05.06.2013 1

Neither Medicaid nor Head Start Work

By Richard Manning

Big government social engineers must be shaking their heads in disbelief.  The honest amongst them have to be asking how they could have been so wrong.

The effectiveness of both Medicaid and Head Start, two bulwarks of the left’s belief that massive government spending could make a difference in the lives of the poor have been exposed as ineffective.

A much anticipated study out of the state of Oregon on the health impacts of having Medicaid versus not having it has released second year data, and the results are devastating to those who believe in the power of government medicine.

The study compared health care outcomes for more than 6,000 people who were just entering the Medicare system after having no health insurance to those outcomes for just under 6,000 people who continued to not have health insurance.

Finally, Medicaid advocates would be able to prove what they instinctively knew to be true – Medicaid saves lives, and helps the health of those who receive it.

The Oregon study now throws not just a pail, but a full bucket of cold water on their expectations that Medicaid makes a difference reporting in the New England Journal of Medicine,

“We found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions. Medicaid coverage significantly increased the probability of a diagnosis of diabetes and the use of diabetes medication, but we observed no significant ef- fect on average glycated hemoglobin levels or on the percentage of participants with levels of 6.5% or higher. Medicaid coverage decreased the probability of a positive screening for depression (−9.15 percentage points; 95% confidence interval, −16.70 to −1.60; P=0.02), increased the use of many preventive services, and nearly eliminated catastrophic out-of-pocket medical expenditures.”

In laymen’s terms, Medicaid had no significant effect on actual measurable medical conditions, but it did “nearly eliminate catastrophic out-of-pocket medical expenditures.”

In this year alone, the Obama Administration plans to spend $267 billion on Medicaid alone rising to $529 billion by 2023.

Think about that, this year alone more than a quarter of a trillion dollars is being spent on a program that doesn’t significantly improve measurable health outcomes for its recipients, but facts be damned, when it comes to other people’s money, it is more about feeling good about our actions rather than whether they achieve the desired impact.

The news on Head Start is no better for those who believe that government can solve all ills.

A program started in 1965, Head Start has been incrementally expanded over the years and now it has become a year-round preschool and day care service for children between the ages of 3 to 5.

The problem with Head Start is that in spite of all its noble intentions of giving underprivileged children a better chance to succeed in school, it doesn’t work.

Currently costing taxpayers $8 billion a year, in 1998 Congress that the U.S. Department of Health and Human Services conduct a study of the efficacy of Head Start program.  The little reported study by the Office of Planning, Research and Evaluation within HHS’ Administration of Children and Families entitled ‘Third Grade Follow-Up to the Head Start Impact Study Final Report’ was released in October 2012.

It is no wonder it has largely been ignored with that enervating title.  But the reports results should not be ignored.  In fact the study revealed that Head Start,

“…had few impacts on children in kindergarten through 3rd grade” versus those who had not been enrolled. Why? “[E]arly effects rapidly dissipated in elementary school, with only a single impact remaining at the end of 3rd grade for children in each age cohort.”

That’s right, the early effects of Head Start went away as the children matriculated through elementary school, with virtually all impact gone by the third grade.

Just another $8 billion a year spent on a social science experiment that has proven to be a complete bust, except in developing a large constituency of government workers dependent upon the programs.

At a time when our nation faces a real budget crisis, these two studies cry out for Members of Congress to conduct real evaluations of which of these feel good social programs are accomplishing their missions and which are just being sustained due to a loud group of advocates who have become dependent upon the government dollars regardless of whether they are accomplishing anything.

The Medicaid question becomes all the more important as states continue to grapple with whether to significantly increase the numbers of people who are eligible for the program.

Given the objective results available, those states which chose not to participate in the program have been proven right – saving taxpayers millions of dollars by just saying no to the program.

Now Congress has the responsibility to re-evaluate every assumption about the federal government’s involvement in both health care and education.  A fresh start about what the appropriate role of the federal government is in both areas underpinned by a knowledge that trillions of dollars have been wasted pursuing a failed liberal ideal.

As a first step, they should rip the failed programs out by the roots and take a giant step toward saving our nation from certain financial ruin.

Who knows, maybe Head Start and Medicaid will become the symbols of do-gooder government gone awry, and be held up for generations as the counterpoint to the next feel good government expansion schemes?

One can only hope so.

Rick Manning (@rmanning957) is the vice president of public policy and communications for Americans for Limited Government.

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