Death is the poor man’s doctor

Irish saying

Out this week was an analysis form the group in Oregon regarding the randomization of thirty thousand “Medicaid lottery” winners. Medicaid coverage did not reverse the course of their diabetes or hypertension in the four years they have been covered. Good health care requires more than access to insurance coverage. It did increase visits to primary care. The winners did not use emergency rooms more nor were they admitted to hospitals more frequently. Medicaid coverage did accomplished a couple of things for these folks:

Medicaid coverage resulted in an absolute decrease in the rate of depression of 9.15 percentage points (95% CI, −16.7 to −1.60; P=0.02), representing a relative reduction of 30%.

And possibly related

Medicaid coverage led to a reduction in financial strain from medical costs, according to a number of self-reported measures. In particular, catastrophic expenditures, defined as out-of-pocket medical expenses exceeding 30% of income, were nearly eliminated.

Also out this week is one of the more sobering statistics from the “Great Recession,”  published this morning:

The suicide rate among middle-aged Americans climbed a startling 28 percent in a decade, a period that included the recession and the mortgage crisis, the government reported Thursday.

The trend was most pronounced among white men and women in that age group. Their suicide rate jumped 40 percent between 1999 and 2010.

Why did so many middle-aged whites — that is, those who are 35 to 64 years old — take their own lives?

One theory suggests the recession caused more emotional trauma in whites, who tend not to have the same kind of church support and extended families that blacks and Hispanics do.

The economy was in recession from the end of 2007 until mid-2009. Even well afterward, polls showed most Americans remained worried about weak hiring, a depressed housing market and other problems.

Related? I guess we are about to embark on a much larger experiment based on which states opt into Medicaid expansion. You gotta love science!