A New Year’s resolution you can make and keep this very day: Buy and read the e-book How Medicaid Fails The Poor by Avik Roy. Encounter Books has done many good things in recent years, but publishing Roy’s short work on the disastrous impacts of Medicaid on those it purports to help is among its most significant.
Once you have read Roy’s work (and the work of Phil Klein, Megan McArdle and Tevi Troy, who with Roy make up the quartus of Obamacare analysts worth reading) you will be ready for the spate of stories in early January on how Obamacare is “succeeding,” or not.
Analysis of the opening act of Obamacare will be premature until a variety of data sets are known. But Roy, McArdle and Troy have at least set us up to ask the key questions.
First, how many people had private insurance in 2013 who no longer have it it in 2014? What does the private insurance universe for individual policies look like, in other words, net-net?
Second, how much greater is the average deductible in 2014 for people who had private insurance in 2013 and still have it in 2014?
And finally, how many more people are on Medicaid in 2014 than were enrolled in the public assistance program in 2013?
These are the three metrics that matter most, and any public official or commentator who does not take the time to distinguish between the privately insured and those on Medicaid is not to be trusted. Those who gloss over the higher cost (including deductible limits) of 2014’s insurance tab for the privately insured with individual policies are also to be dismissed as propagandists, not analysts.
The first two lies are widely known and hardly disputed.
Lie #1: Even if you liked your plan, you often didn’t get to keep it.
Lie #2: Even if you loved your doctor, he or she may no longer be in your network, the president’s promise notwithstanding.
Lie #3: The total cost of individual policies for the privately insured — including the higher deductibles — will not be lower in 2014 than it was in 2013. (Recall the president promised an average premium savings of $2,500 per insured person every year.)
The first three lies were explicit. They were repeated again and again and again by the president and his allies. The fourth lie, though, was implicit, and it is by far the most pernicious of them all.
That lie was that the expansion of the number of enrollees in Medicaid was a good thing. It isn’t. Far from it in fact. It is nothing short of a health care disaster.
The reasons for this absolute truth are many and detailed, and Roy’s book lays them all out in a manner that simply cannot be debated. The book may be ignored, but it cannot be refuted.
To be enrolled in Medicaid is to be condemned to inferior, indeed almost nonexistent, health care. The payment levels provided by Medicaid are so low as to erect barriers to health care to the Americans forced into its often deadly embrace.
Read Roy’s work, and listen to my interview with him in the first hour of my Monday show, and then defend Obamacare if you care to. You will make yourself complicit in the destruction of American health care, and Roy’s book leaves no room for argument on this point.