Let's quickly interpret this to further our pre-existing agenda (healthcare, guns, environment, vaccination, inequality, obama, immigration...)
http://stateofobesity.org/rates/
Obesity is still a big problem and shaves off years of our lives. I think having an anti-obesity agenda is a wonderful thing and shouldn't be trivialized.
Some data:
Though, re: obesity, aren't there a number of papers that seem to say that some extra weight in your latter years may be an indicator of better survivability for some medical events?
Of course it's not a matter that last year things were good, this year things are bad.
What this signals is a "tipping point", where the continuous medical and public health improvements that have added to life expectancy (usually for those 60+)can no longer keep up with the various factors causing increased death at a young and especially middle age (how important obesity is among these is another issue).
It did, however, affect various subjective measures. People feel good about going to the doctor and having an insurance card even if it doesn't help them.
It's possible there is a long term, small, hard to measure effect, but we have little evidence of it.
It also helped people treat their conditions and illnesses (the increased visits, etc).
What it didn't no is have lifestyle-level health effects ("had no statistically significant effects on blood pressure, cholesterol, or cardiovascular risk") which I don't see why anyone would expect it to have. For one, they just checked after 2 years -- not a significant time unless somebody starts dedicated and determined lifestyle changes.
Those people remained poor and retained their lifestyle habits regarding exercise, food etc (which is what accounts for blood pressure, cholesterol, etc). They just get better access to healthcare.
If Medicare gave them leisure time, a private chef or high end restaurant gift cards, and a personal trainer it would be a different story...
Increased visits is a cost (about $1200/recipient), not a benefit.
I agree that we should have run the Oregon experiment a lot longer and tied the implementation of Obamacare to the outcome.
The expansion would have been to people that were earning too much to qualify for Medicaid. That's going to mean they were relatively healthy.
I'm also not real sure that increasing quality of life and financial security is fairly described by the doesn't help them in People feel good about going to the doctor and having an insurance card even if it doesn't help them. I realize you are carefully talking about effects on objective measures of health, but maybe that isn't the only goal of such programs?
I agree with you that making people healthier was not the real goal of Obamacare. If it was we'd have passed the "Affordable Gym Memberships and Vegetables Act" (aka "Michelle Obamacare") instead.
Stress impairs the body's ability to function optimally - think "fight or flight response" vs. "relaxation response" [1].
[1] https://en.wikipedia.org/wiki/The_Relaxation_Response#Fight-...
I think it's probably more accurate to hypothesize that inflammation causes heart disease.
For example, we could provide mandatory calisthenics classes for people on medicaid - think some sort of watered down military PT class. If you need medicaid, you need to show up daily and do jumping jacks.
Similarly, we could replace food stamps/welfare/etc with a government-issued basket of healthy vegetables, complete with printed instructions on how to cook them.
Utah has been having great success helping the poor with (secularized) Mormon style paternalism. Perhaps the rest of us can learn from them.
http://www.npr.org/2015/12/10/459100751/utah-reduced-chronic...
While many people don't have good cooking instruments where they live, I do think making at least part of food aid into a direct provision of healthy fruits and veggies, including those which can be eaten raw-at-worst, would be a large improvement. Honestly, at this stage, government-run cafeterias serving healthy food for free to anyone in need would be a massive improvement.
It's a pity that people have such negative feelings about "paternalism" that they'd rather give out food stamps for buying rice and beans at inflated convenience-store prices than actually let the government provide healthy food directly.