Diabetes Diagnoses Surge in States Which Expanded Medicaid
The big news is that expanded access to Medicaid causes increased diagnosis of diabetes which presumably causes better health in the not so distant future. Google is impressed.
I quote Sabrina Tavernise in The New York Times
The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions.
One in 10 Americans have diabetes, and nearly a third of cases have not been diagnosed. The disease takes a toll if it is caught too late, eventually causing heart attacks, blindness, kidney failure and leg and foot amputations. The Centers for Disease Control and Prevention estimates that the disease accounts for $176 billion in medical costs annually. The poor and minorities are disproportionately affected.
In the new study by Quest Diagnostics, a medical testing company, researchers analyzed laboratory test results from all 50 states in the company’s large database over two six-month periods. In the states that expanded Medicaid, the number of Medicaid enrollees with newly identified diabetes rose by 23 percent, to 18,020 in the first six months of 2014, from 14,625 in the same period in 2013. The diagnoses rose by only 0.4 percent — to 11,653 from 11,612 — in the states that did not expand Medicaid.
This is important news, but it shouldn’t surprise anyone. The reason is that we already know that expanded access to Medicaid causes more diagnosis of diabetes. This was an extremely statistically significant result of the New England Journal of Medicine study of the Oregon Medicaid lottery. Somehow, the study was interpreted as showing small (or for the statistically illiterate zero) benefits from Medicaid.
I love to say I told you so, but I told you so.
So, if my math is correct, there are somewhere north of 2,500 people in red states running around with diabetes that do not know they have diabetes and are not treating it.
What kills me about states NOT funding Medicaid is that the federal government pays an average 57% — up to 73% — of the bill. This is money imported to the state’s economy. As you will learn if you watch Fox TV, these patients will get care anyway by going to the ER or by going to hospital clinics and throwing away the bills …
… which of course means the state is going to pick up that — at least as much as that lowest 27% leftover — ANYWAY. Nuts!
Same Repub states will sacrifice any number of billions of tax giveaways to corporations to attract jobs of course.
The madness grows to the fully psychopathic when the fed is willing to pick up 90-100% of their bills under Obamacare — pure economic gravy: the taxes on the imported money would cover the 10%.
Maybe Obamacare can pay for deprogramming Repubs from the Voodoo economic cult. 🙂
Denis plus the Feds are paying a much higher share of the funding for Medicare expansion: 100% in the initial years and 90% thereafter. Which point you seem to pick up in your fourth para but is unclear in your 57%-73% opening.
I am immediately concerned with our new Illinois governor Rauner who wants to cut $1.5 billion off Medicaid (among other human cut-throat Republican-heaven cuts). I would love to know exactly how much of that would be picked up by the state ANYWAY through other channels. Together with the equal amount lost to the economy from fed funding the different-channel payout would probably qualify Rauner for the fiscal funny farm. If I only knew what channels and how much. Sigh.
Another different-channel angle: if hospitals, etc,, care for disconnected-Medicaid patients (disconnected by Rauner), hospitals may be forced to up their charges to all patients who have insurance. Another way Illinoisans would still get stuck with the supposed ducked medical costs of the poor — except for thosoe patients who don’t show up anymore. Overall result: counting the direct economic boost the 57% (state average) matching funds would make (and the indirect: multiplier effect & taxes on boosted activity), it probably amounts to an overall financial loss.
I can give you an example of the impact on the State of Michigan resulting from the expansion of Medicaid coverage. Michigan’s Economy Will Benefit from Expanding Medicaid, Families USA and Michigan Consumers for Healthcare points to a host of other benefits Michigan will forgo if it does not expand Medicaid.
See more at: http://angrybearblog.strategydemo.com/2013/07/medicaid-expansion-in-michigan.html#sthash.6KcqZybE.dpuf
And how do you think Quest Diagnostics makes money?
It is no secret Diabetes is at epidemic proportions? So what is your point? Quest is doing testing just to make money and that is the reason diagnosis is up? And not because people now have health insurance.
However physicians use the most expensive method to test blood sugar. Why not tell folks to buy a meter ($10-20 and some strips again $10 to 20) and have folks test for a week or so. The lab test costs over $100 if done at a hospital not during a screening session (which is done cash on the barrelhead, not do test and wait for payment)
“And how do you think Quest Diagnostics makes money?”
By running simple medical tests. Did you have a, you know, point?
A1C is the most common and arguably the most accurate tool used to diagnose diabetic conditions. Daily blood glucose testing is great but can be influenced by recent food and drink intake. The A1C is a “rear view” test which measures blood sugar levels over the last 90 days. In this study Quest used a 6.4 benchmark which is really pretty liberal. For example in life insurance underwriting the benchmark is typically 6.0 for most ages.
Joel my point is that the more tests Quest runs the more, you know, money it makes. Especially when the payor is a government entity. Ask MediCal about how Quest makes money. Medicaid for all, quick! Quest’s CEO needs a new Aventador.
Annnd Republicans declare that “Obamacare Causes Diabetes!” In three…two…one…
“the more tests Quest runs the more, you know, money it makes.”
Hmm. So Quest causes diabetes? Is that your point? Or is it that diabetes testing is unnecessary? Or is it that Quest shouldn’t be charging for diabetes testing?
Rent seeking corporations are evil…unless they buttress my political viewpoint. One cool thing about this post is that normally humorless scolds have turned into comedians.
However again for an a1c test you can buy home test kits where you get a drop of blood for about $20. I doubt you can get a hospital with the do now and get paid later model for much less that 5 times that. Labs that do it for a credit card do it for $50.
A1c takes a vial (ounce or two) of blood and a pro laboratory. It is a test how much sugar your red blood cells have picked up — they live about 90 days. It is not — repeat — not a test of how much sugar is in your blood at the moment of drawing.
I was speaking of tests like this one from Wal-Mart http://www.walmart.com/ip/ReliOn-A1c-Test/10575934
Which apparently takes a couple of sticks but dont a vial. In this test you mail the strip in an it gets a reading
Or this home device:http://www.walmart.com/ip/ReliOn-FastA1C-Test-At-Home-A1C-System/39384290 for $22.88.
We don’t expect anyone to come off as pedantic on AB. But thanks for the tip.
These figures are evidence that the Republican healthcare plan is , in fact , working according to plan. Alan Grayson summed it up nicely :