John 的招数：
Economics teaches that people reveal their preferences through their actions. If people act as though they are indifferent between being uninsured and being on Medicaid, we may infer they are equally well off in both states of the world from their own point of view. If someone drops a $20 bill on the floor in Parkland's emergency room, how long do you think it would stay there? Probably not very long. If someone drops a Medicaid enrollment form on the floor, how long do you think it would stay there? Probably until the next janitor comes along with a broom. Health economists tend to think Medicaid insurance is really valuable – worth a lot more, say, than $20. Many patients, through their actions, communicate that they disagree.
there is the argument from paternalism: that people will be better off if we push them into Medicaid, whether they prefer it or not. But even on that score, the evidence is weak. A very comprehensive RAND study, found that the type of insurance people have — or whether they are insured at all — does not affect the quality of care they receive. With respect to cancer care, it is unclear that Medicaid matters very much. Health blogger Avik Roy summarizes other studies that find that Medicaid patients do no better and sometimes worse than the uninsured. Additional evidence is supplied byScott Gottlieb. If you're trying to get a primary care appointment, it appears your chances are better if you say you are uninsured.
Here's my bottom line: after we get through spending our $1 trillion under ObamaCare, there is no convincing reason to believe that the bottom half of the income distribution will have more care, better care, or better access to care than they have today.
