By Colin McCluney
AMSA Education & Advocacy Fellow
Last week, I had the pleasure of representing AMSA, along with other national leaders, at meetings at the White House and the Capitol to emphasize the importance of preserving funding to Medicaid and Medicare. While key entitlement programs are on the chopping block, we want the voice of physicians-in-training to be heard. AMSA joined with 14 other physician organizations in signing a coalition letter
to oppose cuts to Medicaid and Medicare; this letter was hand-delivered to leadership from both parties in the House and the Senate. In addition to expressing our opposition to any reduction in benefits or coverage from Medicaid and Medicare, we emphasized our support for innovation in health care administration to reduce costs.
Medicare has long been one of the most popular governmental programs, covering over 45,000,000
individuals, and has thus been largely protected from significant cuts. Medicaid, on the other hand, is less well-regarded and is frequently targeted as an opportunity for cuts. Why is this? Perhaps it’s due in part to the unglamorous perception that Medicaid is for poor people, a segment of the population that is hard to mobilize politically, frequently forgotten about and easy to demonize (think about the notion of lazy welfare cheats for example). On top of that, some groups and individuals have claimed that people are better off being uninsured than having Medicaid
. Take all these things together and you can see how easy it could be to cut elements of the program. As you might have intuited though, these assertions aren’t true. While Medicaid does cover eligible individuals at certain poverty thresholds, it is worth noting that Medicaid covers some 30,000,000 children
nationwide and provides payment for about a third of all births
. Most exciting, though, are the recent findings to come out of a randomized controlled trial
of Medicaid in Oregon. The origins and methodology have been extensively reviewed elsewhere
but the key results were that individuals with Medicaid received more preventive care (for example, mammograms), had fewer financial problems (for example, borrowing money to pay debt or having bills end up in collections), reported having a regular doctor, and were much more likely to rate their own health as “excellent” or “good” (rather than “fair” or “poor”). While objective data on quantitative health outcomes won’t be available for another year or more, it is clear that Medicaid has already had a substantial positive impact on those individuals lucky enough to have been enrolled. This study – the first on the effects of health insurance since the landmark Rand study – shows clearly the value of Medicaid in improving the health and well-being of some of the most vulnerable Americans.
The budget negotiations will rumble on and Medicaid & Medicare will continue to be targets for cuts. Even after this round of discussions is finished, it is clear that there will be more battles to come. We see, however, that these programs are essential and effective in helping provide access to necessary medical care for a significant portion of the population, and we will continue to fight to support Medicare and Medicaid, to oppose cuts, to ensure & expand coverage, and to reduce waste.