Health policy folks must now look at the states that did not expand Medicaid access to care for the low income populations.
FIND THIS ARTICLE AND SPREAD NEWS ABOUT IT. THIS IS AN IMPORTANT, BRAND NEW, POLICY ANALYSIS THAT IS VERY GOOD NEWS FOR THOSE WHO "GET IT" ABOUT HEALTH CARE AND THE UNDER-SERVED. American Journal of Public Health, February 2018, Vol. 108 No 2. A. Somi, et al. pp 216-218 Correspond with first author...good for Indiana U. School of Public Health [email protected] Here it is....such analyses require a little bit of time to conduct, but it is clear that expansion of Medicaid substantially, profoundly, increased initial early stage and overall diagnoses of cancer in states that expanded Medicaid under the Affordable Care Act. Late-stage diagnoses were not affected....undoubtedly because patients were already experiencing symptoms and problems that had drawn them into the system already. Why is this important? It is because those people who were expanded into Medicaid represent lots of the most at-risk in the population of not getting early diagnosis, screening, routine medical examinations, and miss the opportunity of early diagnosis without access to care (financial access). This expansion effect on early stage cancer is very significant because in addition to being more humane and medically effective, the burden of cost for late-stage discovery of cancer has certainly been reduced in those states that expanded Medicaid. Now, anyone who claims that the ACA "did not work" will need to address the question about why those states that did not expand did not experience the successful early stage detection of cancers....or, in the world of fake news and political spin, perhaps the current Administration will claim that the ACA caused more early stage cancers....I would not be surprised.
It changed everything for the better at the community mental health departments, people without insurance (eligable for medicaid but didn't apply yet, or didn't qualify, or couldn't afford other insurance or copayments). We used to have sample medications for them, apply to pharm companies for free medication, or put them on haldol or other older meds with a lot of side effects. It was very difficult and time consuming. Now, all of my patients are on medicaid and can get safe medications. I do worry about the possibility that they have to work (SSI not SSD folks) and many don't have the mental capacity to do it and were denied disability or didn't apply or are waiting for a decision.
There is a false sense of propriety among some academics and scientists that advocacy is inappropriate, or could challenge our ability to conduct objective work. I believe that this is not true.
We who do analyses with full scientific rigor are often in the best position to present objective information to the general public and to the law makers. We must stand by our work not because of the direction of findings but because it is objective, factual to the limits of data and analyses, and usually paid for by the public.....grants and contracts from state, local or federal sources produce research that, literally, belongs to the People. We must speak truth to power when we know the answers to complex questions. The obvious effectiveness of the ACA must not be clouded by political nonsense, preconceived ideas, wishful thinking among those who would blame the poor and sick for their misfortune, or others who stain the national fabric.
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