Patterico's Pontifications

2/9/2013

How We Were Lied to About Health Care

Filed under: General — Patterico @ 6:11 pm

You already know Barack Obama lied to you about ObamaCare, telling his lawyers to claim in court that the charge for failing to buy health insurance was a “tax” — while telling you that it wasn’t.

But that’s not the only deception that was employed.

We were told there were almost 50 million uninsured in this country. We were told the U.S. does worse than countries with socialized medicine on issues like life expectancy and infant mortality, and other measures. In a speech to the AMA, for example, Obama said:

And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower; and we aren’t any healthier. In fact, citizens in some countries that spend less than we do are actually living longer than we do. . . . We are not a nation that accepts nearly 46 million uninsured men, women, and children.

This is only one example of a flood of rhetoric telling us how inferior our health care system is.

The only problem is: it wasn’t true. Let me explain.

(This post shares some things I learned in an EconTalk podcast with Russ Roberts and Scott Atlas. I have received some good feedback from my posts spreading information I learn on Roberts’s podcasts, because it’s not widely discussed on the blogs. I hope you learn something from this.)

MYTH OF 50 MILLION UNINSURED

For example, we were told that there were as many as 50 million uninsured people in this country. But as Atlas explained, that number was greatly exaggerated.

First, as we discussed on this blog previously, somewhere between 10 and 15 million of that group are not U.S. citizens. That may be a problem, but it’s more of an immigration problem. That does not seem like a reason to turn our health care system upside down.

What about the remaining 35-40 million? Atlas explained that those numbers came from a survey conducted by the U.S. Census Bureau. And there were about 10 million people who said they didn’t have insurance, but did — as was discovered by cross-referencing the claims with medical records that contradicted the claims. For the most part, these people were using Medicaid, which they may not have considered insurance. Apparently people thought the question was asking about private insurance. But someone who is getting health care through Medicaid is hardly “uninsured.”

Then, it turns out that there was another group of about 13 million people who were eligible for public insurance (Medicaid, Medicare, SCHIP/CHIP) who are eligible for state health insurance but did not access it yet.

Ultimately, Atlas says “you are left with a population of less than 5% of people in the United States who don’t have insurance or who are not already eligible for current government insurance programs. I would not call that a crisis in the uninsured.” Indeed.

MYTH OF POOR LIFE EXPECTANCY IN U.S.

But weren’t we told that governments with more involvement in health care have better systems? For example, our life expectancy is pretty wretched according to most measures. Except Atlas points out, when you control for “suicide and immediate death from high speed motor accidents” — things where the health care system can’t save you anyway — all of a sudden we shoot to #1. Plus there is another thumb on the scale that has to do with society and not our health care system, because we are an obese society, and obesity lowers life expectancy quite a bit. But that’s not the health care system’s fault. It’s not your doctor’s fault you are fat. So if we’re #1 even with all the obesity, after you control for things doctors can’t fix, then we’re doing pretty well.

For what it’s worth, Atlas says that studies consistently show that patients with private insurance do better than those with Medicare. We’re skeptical of peer-reviewed studies, of course, and so is Roberts — but Atlas says the numbers are consistent even across easily comparable diagnoses like cancer in defined stages.

THE MYTH OF HIGH INFANT MORTALITY

But aren’t our numbers on infant mortality in the sewer? Aren’t countries with socialized medicine doing better? Not so much. As Atlas explains:

[I]n the United States there are many differences. One important one is that we count every birth. And birth is defined as any sign of life. Actually, ironically, using the very strict criteria defined by the World Health Organization (WHO)–we count any heart rate, any respiration, no matter how premature the infant, no matter how small the infant, no matter how immediate the death is. Other countries, including many civilized countries, countries that we think of as similar to the United States, don’t count births as live births if the baby does not survive for, say, 24 hours.

That skyrockets not only the infant mortality numbers but the life expectancy numbers. If you’re averaging in lives that last only minutes, that tends to drag down the average quite a bit.

OTHER MEASURES

Atlas says in the U.S. we have far better access to, and outcomes from, hip replacement, knee replacement, cataract surgery, and similar procedures. While the greater access (and speedy availability) of such procedures can cost more, it also prevents other still more costly problems.

Fundamentally, we were lied to in countless ways to get ObamaCare. We’re stuck with it now, apparently. But not based on the truth.

UPDATE: Post is edited to change the sentence that originally read: “First, as we discussed on this blog previously, somewhere between 10 and 15 million of that group are illegal immigrants.” Reviewing the transcript of the podcast, that’s not what Atlas says; he says between 10 and 15 million are not U.S. citizens.


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