It may just be that ordinary people, even those with significant problems, are more capable of navigating the seas of American life than elites, either liberal or conservative, tend to assume.
These results run contrary to the predictions of many Obamacare fans, who expected to see more positive effects from Medicaid coverage. It undermines at least a little the case for Obamacare's vast expansion of Medicaid.
Some Obamacare backers, and others as well, point out that the study did not measure all possible health care outcomes. It couldn't because it covered only two years; and Oregon, with more Medicaid money, ended the lottery experiment, so there won't be any more RCT results.
In particular, in a two-year period you aren't going to have too many cases of catastrophic illness among a population of 12,000. There's no way you can measure outcomes in those with long-running ailments like cancer, Parkinson's disease or Alzheimer's.
Blood sugar levels, blood pressure and cholesterol levels can be treated with relatively inexpensive generic drugs. Medicaid coverage may result in more people getting heart bypass surgery and needing expensive drugs for rare ailments.
But that is another way of saying that health insurance as we know it may not do much to improve the treatment of common health problems.
Most U.S. health insurance today, thanks to the tax preference for employer-provided insurance, is not real insurance at all.
Real insurance pays for rare, expensive and unwelcome events, like your house burning down. It doesn't make sense to insure for routine expenses, like repainting your living room.
The Oregon Health Study suggests that insurance isn't necessary for people to get what are now, for people of a certain age, routine measures like blood pressure medicine. Maybe government should help poor people pay for them, but they manage to get them nevertheless.
Americans have come to expect health insurance to pay for routine treatments. Obamacare reinforces that in its requirements for coverage and makes it more difficult for many to insure against catastrophic health care expenses.
That's not likely to make people healthier.
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