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April 21, 2014

Andrew Silow-Carroll: Passoverkill? Suggestions to make next year's seders even more culturally sensitive

Sara Israelsen Hartley: Seeking the Divine: An ancient connection in a new context

Christine M. Flowers: Priest's execution in Syria should be call to action

Courtnie Erickson: How to help kids accept the poor decisions of others

Lizette Borreli: A Glass Of Milk A Day Keeps Knee Arthritis At Bay

Lizette Borreli: 5 Health Conditions Your Breath Knows Before You Do

The Kosher Gourmet by Betty Rosbottom Coconut Walnut Bars' golden brown morsels are a beautifully balanced delectable delight

April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review June 24, 2013 / 16 Tammuz, 5773

Study Casts Doubt On Whether Health Insurance Improves Health

By Michael Barone




http://www.JewishWorldReview.com | Does having health insurance make people healthier? It's widely assumed that it does.

Obamacare advocates repeatedly said that its expansion of Medicaid would save thousands of lives a year. Obamacare critics seldom challenged the idea that increased insurance coverage would improve at least some people's health.

Now, out of Oregon, comes a study that casts doubt on the premise that insurance improves health.

In 2008, Oregon state government had enough Medicaid money to extend the program to 10,000 people but many more were eligible. So the state set up a lottery to determine who would get coverage.

That created a randomized control trial (RCT), to compare the health outcomes of about 6,000 people who won the lottery with a similar number who lost.

RCTs are the best way to test the effects of public policies, as Jim Manzi argues in his recent book "Uncontrolled: The Surprising Payoff of Trial-and-Error for Business, Politics and Society."

Other studies compare the effect of policies on populations that may differ in significant ways -- apples and oranges. RCTs compare apples and apples.

The only previous RCT on health care policies was conducted by the RAND Corporation between 1971 and 1982. It found no statistically significant difference in health outcomes from having more insurance. But health care has changed a lot since then.


The Oregon Health Study, published last month in the New England Journal of Medicine, found much the same thing. Comparing three important measures -- blood sugar levels, blood pressure and cholesterol levels -- It found no significant difference after two years between those on Medicaid and those who were uninsured.

It did find lower levels of reported depression among the group on Medicaid. And it found, unsurprisingly, that they did save significant money. Those findings may not be unrelated.

The findings have serious implications for Obamacare. Half of its predicted increase in insurance coverage comes from expansion of Medicaid.

Obamacare supporters have assumed that those eligible for Medicaid -- poorer, sicker and less steadier in habits than the general population -- would have great difficulty getting health care without insurance.

The Oregon Health Study is evidence that at least in that state Medicaid-eligible people without insurance -- a "pretty sick" population, one state official said -- nevertheless managed somehow to get care that produced results about as good as those who won the lottery.

It may just be that ordinary people, even those with significant problems, are more capable of navigating the seas of American life than elites, either liberal or conservative, tend to assume.

These results run contrary to the predictions of many Obamacare fans, who expected to see more positive effects from Medicaid coverage. It undermines at least a little the case for Obamacare's vast expansion of Medicaid.

Some Obamacare backers, and others as well, point out that the study did not measure all possible health care outcomes. It couldn't because it covered only two years; and Oregon, with more Medicaid money, ended the lottery experiment, so there won't be any more RCT results.

In particular, in a two-year period you aren't going to have too many cases of catastrophic illness among a population of 12,000. There's no way you can measure outcomes in those with long-running ailments like cancer, Parkinson's disease or Alzheimer's.

Blood sugar levels, blood pressure and cholesterol levels can be treated with relatively inexpensive generic drugs. Medicaid coverage may result in more people getting heart bypass surgery and needing expensive drugs for rare ailments.

But that is another way of saying that health insurance as we know it may not do much to improve the treatment of common health problems.

Most U.S. health insurance today, thanks to the tax preference for employer-provided insurance, is not real insurance at all.

Real insurance pays for rare, expensive and unwelcome events, like your house burning down. It doesn't make sense to insure for routine expenses, like repainting your living room.

The Oregon Health Study suggests that insurance isn't necessary for people to get what are now, for people of a certain age, routine measures like blood pressure medicine. Maybe government should help poor people pay for them, but they manage to get them nevertheless.

Americans have come to expect health insurance to pay for routine treatments. Obamacare reinforces that in its requirements for coverage and makes it more difficult for many to insure against catastrophic health care expenses.

That's not likely to make people healthier.

Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

Comment by clicking here.

JWR contributor Michael Barone is senior political analyst for The Washington Examiner.




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