On Right Wisconsin, I wrote about Gov. Scott Walker’s decision to reject federal funds to expand Medicaid:

Others have raised additional pertinent objections to expanding Medicaid. Harvard University Prof. Malcolm Sparrow estimates health care abuse and fraud as “hundreds of billions of dollars a year,” with up to $60 billion per year in  Medicaid fraud alone. The Wisconsin Reporter  extrapolates Wisconsin’s share at $210 million in yearly Medicaid fraud. If you provide more Medicaid, you will get more Medicaid fraud. …

The only two valid reasons for expanding Medicaid would seem to be a reduction in overall health care spending and a corresponding improvement in the health of Medicaid recipients. The former will not happen. As it turns out, the latter rationale doesn’t quite pan out either.

The New England Journal of Medicine studied the state of Oregon’s 2008 Medicaid expansion, which, quoting from the study, “generated no significant improvements in measured physical health outcomes in the first two years.” …

The NEJM study came a year after the Cato Institute looked at the first year of Oregon’s Medicaid expansion. Expanding Medicaid unsurprisingly led to “higher medical consumption,” such as a 63 percent increase in mammograms, a nearly 60 percent increase in average outpatient visits, a nearly 30 percent increase in hospital admissions, a 15 percent increase in diabetes screening, and a 25 percent increase in Medicaid spending. The only benefit Cato found was reduced out-of-pocket patient costs; it predicted the NEJM study a year in advance by showing no significant health improvements. …

Ever wonder why small businesses are so concerned about the effects of Obamacare? It’s because small business owners pay 100 percent of the costs of their own health insurance. They see the bills and they write the checks. They know how much health insurance costs. Their employees generally do not, unless their employers tell them how much they’re contributing.