Did Romneycare lower the amenable death rate in Massachusetts? Or did the Red Sox and the Patriots? It depends on how you read the document, Massachusetts Deaths, a report that comes out annually from the Mass. Department of Public Health (DPH). A subject covered in some depth in 'Massachusetts Deaths, 2008' (and perhaps in earlier years) is what the epidemiologists call "amenable mortality."
Some of the statistics about amenable deaths (meaning those that could be prevented with timely health care) and some of the commentary in the report have found their way intentionally or unintentionally into the debate about the benefits of so-called healthcare reform in Massachusetts. On page 30, the report says in part:
"When the amenable mortality for 2000 is compared with that of 2008, it has declined for the state overall... When amenable mortality for 2006, before the implementation of health care reform in January 2007, is compared with amenable mortality for 2008, there has been a significant decline for the state as a whole..."
That wording might make you think that the decline prior to so-called healthcare reform was not significant; that it was just the decline after Romneycare kicked in that was significant. But you need to ask some questions about the word "significance" when it shows up in a statistics-laden report.
It turns out if you ask the DPH guys involved in running the numbers you find out the declining trend before the implementation of Romneycare was just as statistically significant as the "significant" decline that the state report brags about for the period between 2006 and 2008. In other words, Romneycare had nothing to do with it. I asked them: "Does it make sense for the state to imply that the 2006-2008 decline was related to healthcare reform, when the earlier decline -- before healthcare reform -- is just as significant?"
The DPH's reply via email:
"We will have to be more careful when we make comparisons that lead to such implications in the future. We will have to include more language like,
'healthcare reform was concurrent with an already declining trend in amenable mortality.'
"Thanks for pointing this out."
The response is a little weaker than I would like to see given that the pre-Romneycare declining trend covered 6 years and the post-Romneycare concurrency only covered two years. I'd like to see the DPH withdraw the report and rewrite it without the propaganda. Otherwise this misleading information exists forever on the Internet.
Or maybe the DPH could just amend the report to say that the amenable mortality rate declined concurrent with the Red Sox winning a couple of World Series and the Patriots winning a couple of Super Bowls. Maybe the old town teams are the reason for better health -- as measured by amenable mortality -- all through the past decade in the years before so-called healthcare reform.
-- Dennis Byron