Can Obamacare fix what ails American’s health care system?

9/6/2013, 4:16 p.m.

Sally C. Pipes agrees with Schwartz.

Pipes is president, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute in California.

Pipes is convinced that Medicare is a proven failure as a means of fixing the health care system.

State legislators across the country are wrestling with whether to expand Medicaid, with the bulk of the funding to come from the federal government, thanks to Obamacare, said Pipes.

“Thus far, a substantial number of states have rebuffed the federal government’s offer -- or are leaning that way. They're right to do so. The states and the federal government have spent trillions on the program -- but new data show that Medicaid beneficiaries’ health is not getting any better,” said Pipes.

Pipes, who has studied and researched Obamacare, shares data from Oregon, which she said inadvertently became a laboratory for testing the efficacy of its Medicaid program in 2008. Oregon had funds to add 10,000 patients to the program, but 90,000 met eligibility guidelines. State officials came up with a novel solution — a lottery that would randomly select qualified applicants.

“The lottery afforded researchers a once-in-a-lifetime opportunity to conduct a large-scale study comparing adults newly enrolled in Medicaid with a control group who remained uninsured. Their work, based on two years’ worth of data, was recently published in the New England Journal of Medicine.

ecently published in the New England Journal of Medicine.

The data after year one seemed promising. The lottery winners used more health services and got more preventive care, including cholesterol screenings, flu shots, and mammograms.

“But the Oregon study looked at more than just health usage after year two. It also examined health outcomes,” said Pipes. “The researchers measured enrollees’ blood pressure, cholesterol, and blood sugar levels. These metrics are risk factors for stroke, heart disease, and diabetes — all of which can be managed or prevented with early intervention.”

The results? Although Medicaid patients used 35 percent more health services, the coverage appeared to have no effect on blood pressure, high cholesterol or elevated blood sugar. In the researchers’ words, “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first two years.”

Because of that conclusion, Pipes is convinced that it’s hard to see how being on Medicaid is any better than being uninsured.

Previous studies have found that Medicaid patients fare worse than those with private insurance — or even those without insurance.

A 2010 study of 900,000 surgical cases, for instance, found that Medicaid patients had the longest hospital stays, the highest total hospital costs, and the highest risk of death. And according to a report published in the Journal Cancer, Medicaid patients with cancer are two to three times more likely to die than other patients.

A 2011 study found that Medicaid patients were 8.1 percent less likely to be alive 10 years after a lung transplant, compared to those with private insurance and those without insurance.

“Obamacare was premised on the idea that extending access to preventive care would save money and lives. The Oregon study is the latest to throw cold water on those claims,” said Pipes.