Shocking! When States Expand Their Medicare Coverage, Less People Die

Expanding U.S. state Medicaid programs may contribute to reduced death rates, as the poor, elderly and other vulnerable people benefit from greater access to health care, Harvard University researchers said in a report.

Three states that expanded Medicaid in 2001 and 2002, New York, Arizona and Maine (BSTIME), collectively saw a 6.1 percent decline in the death rate for people age 20 to 64 compared to neighboring states, according to the study published in the New England Journal of Medicine. Researchers at the Harvard School of Public Health, led by assistant professor Benjamin Sommers, found larger reductions among minorities and low-income people.

www.bloomberg.com...

So what does this probably mean? If everyone had healthcare, we would have less deaths. More people would to go the doctor when they NEEDED to, not when the felt they could PAY it.

American health over bombs please.

Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

"We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

www.reuters.com...

But I thought government sponsored health plans were a sure way to die...you know...death panels and all that.

Less people dying...always a good thing...I really honestly can see how anyone can spin this as a negative...but I'm sure we are about to see it.

reply to post by OutKast Searcher


Because they are brainwashed by corporations PR firms

reply to post by RealSpoke

Because they are brainwashed by corporations PR firms

Brainwashed by the PR firms of these corporations? $124,110,831 was spent by those corporations in lobbying alone, for the year 2012 which is not yet over. However, when we go back to the year 2010, when The Affordable Health Care Act was passed as HR 3962, we find that those corporations, in total, spent $245,334,420 lobbying. Would you suggest this money spent by the pharmaceutical corporations was to brainwash opponents of Medicaid and other socialized health care programs?

It is imprudent for the brainwashed who live in glass houses to throw stones.

reply to post by RealSpoke

Dear RealSpoke,

I'm sorry that I'm a little too tired to go into all of the details, but OMB says there will be 30 million uninsured after Obamcare is up and rolling.

Further, being able to pay for health care is not the same as getting it. Enrollment in medical schools is falling, the total number of doctors is shrinking and in many areas we have fewer doctors than recommended. Additionally, many are leaving because levels of government compensation aren't sufficient.

More people would to go the doctor when they NEEDED to, not when the felt they could PAY it.

I'm sorry, but increasing demand on doctors in the face of a declining numer of doctors isn't going to work.

With respect,
Charles1952

reply to post by Jean Paul Zodeaux


I don't mean everyone is brainwashed. I get that there are people that are truly believe in the free market...there is just a large portion of people that are anti-single payer who believe in death panels and parrot tea party rhetoric.

Mandate To Buy Coverage: Health Insurance Industry's Idea, Not Obama's

The idea was pushed early in the debate by America’s Health Insurance Plans perhaps like no other health care lobby in Washington. AHIP, as it is known, includes the biggest names in health insurance such as UnitedHealth Group (UNH); Humana Inc. (HUM); Aetna Inc. (AET) and Cigna Corp. (CI) along with most big Blue Cross and Blue Shield plans.

www.forbes.com...


The original plan for Obamacare contained a public opition, insurance companies lobbied, and we get what we have now.

It is pretty much pro-corporation for the most part, it guarantees the industry customers and higher prices through for-profit private insurance. The corporations do not want a single payer health service program for EVERYONE. Of course they will lobby for medicaid at the moment because it gives them money that they would have not had otherwise, because those people cannot afford private insurance.

In widely covered testimony before the Senate Commerce, Science and Technology Committee in June 2009, Wendell disclosed how insurance companies, as part of their efforts to boost profits, have engaged in practices that have resulted in millions of Americans being forced into the ranks of the uninsured. Wendell also described how the insurance industry has developed and implemented strategic communications plans, based on deceptive public relations and advertising and lobbying efforts, to defeat or weaken reform initiatives.

During my 20 years as a health insurance PR executive, I was involved in numerous efforts to make the very term "single payer" toxic to most Americans. We even spent hundreds of thousands of premium dollars in 2007 to help finance the operation of a front group, called Health Care America, for the sole purpose of trashing a movie -- Michael Moore's Sicko -- that put single payer systems abroad in a favorable light. You can rest assured that the industry will spend much, much more to make sure that Vermont does not succeed.

www.huffingtonpost.com...

reply to post by RealSpoke


Insurance companies are definitely the problem when it comes to healthcare. I figured that you got it. I was just compelled to clarify...I'm just saying, that's all.

reply to post by charles1952


You do realize that there are a ton of countries with nationalized healthcare..

And you're wrong

Medicine Remains Attractive Career as Enrollment Reach All-Time High

The number of first-time applicants to medical school reached an all-time high in 2011, increasing 2.6 percent over 2010 to 32,654, according to new AAMC data. This is the largest first-time applicant pool since the AAMC began tracking such information in 1989. The total number of applicants grew by 2.8 percent this year to 43,919, up from 42,741 in 2010.

www.aamc.org...

reply to post by RealSpoke

Dear RealSpoke,

Thanks a lot, I'm really grateful when I'm proved wrong, that allows me to adjust my thinking and have a better set of beliefs. But I'm not sure you have in this case. I'm glad that there are more medical students enrolling this year, but I still maintain there is, and will be, a significant shortage.

I don't normally reference The New York Times but I think one of their articles applies.
www.nytimes.com...

RIVERSIDE, Calif. — In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

With respect,
Charles1952

reply to post by charles1952


Then you could say there was a shortage regardless. Only 50 million Americans are uninsured out of 300 million, Obamacare is not going to make all of those 50 people be insured. Not that I like Obamacare, I'd like to see a single payer option.

I just don't buy that there is going to be this pandemic doctor shortage. We can always give incentives, and medical school enrollment is up.

The new legislation contains several incentives aimed at curbing the shortage by encouraging medical students to go into primary care rather than choosing other specialties, such as cardiology or orthopedics, which are generally more lucrative. In addition, the legislation temporarily raises Medicaid reimbursement rates for primary care doctors and offers special loan repayment programs to students who choose primary care. Heim said these incentives should help but won't eliminate the impact of the new patient load. "All of them fall short for what it's going to take to truly build a primary care workforce that's going to take care of everyone," she said.

www.kaiserhealthnews.org...

reply to post by RealSpoke

Dear Real Spoke,

I think you are right. It looks like there will be a shortage regardless, and you're right about the uninsured, the last estimate I've seen is that about 30 million won't be covered.

I found the Times article about the shortage convincing, but they could be wrong. They're using the same organization as a source that you did, though.

What I'm worried about is why is their fear of a doctor shortage, are they getting out early? Reluctant to go in? That's all for another discussion, but I have heard that some complain they're filling out more and more forms and spending less time with their patients.

Anyway, thanks for the reply.

With respect,
Charles1952

reply to post by charles1952


I think you're overlooking quite a few factors.. For instance even if enrollment for medical school is down, there's no narrowed pool of applicants. I looked at going to medical school for awhile, and about any school I investigated, they accepted 5-7% of qualified applicants. Does that sound like declining enrollment? Following that, Doctors aren't needed for every task. There are many many many forms of preventative medicine that can be provided by Physician's Assistants, Nurse Practitioners..As well as some other medical people, I'm sure.

reply to post by RealSpoke


It's the "they'll ration health care" scare tactic at work. Did they ration auto insurance when that became mandatory? No. Medical schools set a goal of increasing enrollment by 30% by 2015 and are well on track to meeting that goal. The "shortage" of primary care physicians is being blamed not on the ACA but on the increasing age of baby-boomers.

reply to post by charles1952

What I'm worried about is why is their fear of a doctor shortage, are they getting out early? Reluctant to go in? That's all for another discussion, but I have heard that some complain they're filling out more and more forms and spending less time with their patients.

The shortage is of primary care because specialists make more money, have more prestige, and less risk involved if you do no have to start your own private practice.

A study done by the American College of Physicians in 2009 compared the U.S. health system with those of 12 other countries and analyzed why the latter had better medical outcomes for far less funding. Over and over the studies prove that systems that have a primary care physician or have what is deemed “medical home,” always fare better.

The overhead in a PCP office runs about 65 percent, of which 40 percent is spent dealing with insurance companies. Another reason is that the earnings of PCPs are approximately half to a third of our colleagues in the more lucrative sub-specialties.

Unfortunately most medical schools in this country favor overspecialization. Many of the “osteopathic” medical schools (schools granting a D.O. degree vs. Allopathic which grants an M.D. degree), highly promote the training of primary care physicians.

www.silive.com...

reply to post by Blackmarketeer

Dear Blackmarketeer,

That's good news. There were a couple of warnings in that article though.

“But this won’t amount to a single new doctor in practice without an expansion of residency positions.”

Medical school deans polled for the AAMC survey indicated that they are concerned about the number of qualified primary care instructors and their ability to provide an increased number of students with clinical training. Roughly half of the deans also expressed concern over being able to maintain or increase class sizes in the current economic environment.

As far as the reality of the shortage goes, Here's CNN and Bloomberg. There are many more. There are other problems with whether the enrollment figure increase solves the problem, but I've got to call it quits for tonight.

www.cnn.com...

www.bloomberg.com...

With respect,
Charles1952

reply to post by Miraj

Dear Miraj,

I've got to run for tonight, but you've got a couple of good points.

The narrow pool of applicants is because one, they don't have enough instructors for more, and two, they don't have the physical plant.

You're quite right, we can pass some work off to nurses. Here's an old (2001) article worrying about a nurse shortage. I don't know if it's been fixed. archives.cnn.com...

Sorry, got to vanish.

With respect,
Charles1952

reply to post by RealSpoke


as some one who lives in new zealand i can tell you for a fact,
our health care is great, and is in no way considered socialistic,

in my mind allowing insurance company's between the people that need health care and the doctors and hospitals is crazy.

we have a single payer system where "small" amounts of payment are required when using the service.

for many with higher incomes insurance is purchased simply to get a single room and faster surgery.

what our studies show is that if "primary " health care is aces-able for everyone at reasonable prices,
people get treated BEFORE it gets too serious and escalates.

while many many people here applaud the enactment of universal health care in the USA,
most question the wisdom of having insurance "middlemen" as they exist to profit,
not ensure care and treatment

nothing is perfect but i am thanful for small miracles when they happen.

a nz resident

xploder

reply to post by charles1952


Read the two sources in the OP. The studies conclude: with expanded health care coverage, more people lived.

No two ways about it.

expanded health care coverage = more people living.

Going off on a tangent about doctor shortages is pointless. Clearly in these states where Medicare was expanded, nothing of the like occurred.

I tell you what, if they truly implement the ACA, and there is a resultant doctor shortage, then you can lead the crusade to restrict health care coverage back to the wealthy again. The poor will have to get back into their little box.

reply to post by charles1952


I'll give you that..

I know a lot of doctors. Or rather former doctors. That instead of going to teach in a medical school chose to do lower level programs like nursing and Biology. And I do mean good doctors, as I've had several lecture in biology classes. The same thing occurs in community college nursing programs where I'd wager most nurses get their education. The money isnt there to teach versus the actual profession. This could be something we could fix nationally and probably drive down medical costs now that I think about it.

I remember listening to a Ron Paul interview and he said that nurses should be able to prescribe basic medications like anti-antibiotics. This would help keep the cost down and lower the demand of having to see a doctor over something like an ear infection.

If there were a huge shortage the USA could implement a program that would give an incentive for foreign doctors could come here. A lot already do, so I don't see how it could be that big of a problem.

Or maybe give tax breaks to doctors that open their own private practice for non specialist care?

I just never see the USA getting to the point where every single doctor in the area is booked full. That is just not realistic at all.