In the Short Run, We Are All Dead. At Least According to That New Oregon Medicaid Study.

Well, we AB types–readers and writers, alike–are familiar with John Maynard Keynes’s famous line that “In the long run, we are all dead.”  By which he either meant that economists, if they are to be useful, must try to predict and recommend short-term government policies that avoid or help end current, severe economic downturns, rather than just predicting long-term economic results, or instead he meant that since he was gay and had no children, he didn’t care about the long-term economy and wanted economic policy to concern itself only with the here-and-now and never with the long run.

It’s a fielder’s choice, if you ask me.  Which is why you shouldn’t ask me.  And you shouldn’t ask Niall Ferguson either.

Conveniently, in the very same week in which high-profile economists are debating what Keynes meant, we learned that a study of the effects of access to healthcare insurance (in that case, through Medicaid) shows that access to healthcare does not reduce cholesterol levels, blood pressure, or blood-sugar levels, over a two-year period among people who have elevated levels of one of another of these ailments and who were not previously receiving medical treatment for them because they had no insurance. At least it did not in Oregon, where the study took place, for the sampling involved.

The study is being widely interpreted as showing that healthcare insurance does not improve actual health, and has lead some people to suggest that this means that we should not have healthcare insurance at all, whether publicly or privately financed.

But that’s ridiculous. Or at least it’s insufficient as a response.  What the study obviously shows is not simply that we shouldn’t have healthcare insurance but that we shouldn’t have healthcare. We should not have medical care.  At all.  No doctors, no hospitals, no prescription drugs, no medical devices.  None of it.  We’re spending huge amounts of money on healthcare, and now we know that it doesn’t improve health!

In the long run, we are all dead.  And if you have no access to healthcare and have, say, a heart attack, a stroke, cancer, a diabetic coma, or a serious physical injury, you may well die without medical attention even if you would have lived if you’d had medical attention. In the long run, we are all dead, and in the short run those who have a life-threatening illness or injury and no access to medical care may be too, even if access to medical treatment might have lengthened that run quite a bit.*

So we need to end the medical-industrial complex, because, after all, how much difference is there, really, between the long run and the short run?  Lipitor, insulin, and blood pressure medications are okay, I guess, if you have nothing better to spend your money on.

But even if you don’t, why throw your money away on stuff like that, when those things don’t even improve your health?  And, as for the government and Medicaid, and Obamacare, and Medicare, and all that: Well, what’s that line about, families are tightening their belts, so the government should, too?

At least now we’ve finally found the way to stop healthcare inflation.  End healthcare itself.

*Paragraph rephrased and clarified after initial posting, to avoid possible misinterpretation.

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UPDATE:  This post, though obviously satire targeted at the rightwing’s conclusions about the study, also is intended to raise what seems to me a critical medical question that, to my knowledge, no one else has asked: Does the study indicate that the treatments for high cholesterol, high blood pressure, and early-stage diabetes are ineffectual?

It may be that the diet recommendations given to these new Medicaid patients–less salt, low sugar, lower-cholesterol diets, respectively–weren’t adhered to by most of the patients.  Or it might mean that, once diagnosed with one or another of these illnesses, those in the study who did not get Medicaid nonetheless changed their diet somewhat in light of the diagnosis.  Or it might mean that the medications that were prescribed for the Medicaid recipients who did obtain medical treatment are less effective than thought–which strikes me as something that should have been the headline takeaway, but obviously was not.

If there’s some other possible meaning to the study’s results, what is it?  Seriously.  If these treatments are medically ineffective, isn’t that something that the public should be told?  And if the treatments are effective in the general population, then why would these very same treatments–specifically, the medications–not work with the Medicaid recipients in the study? And, why aren’t these the questions that the pundits are asking?

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