We commented the other day on the new study about Oregon Medicaid users showing that enrollment in Medicaid increases ER use, contrary to the claims of ACA supporters who said insurance would push people to use less expensive primary care doctors instead of the ER. There’s been lots of insightful commentary about this study, but one of the best reactions was from Megan McArdle, who put the study in the broader context of popular myths about health care:
When I talk to smart, educated, well-read people about Obamacare, I generally hear three major points advanced in its favor: first, that it means that people with pre-existing conditions will finally be able to buy insurance for the first time; second, that it prevents young people from free-riding by going without insurance and then sticking the rest of us with the bill for uncompensated emergency room care; and third, that it will allow poor people to go to a regular doctor rather than relying on expensive, unnecessary ER visits. All three rely on a folk conception of how the health-care system works that isn’t quite right.
McArdle goes on to argue that Obamacare really isn’t targeted to lower costs nationally or make people healthier; it’s targeted to make Americans more financially stable by shifting costs around. This analysis coheres with the first Oregon study from last year, that found Medicaid users weren’t more healthy those the un-enrolled but were more financially secure. The question then becomes: is there a better way to help make health care more affordable for those struggling to pay? Any answer to that question will have to look at what health care is, not how we pay for it.Unlike most accounts of the law from supporters that relied on misleading or false statements to see the law to the public, McArdle accurately captures what the ACA actually is and what it’s capable of doing. Read the whole thing.