Politics & misleading Medicaid statistic

Posted By

Tags

The following is a guest blog post from Trudy Lieberman, one of our contributors.


When the Florida legislature recently adjourned without expanding Medicaid after contentious debate, one statement by Rep. Richard Corcoran undoubtedly influenced the outcome. When Corcoran’s constituents emailed him asking for Medicaid expansion, he replied:

“The largest national study, conducted by the University of Virginia, found that Medicaid patients were 97% more likely to die than those with private insurance.”

Really? That makes it sound like the whole program ought to be scrapped because Medicaid benefits are likely to kill the 65 million or so Americans who depend on them for their healthcare. How many constituents would favor expansion after reading that? (The Affordable Care Act called for all states to expand their Medicaid programs, but the Supreme Court gave them the option. So far 22 have refused.)

Corcoran’s provocative comment certainly deserved media scrutiny. He was twisting results of a study to advance a political agenda. In my view a politician making such a sweeping, questionable remark is no different from a drug or device company making a claim based on flimsy evidence. Lately we’ve been trying harder as journalists to dig behind the medical claims. But when it comes to challenging such claims in the health policy world, not so much. Except for PolitiFact’s critique published in the Tampa Bay Times, our search of Florida’s media turned up no other stories dissecting Corcoran’s response to his constituents.

PolitiFact spoke to one of the study authors who said it was a misleading statistic. The University of Virginia study published in 2010 examined 900,000 surgery cases across the U.S. and followed patient outcomes. For starters, it examined patients with all kinds of insurance not just coverage from Medicaid, and some had no insurance. Researchers then adjusted for patient health and other variables like age and income. Yes, they did find that Medicaid patients were 1.97 times more likely to die following a procedure than patients with private insurance. From that number Corcoran concluded Medicaid was a bad program because recipients were 97 percent more likely to die.

Here’s where the need for skepticism—and truth—come in. Did that mean Medicaid is the reason patients had higher mortality rates? Not so fast.  One of the researchers pointed out that Medicaid patients usually have a whole bunch of risk factors that may have contributed to the poorer outcomes. People on Medicaid are likely to be sicker, poorer, and the least educated, and we know both higher income and more education correlate with better health. Dr. Irving Kron, a heart surgeon and University of Virginia professor, told PolitiFact  “the problem with Medicaid is there’s more emergencies because they’re sicker than most people…They wait for care and unfortunately, emergent patients don’t do as well as elective patients.”

Misleading Medicaid stat

In other words, being on Medicaid was not the reason for their poorer outcomes. “Corcoran’s statement implying that Medicaid is the cause of higher mortality is just wrong,” My fellow HealthNewsReview contributor Andrew Holtz told me. “Journalists should have looked up the study and found it did not say Medicaid causes higher mortality.”

The study also found that patients without insurance had worse outcomes. They were 74 percent more likely to die than those with private insurance who researchers found had the best outcomes. “Researchers said insurance status could be a good proxy for socio-economic problems in peoples’ lives,” Holtz noted.

Researchers did not investigate the quality of care given to people under the Medicaid program although Corcoran’s constituents and others could easily jump to that conclusion. We know that healthcare quality and safety problems plague the entire health system, also a point that would have been worth a journalist’s look in the context of Corcoran’s statement.

When PolitiFact discussed the study with Corcoran, he insisted the University of Virginia study supported his conclusion. “My point was that Medicaid is a subpar healthcare delivery system,” he said.

There’s nothing new about politicians making outlandish claims, but now they increasingly appear in health policy debates. What’s needed more than ever in the face of such unwillingness to use evidence correctly is a lot more journalists and news outlets willing to push back and set the record straight.

You might also like

Comments (10)

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.

Terri T.

May 12, 2015 at 9:48 am

Quote from the article: “One of the researchers pointed out that Medicaid patients usually have a whole bunch of risk factors that may have contributed to the poorer outcomes. ” Absolutely, that is true, just as it is true that a great part of the reason for the differences in hypertension management has to do with the fact that some groups do better about taking their medicine and following diet guidelines than others do. I worked and observed this ‘disparity’ for many years – and it has way less to do with any racial group being treated less aggressively, than with failure of said patients to do their part in their treatment plans. Pretending that it is poor care given to a group based on factors such as ethnicity, does nothing but facilitate that group blaming others, rather than owning their responsibilities in attaining a more healthy life.

Jeannine

May 12, 2015 at 10:43 am

It’s no surprise when I hear outrageous unsubstansiated remarks coming from the Republicans and the tea party, they will say or do just about anything to to undermine our president and his policy’s including the ACA, the disturbing aspect of all this is that for the most part these false claims and accusations basically go unchallenged and end up becoming folk lore

    Trudy Lieberman

    May 12, 2015 at 1:31 pm

    These misstatements do have a way of becoming “truths.” That’s why it’s so important for the media to set the record straight and present the evidence or lack of it for what’s being said.

    Catherine

    May 12, 2015 at 2:48 pm

    Let’s step back from the political ledge. Every person in every political party has their own agenda. Their agenda is not always those of their constituents. Even journalist have person stories to tell of how insurances “killed” their loved ones, etc. If a person does not take responsibility for their own lives, health and habits then please do not ask the government to ALWAYS solve their problems.

Louise Dotter

May 12, 2015 at 11:19 am

I emailed the ‘gentleman’ in question a link to this blog – maybe if a lot of people do the same he might actually READ it! That is if he can read! !@#$%

Tim Sanders

May 12, 2015 at 2:14 pm

I am wondering how 1.97% subtracted from 100% equals 97%? Other than that math question I agree completely with your article. This is the Republican, Tea Party, Christian Right, Far Right Conservative answers to everything. They are schooled in Congress (with Taxpayer money) how to respond to these issues by lobbying groups and groups like ALEC, Grover Norquist and Carl Rove. I will attempt to write a letter to the Tampa Bay Times Editor and educate him on the need for critical and accurate research by qualified journalists when reporting on what facts, proven lying politicians twist and manipulate. Thanks for bringing this to my attention.

Pogonip

May 12, 2015 at 3:35 pm

The message from Mr. Corcoran’s statement is that doctors and other care givers dole out the level of care depending on the financial outcome. If paid by Medicare or Medicaid, the quality is lower than if paid by private insurance. That simply isn’t true in my experience, and I hope not ever true. It was true in my grandparents’ time, when “charity wards” were where poor people were treated, but that’s no longer the case. But the GOP often refers to the “good old days” and that was a part of it.

Sarah Collett

May 12, 2015 at 11:18 pm

I’ve been a Medicaid patient, a self pay patient and now an ACA patient. I was much more likely to keep appointments and follow certain advice as a medicaid patient. Insurance premiums eat up 20+% of our pay and 1 complaint about my hip cost $1400 with no resolution because I couldn’t afford it. I have a long list of symptoms & complaints…but I’ll return when it’s a TRUE emergency & probably not before. (Mostly due to cost; partially due to lack of faith in current medicine.)

William

May 13, 2015 at 7:00 am

I wonder what kind of medical insurance every state representative and senator in all the non-participating states have?

Lee Goscin MD, PhD Largo, FL

May 16, 2015 at 7:01 pm

Yes uninsured have worse outcomes but not as bad as Medicaid patients. The Medicaid Expansion in Oregon NE JMed 5/2012 failed as did single payer in Vermont 2015.