True Believer Easily Led By Liars Who Spout Misinformation He Likes About Medicaid & ObamaCare (Which He Hates)

One seldom discovers a true believer that is worth knowing ~ Henry Louis Mencken (9/12/1880 to 1/29/1956) an American journalist, essayist, magazine editor, satirist, critic of American life and culture, and scholar of American English. Known as the "Sage of Baltimore", he is regarded as one of the most influential American writers and prose stylists of the first half of the twentieth century.

A "true believer", according to the Libertarian Blogger Willis Hart, "is wholly incapable of critical thinking". "These folks", the Libertarian concludes "are at the very minimum useless and can in fact be dangerous during the reigns of charismatic leaders".

I AGREE, I say to the blogger I've referred to as "Mr. LB" in prior posts. Although to that definition I'd add (or emphasize) the fact that true believers tend to get their information from one side and NEVER question whether or not those representing that perspective are being honest with them or if they are being partially honest but spinning the truth to make it essentially a lie.

And THIS is the case with the oblivious true believer Mr. LB, who is oblivious to the fact that he is what he castigates those who disagree with him for being (in his mind). A good portion of the information he uses when authoring his blog posts comes to him via Libertarian and "fiscally conservative" sources (Think Tanks and individuals who identify as Libertarian/fiscally conservative). And, when I've looked into his various claims, what I find is a grain truth and a silo of spin. The latest example of this is a post in which he slams Medicaid and the Affordable Care Act (AKA "ObamaCare")... as follows...

Mr. LB: According to a recent study from the University of Virginia, surgical patients on Medicaid were 97% more likely to die prior to discharge than privately insured patients were and 13% more likely to die prior to discharge than patients who didn't have any insurance at all. And, yes, this study DID control for intervening variables such as age, income, geography, surgical procedure, and prior health status. Wow, I guess that there really is a difference between "coverage" and actual healthcare (1/15/2014 AT 8:06pm)

Could this be true? Is not having insurance at all better than being insured by Medicaid? Of course not. If you don't have insurance you don't get treatment (unless you are wealthy and pay out of pocket). The results of not getting treatment when you need it are predictably worse than if you do get treatment, as the following Kaiser Health News article confirms.

Jonathan Cohn, Senior Editor of The New Republic: ...for the last few months, a cadre of conservative writers and intellectuals has argued that [Medicaid] doesn't actually help beneficiaries and may actually hurt them. To prove their point, they've cited a handful of studies in which Medicaid recipients ended up in worse health than people with no coverage whatsoever. According to Medicaid's critics, this evidence suggests that expanding the program, as the Affordable Care Act would, is a bad idea. (Are You Better Off With Medicaid Than No Insurance? A Landmark Study Says Yes, Kaiser Health News 7/7/2011).

So, should we scrap Medicaid (and perhaps Medicare) and turn these functions over to the private health care insurance industry? Does this study prove government can't do anything right and we're best off letting the private sector handle things whenever possible? Absolutely not. There is actually another explanation as to why the results for people on Medicaid are worse (even than for those with no insurance). And the reason is really simple (in fact I guessed it before doing any research). However, as a true believer, I can understand why the following did not occur to Mr. LB.

Jonathan Cohn: ...if you know you suffer from serious medical problems, you're more likely to sign up for public insurance when it's available. As a result, the Medicaid population may be fundamentally sicker than the uninsured population - and end up with worse medical outcomes, even if they're benefiting from the program's coverage. (Excerpt from the same Kaiser article quoted above).

The stats for the people on Medicaid are worse because they are generally sicker, and expanding Medicaid in Virginia would NOT "imperil the lives of low-income people who have surgery"; which is the nonsensical assertion made by Pete Snyder "a Northern Virginia businessman who is seeking the Republican nomination for lieutenant governor". Pete Snyder is, I suspect, the source of Mr. LB's claims... although I can't be certain, given the fact that Mr. LB rarely cites sources. In any case, I'm going to cite PolitiFact to debunk/explain this one...

Politifact: ...researchers place little of the blame on Medicaid... [because] Medicaid recipients are the poorest, sickest and least educated group of patients. They are the least likely group to seek preventive health care. As a result, they are more likely to enter hospitals in dire conditions that require emergency surgery. ... Does the research prove, as Snyder and other conservatives suggest, that it's safer to be uninsured than on Medicaid? Ailawadi, co-author of the study, said it does not. (Pete Snyder says Medicaid causes higher risk of surgery death, Politifact says "Half True" 3/6/2013).

As for the uninsured people that have better results (the "13% more likely to die prior to discharge than patients who didn't have any insurance at all" folks)? Politifact gives the reason for this as well (as per the same study Mr. LB says he is citing).

Politifact: Many of these people may have been uninsured by choice. "The uninsured population in our study included a subgroup that may have had a high income", Ailawadi said... (excerpt from the same Politifact article quoted above).

The outcomes for this group of uninsured people are better than for those on Medicaid because they're healthier (and THAT is why they chose to go without insurance). Now, Mr. LB says "yes, this study DID control for intervening variables such as age, income, geography, surgical procedure, and prior health status" and it is true the paper does say that. But is also goes on to say "researchers place little of the blame on Medicaid", but that is the precise inference Mr. LB is drawing (and he draws it even though he read the PolitiFact article).

Am I missing something, or does "researchers place little of the blame on Medicaid" mean something other than what it seems to mean? I guess Mr. LB's takeaway from the study is what he wants it to be, and for that reason I say he is an easily-led true believer. Led by his ideology or led by people like Snyder who are obviously spinning (lying) in an effort to argue against the Medicaid expansion provided for by the ACA (the expansion the Conservatives on the Supreme Court decided the states did not have to accept).

In regards to that claim (Medicaid being worse than private insurance and even worse than no insurance), PolitiFact says "Half True" (which technically is the case), but I say Snyder is 100 percent a liar. And Mr. LB is a gullible sap for buying into these lies. Also, "at the very minimum useless" and possibly dangerous (if enough useless idiots like LB listen to and believe these lies).

SWTD #225, wDel #46.