Researching the Health Care Debate Wharton School October 23, 2008.

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Presentation transcript:

Researching the Health Care Debate Wharton School October 23, 2008

The Myth of Non-Biased Sources

Bias Ideological Bias Ideological Bias Institutional Bias Institutional Bias Personal-Actualization Bias Personal-Actualization Bias

How You Present Data Matters 2 million Americans are behind on their mortgages! 2 million Americans are behind on their mortgages! More than 94% of mortgages are current. More than 94% of mortgages are current.

A Few Common Claims 47 million Americans without health insurance 47 million Americans without health insurance Rudys Prostate Rudys Prostate Life expectancy = Quality of health care system Life expectancy = Quality of health care system

47 million Americans without health insurance Actually 45.7 million Actually 45.7 million –U.S. Census Bureau, Current Population Report, Income, Poverty, and Health Insurance Coverage in the United States: million eligible for current programs 12.1 million eligible for current programs –National Institutes of Health 20 million are not US Citizens 20 million are not US Citizens –U.S. Census Bureau, Current Population Report, Income, Poverty, and Health Insurance Coverage in the United States: million have incomes over $75, million have incomes over $75,000 –U.S. Census Bureau, Current Population Report, Income, Poverty, and Health Insurance Coverage in the United States: million have incomes over $50, million have incomes over $50,000 –U.S. Census Bureau, Current Population Report, Income, Poverty, and Health Insurance Coverage in the United States: 2007

47 million Americans without health insurance 45 % Uninsured for less than 4 months 45 % Uninsured for less than 4 months 16 % uninsured for more than 2 years 16 % uninsured for more than 2 years –CBO, How Many People Lack Health Insurance and For How Long?

Rudys Prostate 5 year survival rates: 5 year survival rates: –US 98% –UK 74.4% BUT death rate from prostate cancer BUT death rate from prostate cancer –US 26.7 per 100,000 men –UK 27.0 per 100,000 men

Rudys Prostate Early Screening? Early Screening? Mislabeling? Mislabeling? Higher incidence in US? Higher incidence in US?

Life Expectancy US has lower life expectancy than other industrialized nations: US has lower life expectancy than other industrialized nations: –Japan 82.0 years –Canada 80.4 years –France 80.2 years –Germany 79.4 years –UK 79.1 years –US 77.8 years OECD Health Data, 2008 OECD Health Data, 2008

Life Expectancy Exogenous factors Exogenous factors –Murders, suicides, accidents –Lifestyle (obesity, smoking) Utah 78.7 years Utah 78.7 years Nevada 75.9 years Nevada 75.9 years –U.S. Census Bureau, Population Division, Interim State Population Projections, 2005.

Projections are even worse

Assumptions Matter or Garbage In, Garbage Out

How much does Obama health plan cost? $65 billion per year $65 billion per year –Obama Campaign $110 billion per year $110 billion per year –Lewin Group $160 billion per year $160 billion per year –Urban Institute/Brookings Institution $600 billion per year $600 billion per year –Health Systems Innovations

Insurance Coverage Under McCain Plan 27.5 Million more insured 27.5 Million more insured –Steve Parente, University of Minnesota 5 million fewer insured 5 million fewer insured –Health Affairs

Every econometric study is an effort in persuasion. I have to persuade the other guy that my assumptions are responsible. Depending on what I feed into the model, I get totally different answers. -- Uwe Reinhardt Princeton University

Websites American Health Quality Association ( American Health Quality Association ( Council for Affordable Health Insurance ( Council for Affordable Health Insurance ( Duke University Center for Health Policy ( Duke University Center for Health Policy ( The Commonwealth Fund ( The Commonwealth Fund ( Agency for Healthcare Research and Quality ( Agency for Healthcare Research and Quality ( The Galen Institute ( The Galen Institute ( Henry J. Kaiser Family Foundation ( Henry J. Kaiser Family Foundation ( CBO – Health ( ons/health.cfm) CBO – Health ( ons/health.cfm) ons/health.cfmwww.cbo.gov/publications/collecti ons/health.cfm American College of Physicians ( American College of Physicians ( Journal of American Medicine ( Journal of American Medicine ( New England Journal of Medicine ( New England Journal of Medicine ( Robert Wood Johnson Foundation ( Robert Wood Johnson Foundation ( Centers for Medicare and Medicaid Services ( Centers for Medicare and Medicaid Services ( U.S. Census Bureau, Health Insurance ( ns/hlthins.html) U.S. Census Bureau, Health Insurance ( ns/hlthins.html) ns/hlthins.htmlwww.census.gov/hhes/www/hlthi ns/hlthins.html