How to Arrive at the Best Health Policies

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Randomized trials are highly effective for suggesting ways to improve healthcare delivery, but they're also rare. That may be changing.


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When the 48-year-old man from Oregon didn’t have insurance, he felt he had no place to go but the emergency room. The man, who has , went to the emergency room often when he suffered from . “Emergency rooms, from what I understand, they can never turn you away,” he said. “I mean, you don’t have much options when you don’t have insurance.”



Then, when he enrolled in the state of Oregon’s plan, that all changed. He started seeing doctors in their offices, and stayed away from the emergency room: “I have had 5 appointments with my primary, one with the diabetic because they had me go to a diabetic educator, and then an appointment with my pharmacist, and then he does a phone-in thing with me every 2 weeks.”

His experience confirms common assumptions about how healthcare works. If we can just invest in preventive care, we can reduce the use of the emergency room and lower healthcare costs, the thinking goes. But it turns out that his experience wasn’t typical.

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Source: The New York Times