One often overlooked and often thrown out finding of the Oregon health insurance experiment is self-reported health and well-being. The randomly controlled trail that is often cited for it’s excellent methods and unarguable results found that having “Medicaid increased the probability that people report themselves in good to excellent health (compared with fair or poor health) by 25 percent.”
That’s important! Yes, it’s good to find objective measures of health but let’s look at this differently. We are all human right? Actually, there is an extremely high chance that a computer program is reading this for search optimization and other nefarious purposes (hi computer overlords!). Remember the last time you were sick? For me, one of two things happen when I’m sick. Either things are going very well with my care and with my life generally and I barely know that I’m sick. Or, my care is frustrating and other things in my life aren’t going well and I’m sad and wallowing in my pain and illness. I have zero scientific explanation other than the placebo effect whether this has any effect on my physical health.
Getting a little personal here (sorry), I’ve been having some trouble with my kidneys over the past few weeks. I had an extremely good experience with my care and was at the Academy Health conference when I first got sick. I was beyond happy and if anyone asked me, I would say that I was in good health and I was able to live life as if nothing was wrong. I came home and got sick again. I had a terrible care experience (lecturing physicians, mix ups in the labs etc) and my mental health was not in a good place. It was debilitating. I barely left my house and felt downright crummy. I’m not being a good health researcher here, but my limited experience tells me that when you are in a better place mentally, the experience of getting sick is better and your quality of life is better– separate from the physical health. Plus, you’re able to do things you want to do– like work and contribute to society. Isn’t that what we want for everyone?
Now you’re probably asking– did the Oregon Health Insurance Experiment say anything about mental health?
Medicaid increased the probability of not screening positive for depression by 10 percent.
Medicaid reduced observed rates of depression by 30% (by 9.2 percentage points, relative to a base of 30).