On May 1, 2013, the New England Journal of Medicine published a landmark study with important implications for President Obama's health care law. It was specifically designed to compare health outcomes for Medicaid patients against those who are uninsured.
In 2008, Oregon expanded its Medicaid roles, but only had enough funding to cover a portion of residents who wanted to sign up. To distribute spots in the program, officials set up a lottery. The researchers compared 6,387 lottery winners to 5,842 who didn't get a slot, tracking factors such as blood pressure, cholesterol, blood sugar, depression, and out-of-pocket medical spending. Supporters of expanding Medicaid are pointing to the findings that beneficiaries had less depression and more financial security. Catastrophic out-of-pocket medical expenditures, for example, were "nearly eliminated."
Opponents of expanding Medicaid focused on the paper's conclusion that the new coverage "generated no significant improvements in measured physical health outcomes," including blood pressure, cholesterol and blood sugar. Sen. Ted Cruz, R-Texas, claimed at a press conference, "Expanding Medicaid will worsen health care options for the most vulnerable among us in Texas."
Even the most negative reading of these results does not suggest that Medicaid patients became worse off in any consistent way. The results were, at worst, mixed - better results for depression, no statistically significant improvement in several measurements of physical health.
"I think it would be fair to say that our study provides no evidence that Medicaid beneficiaries are worse off," Dr. Baicker, the study co-author, told PolitiFact. "It provides evidence that they are better off in some dimensions, but it fails to provide evidence that they are better off in other dimensions. However, in no dimension does it provide evidence that they are worse off."
She added that the study found that beneficiaries did consume more health care, meaning that the program costs more money.
"It's up to policymakers to weigh those costs against the benefits," she said.
GREENHOUSE GAS
"Science has not shown greenhouse gases to be a problem," Rep. Wayne Smith R-Texas, told the Austin American-Statesman on April 17, 2013.
Scientific consensus is that increases in greenhouse gases, mostly due to burning fossil fuels such as coal and oil, have contributed to global warming, though the pace of that warming is uncertain.
The latest assessment of global warming factors was published in 2007 by the International Panel on Climate Change. That body was created in 1988 by the World Meteorological Organization and the United Nations Environmental Programme to evaluate the state of climate science as a basis for informed policy action, on the basis of peer-reviewed and published scientific literature. The 2007 report says both that evidence of global warming is "unequivocal" and most "of the observed increase in global average temperatures since the mid-20th century is very likely due to the observed increase in anthropogenic greenhouse gas concentrations."
A 2009 survey of 3,146 earth scientists asked if "human activity is a significant contributing factor in changing mean global temperatures." Eighty-two percent answered affirmatively, with 97 percent of those respondents with the most climate expertise saying yes.
Dr. Doran, professor of earth and environmental sciences at the University of Illinois, Chicago: "It seems that the debate on the authenticity of global warming and the role played by human activity is largely nonexistent among those who understand the nuances and scientific basis of long-term climate processes.
The challenge, rather, appears to be how to effectively communicate this fact to policy makers and to a public that continues to mistakenly perceive debate among scientists."
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