On the ongoing right-wing bloviation about how poor people don't actually need health care, I have recently heard mention of something called "The Oregon Study." How did our state end up getting used to justify scrapping public insurance? —Doctor This!

Oh, Oregon, how God hates you. Here's the backstory:

In 2008, a shortage of state health care dollars led to the Oregon Health Plan—our incarnation of Medicaid—being offered by lottery. Health policy scholars realized this situation could be employed as a de facto randomized controlled trial of Medicaid.

The study encompassed 10,000 participants over two years. That wasn't enough to determine whether OHP recipients died at a higher rate than the uninsured.

That said, the study did find that some markers of health—blood pressure, cholesterol, a pre-diabetes indicator called HbA1c, and a cardiac index known as the Framingham risk score—weren't conclusively better among the Medicaid group. (Each marker was somewhat better in the Medicaid group, mind you—just not to a degree that it couldn't possibly have been random.)

Was this due to the small sample size and short duration of the study? Quite possibly, but that didn't keep conservative pundits from seizing upon the findings as proof that Medicaid doesn't make anyone healthier.

Of course, plenty of indicators did improve to a significant degree in the Medicaid group, including self-reported health, incidence of depression, and proper diabetes management. But screw that, we've got a tax cut to ram through.

Here's the thing—Medicaid isn't a drug that either works or doesn't. Medicaid is just going to the doctor. I've had both OHP and private insurance, and I've gone to the same doctors and taken the same medications the whole time.

It's possible that medical care in general may be overrated. Still, Medicaid foes seem unwilling to expand their money-saving ideas to their logical end by letting employer-insured conservative pundits join the lucky poor in being spared the indignity of unhelpful, non-life-prolonging health insurance. Go figure.

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