He writes:

A newly published study of the Medicaid expansion in California says that the program substantially reduced in-hospital mortality for patients who gained coverage, put hospitals on a firmer financial footing, and improved access to care, and better care, for millions of residents. Yet Robert Ver[B]ruggen of National Review thinks the study shows that “we have a system that makes it entirely rational to dump tons of money into a healthcare program that doesn’t improve health very much.” (H/t Kevin Drum, who unearthed the Ver[B]ruggen article.) Something must be off here, and the answer may be that Ver[B]ruggen didn’t pay much attention to what the paper’s authors, led by Stanford economist Mark G. Duggan, actually said about what they learned. The expansion led to substantially greater hospital and emergency room use, and a reallocation of care…to private and better-quality hospitals. — Duggan, et al.

What? Aside from the fact he misspells my surname, I have no idea how someone could read the post I actually wrote and think this makes any sense whatsoever as a response.


The quote he provides from the study is included in my own post; indeed it leads the post and comes long before the line about how our system makes it rational to expand Medicaid despite studies (not just this one) showing that health benefits are hard to detect. I also specifically noted the statistically insignificant 7 percent reduction in mortality that he characterizes as a finding that Medicaid “substantially reduced in-hospital mortality.” (He doesn’t mention the finding was insignificant, meaning we can’t be confident it’s not actually zero, until much later in his column.) Further, I discussed in a lot of detail the benefits the study finds for hospitals and state governments and said the expansion “made care more accessible to patients.” Indeed, I used much of the post as an opportunity to push back against conservatives who claim Medicaid expansion is a bad idea from the standpoint of state governments, which incur little of the cost but see a lot of the financial benefit.

I don’t want to belabor the point here. But I encourage people to read what I wrote rather than Hiltzik’s bizarre mischaracterization of it.