enrollment, but in washington state we know it s been this way so far. eight times as many people enrolled in medicaid than those that purchased individual health plans, and seven times as many signed up for medicaid versus private insurance in that crucial 18-34 age range. so we wanted to ask the question if this happens nationwide, if this is an example what s going on nationwide, what does that mean for the law? michael cannon is with the cato institute and co-author of healthy competition, michael weinberg is senior policy adviser to the bay area council, and sarah cliff is a reporter for the washington post . nice to have you all today. we re dealing with just the numbers we have, and we want to be clear about that because we re still waiting for more information but, sarah, what would happen if eight times as many people sign up for medicaid as those that sign up for private insurance, does that mean we re in the death spiral that some folks have talked about? so i think one
human terms, it s hard to imagine. i imagine myself 88 years old, and i m going to get a coupon and shop on the private market for insurance because i have a discount coupon, and so maybe someone will want to pick me up as an 88-year-old pensioner. it s hard to imagine in human terms, but in economics terms, there any reason to believe that putting someone in the market with some subsidy would be more efficient and bring down costs? this is amazing because this is a case where conservatives not just extreme ones, won t take no for an answer. we have lots of head to head comparisons of private insurance and it always ends up being more expensive. you can see that. we ve got medicare advantage, running medicare through private insurance companies and turned out to be a money losing proposition for the taxpayer and medicaid versus private insurance. medicaid is a lot cheaper. there s the international thing, every other advanced country relies on government provision
inadequate care for what you get particularly for the acute care population. health outcomes in medicaid are worse than those in private insurance. there is disagreement there. that s significant disagreement. i should say there is very little disagreement about medicaid versus private insurance. i want you to tell me we ll take a quick break. tell me what the vision to cover people looks like. don, we re going to talk about the medicaid ruling part of the supreme court decision which got less attention but is really important. probably more than half are cut under medicaid. it s very important to understand how math and science kind of makes the world work. in high school, i had a physics teacher by the name of mr. davies. he made physics more than theoretical, he made it real for me. we built a guitar, we did things with electronics and mother boards. that s where the interest in engineering came from. so now, as an engineer,