For fans of expanded health care coverage, the news out of Oregon recently wasn’t good. When researchers studied the impact of opening up Medicaid to thousands of new enrollees, they found that insurance did little to affect levels of disease. To opponents of Obamacare, which aims to bring millions more people into the system, the study proved a point: expanding coverage is both ineffective, and expensive.
Still, the research, which was published in the New England Journal of Medicine last month, did offer one ray of positivity. It showed that people with health insurance are less likely to suffer from depression: 30% less likely, in fact. Is it possible that the Affordable Care Act could make for a less depressed nation?
The research looks at Oregon’s 2008 effort to bring 10,000 new people into its Medicaid system, using a lottery. By comparing those people who were lucky to get accepted (90,000 applied) and those who weren’t, the researchers could draw conclusions about the impact of health care coverage. Among the non-enrollees, a third showed symptoms of depression; but among the lottery-winners, only one-fifth did.
The question is, what caused the change? In a piece for the Boston Globe, Leon Neyfakh interviews several health care experts, including Jonathan Gruber, a health care economist at MIT. He’s in little doubt: the uninsured live in “constant daily stress” about medical bills, so relief from that is likely to have a positive effect.
Neyfakh adds there is plenty of other research linking negative economic conditions (like losing your job) and depression. So it stands to reason that health insurance, which offers a safety net against both illness and bankruptcy, would be palliative. He writes:
For health care economists, it is intuitive to see health insurance first and foremost as an economic tool, and it’s frustrating to them that more people don’t talk about it that way. Health insurance, after all, doesn’t prevent terrible things from happening to us. It just makes it easier for us to cope with them when they do, and provides us with the peace of mind associated with knowing that a health emergency won’t destroy us financially.
The Oregon study is just one piece of research (though it involved several thousand people, and studied them over two years). But it could point to something positive and overlooked about health care coverage. Its importance is not just in fixing people when they get sick, but also in making them better when they’re “well.”