Meade wrote: without improving health outcomes for the people it is ostensibly designed to help.
It is not true that medicaid does not improve health outcomes.
A guy named Avik Roy published an article last year identifying certain areas where medicaid patients are worse off statistically than uninsured people. His analysis is eye opening, but it is also selective.
The conservative media has taken his work and echoed it endlessly as if it were the truth, the whole truth, and nothing but the truth. Avik Roy is a health care policy specialist, and was Mitt Romney's senior advisor on health caree.
Avik Roy, by the way, is a good guy. I've been arguing with him at his blog, and I'm convinced he really wants to see universal coverage, and is motivated by improving health care. The problem is that most of his comrades on the right are a little less noble, to put it kindly.
Avik Roy has a lot of good ideas for improving medicaid. I trust his good intentions.
One idea I want to challenge him with is the commonly repeated trope from the right, "Don't expand medicaid until it is reformed." If reforms are needed in medicaid, they can be made more easily after expansion, as political pressure will grow to make medicaid more efficient.
The strategic reason to expand medicaid now is that it will settle the issue of universal coverage once and for all. Then the right and left can work together on practical efficiencies.
I was hoping Obamacare would settle the ideological debate and move us towards pragmatism. But no, the Supremes kept the civil war alive for another 5 to 10 years.