Massachusetts Health Stats

Ezra Klein, Holtz-Eakin Both Wrong about RomneyCare

The left and right are having some kind of shouting match over RomneyCare, Massachusetts so-called multi-year health care reform. The premise put forward by Journolister-in-Chief Ezra Klein of the Washington Post is that RomneyCare results in Massachusetts have value as a leading indicator of what will happen across the United States under the 2010 Patient Protection and Affordable Care Act (PPACA). The response from former Republican Congressional Budget Office director Douglas Holtz-Eakin is that PPACA and RomneyCare are not the same.

At least relative to RomneyCare, both Klein and Holtz-Eakin are wrong.

 

Heavy Overthinking Permeates Flawed Academic Analysis of RomneyCare

For whatever reason, the author of the blog "A Certain Enthusiasm" has spent a lot of time trying to prove RomneyCare a success. I can't figure out whether he's a MittManiac or a lefty but he keeps trying to squeeze the old five pounds of you know what into the one pound bag. His current premise -- like others trying to rationalize the failure that is RomneyCare -- is that it is a success because 'private healthcare premiums' in Massachusetts are growing more slowly than elsewhere in the country.  It's the we're not as bad as them version of good.

Given its length and apparent independent thinking, his theory deserves a thorough review.  I have reviewed it. He's wrong. See below.  But I applaud his effort although it illustrates the overuse of statistical devices and overthinking of the derived "estimated results" by academics. (There is no "about us" link on the blog that I can see so I don't know if the author is an academic. But he makes my point about the academy nevertheless.)

• Why use statistical projections as derived estimated results when you have almost 100% complete census data available? 
• Why regress the flimsy data points the academics tend to depend upon when you can look back at complete data, and regression is basically for looking forward? 

WaPo's "Five Myths about Medicare" Uses Five Old Medicare Myths to Fight Premium Support

The Washigton Post on February 24 featured an opinion piece titled "Five Myths about Medicare."  There are definitely five outrageous myths in this article. But they are not myths being cleared up by WaPo but old Medicare myths introduced by the author apparently to oppose Medicare premium support. Here's what WaPo says followed by the truth:

• This article says “the majority of Medicare beneficiaries have supplemental insurance… However, Medicare coverage is still costly; beneficiaries pay relatively high deductibles and co-insurance.” Actually,
  • Medicare beneficiaries is NOT still costly with supplements; we seniors don’t pay high co-pays or deductibles IF we have private Medicare supplemental insurance. That benefit -- plus some protection against catastrophe -- is why we have to get private insurance (there is also an increasingly popular 'public' option, Medicare Part C, that supplements Medicare--see below)
  • More misleading by WaPo, the number of us seniors with supplemental insurance is much more than a “majority;” more than 90% of us on Medicare depend on supplements of some kind (see illustration).  

 

Far-Left Republican Bloomberg Praises RomneyCare

Has Bloomberg gone mainstream Republican or totally far left?  It's hard to tell these days because both groups are falling over each other to praise the so-called and totally screwed up Massachusetts health care reform¹ known as RomneyCare. 

• The lefties praise it because it is like Obamacare, and because they think it is a success because some Harvard professor tells them it is. 
• The mainstream Republicans praise it because if Romney loses the nomination it will be because of the disaster that is RomneyCare.  And if Romney loses the nomination, the Republicans lose the presidential election.

I vote for far left.

It's Official: Baby Boomers Don't Know Medicare Sucks

Bankers Trust, which sells retiree insurance of various types mind you, has comissioned some probably reliable statistical research that proves the obvious: Baby boomers didn't/don't know that Medicare sucks. 

We find out fast enough once we start looking at Medicare but maybe a little publicity about this new research will speed up the process and make our children better understand the benefits of Wyden/Ryan and similar proposals to modernize senior health care insurance.

I explain the situation in multiple places on this blog but let me try one more time:

Who Loves the RomneyCare Failure in Massachusetts and Why

Recently the Boston University National Public Radio station conducted a poll of some sort among Massachusetts residents on the popularity of RomneyCare. I did not even look at the methodology for bias because the results were so predictable.

The poll was apparently wrapped around and designed to refute a claim that RomneyCare is an "abject failure." The far left wing NPR outlet says it isn't. But RomnyCare is a failure. a spectacular failure. It did not achieve the objectives outlined by then Governor Romney when he introduced the concept in November 2004 (see http://www.boston.com/news/globe/editorial_opinion/oped/articles/2004/11/21/my_plan_for_massachusetts_health_insurance_reform/). Proposals that do not deliver against objectives are called failures (I'm not sure what abject means; perhaps WBUR was quibbling about that added adjective).

"Medicare as We Know It" Depends on "Commercial Insurers"

In the category of academics with their heads up their ink wells when it comes to Medicare, you can't beat this pair writing on Health Affairs blog. Ms. Archer's and Mr. Marmor's political screed misses very key points about Medicare. Clearly neither author is on Medicare nor has either apparently ever talked to a person that is. 

Their ideological statement begins with the typical academic premise about Medicare (also fondly referred to by many academics and politicians as "Medicare as we know it"), the idea that it is good insurance. The authors are totally wrong when they say "Medicare is designed to absorb risk." Medicare is designed to do exactly the opposite; it is terrible insurance with lifetime limits, geographic restrictions, no drug/vision/dental/annual-physical-exam coverage, high co-pays, and high deductibles.

Harvard Inventor of RomneyCare Argues against ObamaCare

John McDonough, Harvard professor and one of many self-annointed architects of RomneyCare (and therefore of PPACA), keeps making the argument against the massive federal governmental involvement in healthcare insurance.

In September McDonough wrote that

• There are a little more than 300 million people in the United States
• 257 million of us have healthcare insurance
• 26 million of us are eligible for Medicaid but have not bothered to sign up for it for whatever reason
• 10 million of us don't want healthcare insurance and will pay a financial penalty/fine/tax assuming they ever get caught
• 6 million of us are not us; they are illegally in the country
• That leaves 12 million who
  • either want insurance but can't afford it (let's say half?)
  • or that will get insurance rather than pay the penalty until they figure out how easy it is to evade the penalty (let's say the other half?)

Right Wingers Struggle to Understand RomneyCare

The right wing is all twisted up in its skivvies trying to defend RomneyCare and/or explain how it differs from the Patient Protection and Affordable Care Act (PPACA) and/or distance themselves from RomneyCare's Herigate Foundation thinking and/or... These mental gymnastics lead to the flawed thinking behind an American Spectator article by "Robert P. Kirchhoefer... a Washington, D.C. attorney who previously worked in banking and finance..."

Mr. Kirchhoefer should stick to his lawyering because his finance figuring needs a lot of help. Kirchhoefer leaves out the major financial aspect of RomneyCare as described by Romney himself when Romney announced his healthcare insurance proposal in the Boston Globe in November 2004.

HHS Tricks Senior Citizens with Medicare Savings Stats

The U.S. Health and Human Services (HHS) department is like a New York City street con dealing three-card monte. In a politically corrupt February 2, 2012 press release -- put out with a report HHS calls Medicare Beneficiary Savings and the Affordable Care Act (see the report's lead table below) -- HHS claims:

"Savings for people with Medicare will increase over time... the average person with Medicare will save nearly $4,200 by 2021..."

If your Part B premium just went up $40 for 2012, you're probably thinking

"Medicare savings? Medicare savings? Where are the $160 savings for 2012?"  

*None of these savings apply at all unless a long list of assumptions about reduced payments to nursing homes, home health care providers and hospitals and cuts to be made by the Medicare death panel passed under the Patient Protection and Affordable Care Act (PPACA) actually happen. These cuts are as unlikely to happen as the doctor cuts that are supposed to go into effect February 29... even if PPACA is found constitutional.

As the table title says, these savings are for "FFS" (Fee for Service) Medicare beneficiaries ONLY, those on Medicare Parts A, B and D.  But the 2010 actuarial analysis on which this 2012 HHS report depends ALSO notes that there are significantly increased costs for Medicare Part C beneficiaries over most of the same time period. Because 25% of us seniors are on Medicare Part C, the 2012 report's table should have had another column for Medicare Part C.  The result would have been a much lower amount for the savings of the HHS' "average person with Medicare." This omission by HHS can be considered nothing but corrupt politicization of a program so important to senior citizens.