alaska wants to try allowing their citizens to get prescriptions from Canada to see if there's a major difference in cost. Texas decides to go for full privatization, to see if bidding lowers their costs. Pennsylvania, led by IIOY, tries out Death Panels, wipes out most everyone over the age of 70, and throws a huge party with the savings. California creates a state-wide plan, mandates that everyone participates, with a sliding scale for payment based on income levels. And so on and so forth.
That's all I've got for now. It's late and I'm sleepy.
<a href="http://www.thenest.com/?utm_source=ticker&utm_medium=HTML&utm_campaign=tickers" title="Home D