Now that it’s been a few months, we can all calm down and stop arguing over power calculations in the Oregon Medicaid Study and acknowledge that the most important finding in the study was this one:

p had them confidence intervals/values with the stastically significant to which they refer/the whole relevant academic community was looking at her/p hit the floor/next thing you know/p values got low, low, low, low, low, low, low, low

For all the talk about the state of American health, and whether Medicaid provides quality healthcare, people really neglected to discuss that health insurance is insurance, a fundamentally financial project in which customers exchange regular payments for a promise to be protected from the consequences of low-probability but high-cost events. It’s certainly an interesting question whether car insurance or homeowner insurance effect the rates of collisions or fires, but more importantly it is completely clear that these products eliminate people who have suffered those events from also being bankrupted. Similarly, health insurance is a way that people who contract cancer from not also contracting six-figure debts. Despite what is my very strong discomfort with conventional methods of statistical significance, it is clearly obvious from the above results that even the relatively-minimal insurance afforded by Medicaid succeeds somewhere between “substantially” and “wildly” in reducing the financial risk of illness.

Now, the health care market is a funny one, because of the weird ways we think about it and conceptualize, the expense of it, and the large hand the taxpayer has in it. But while we should definitely strive to increase the efficiency of health care, by encouraging good behavior and incentivizing preventative care and reducing wasteful care and introducing more cost-reduction pressure and reducing administrative costs and eliminating infections in hospitals, all that is separate from following the commitment our society has already made to guarantee at least some forms of medical care to those in need with a commitment to put a ceiling on the financial risk that individuals can incur when they elect to not simply wander off and die when catastrophic illness strikes.

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