Tim Carey: Reality of Medicaid

April 8, 2013 

Medicaid realities

I read with interest and concern Dr. Christopher Conover’s March 28 Point of View (“N.C. faces a ‘Sophie’s Choice’ on Medicaid”) claiming that studies out of Oregon demonstrated a lack of benefit from enrolling in Medicaid because there was no difference in the death rate between the uninsured and Medicaid enrollees.

However, the authors of the study of younger Medicaid enrollees he cited state: “We find that in this first year, the treatment group had substantively and statistically significantly higher healthcare utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection) and better self-reported physical and mental health than the control group.”

The overall mortality rate in this young population was very low – 0.8 percent per year – and the authors indicate that the study was not designed to detect a difference in death rates. This misstating of research results by Dr. Conover is unfortunate, since he is purporting to base his opposition to Medicaid expansion on evidence.

Uninsured patients at the healthcare facilities where I provide care tell me daily of their difficulties accessing care and their reliance on emergency rooms. Unfortunately, Dr. Conover chooses to ignore both the academic research as well as the clinical reality of healthcare in North Carolina, a state with high uninsurance rates and an urgent need to assist our citizens.

Tim Carey, M.D., Chapel Hill

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