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|Thursday, May 02, 2013|
BY BRANDON SAWYER | OB RESEARCH EDITOR
Second-year results of the ongoing "Oregon Health Insurance Experiment" were just published in The New England Journal of Medicine. This unique study was borne out of Oregon's decision to expand Medicaid to thousands of low-income adults selected by lottery in 2008. A team of researchers, led by MIT economist Amy Finkelstein, has tracked d this group and a control group who did not receive Medicaid and remained uninsured, observing the measurable health, financial and other effects of health insurance coverage.
So far the study – of 6,387 randomly selected adults with Medicaid and 5,842 randomly selected witout coverage – found "no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions," nor difference in "average glycated hemoglobin levels or on the percentage of participants with levels of 6.5% or higher."
It did find among those with coverage a higher diagnosis of diabetes and use of diabetes medication,less incidence ofr depression, increased use of preventive care, and near elimination of "catastrophic out-of-pocket medical expenditures."
Given the political debate raging before a host of "Obamacare" reforms take effect next year, the study has gained a lot of attention. Forbes contributor David Whelan thinks the findings prove once again that having health insurance and being healthy are two different things.
Is having health insurance the same as having good health? The answer is no. People die every day despite great insurance. Others live long healthy lives without any coverage at all. The Amish community located 20 miles south of where I’m sitting includes many members of the second group. Yet the important distinction is usually lost by the time you travel 1,000 miles to Washington.
The Washington Post's WonkBlog calls the Oregon experiment a "beautiful, rare unicorn," due to therandomized clinical-trial data it provides, but the blog, written by Ezra Klein and Evan Soltas, concludes:
The problem with the Oregon study... is we don’t really know what we’re learning. It’s not clear, for instance, if the results are applicable to all health insurance, to all Medicaid insurance, or just to Oregon’s Medicaid program. It also only has two years worth of data, so we can’t know whether the sharp uptick in preventive medicine and diabetes diagnoses will pay off down the road.
Oregon is likely to remain in the health care glare as it moves ahead with CoverOregon, one of the first state health insurance exchanges to flesh out, initially limited to small businesses and individuals. Insurers are currently submitting their rate requests for next year, and individual rates could rise significantly as new mandates from the Affordable Care Act kick in.
For more on health care costs and reforms in Oregon, check out this month's Data Dig: What's driving the cost of health care?
Monday, September 28, 2015
BY BEN WATERHOUSE
How Portland's Garden Bar plans to become the Starbucks of salad.
Thursday, August 20, 2015
BY DAN COOK
The state’s angel investing fund gets hammered in Salem.
Wednesday, September 30, 2015
BY KIM MOORE
Striving for social equity is the mission of many nonprofits, and this year’s 100 Best Nonprofits to Work For in Oregon survey shows employees are most satisfied with their organizations’ fair treatment of differing racial, gender, disability, age and economic groups. But as a national discourse about racial discrimination and equity for low-income groups takes center stage, data show Oregon’s 100 Best Nonprofits to Work For still need to make progress on addressing these issues within their own organizations.
Tuesday, September 08, 2015
BY LINDA BAKER
Alan Lehto, TriMet's director of policy & planning, shares a few thoughts on ride sharing and more nimble bus services.
Wednesday, August 19, 2015
BY AMY MILSHTEIN
Training, from the mundane to the sublime, bolsters companies and workers in an uncertain world.
Thursday, October 08, 2015
BY LINDA BAKER
In an era dominated by self-promotion and marketing speak, John Bradley, CEO of R&H Construction, is a breath of fresh air.
Wednesday, August 26, 2015
BY KIM MOORE AND LINDA BAKER
Child care in Oregon is expensive and hard to find. We delved into the numbers and talked to a few executives and managers about day care costs, accessibility and work-life balance.
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Engaging employees and customers along the way.