The other day, Politico published an opinion piece arguing that Americans should be “extremely anxious about the outcome” of the Supreme Court’s decision on the health reform law. The op-ed, by Scott Atlas, the chief of neuroradiology at the Stanford University Medical Center and a fellow at the Hoover Institution, warned “the entire U.S. health care system as we know it is at risk.” He doesn’t like Obamacare very much because it:
Creates centralized social programs; interposes government into personal decisions; ensures equality in the interest of ‘fairness’ instead of incentivizing achievable excellence and quality; and mischaracterizes America’s flaws, despite the facts, as a premise for transformative social programs rather than celebrating America’s great achievements and then extending American exceptionalism.
I was most interested in the part about the facts. Since this is an op-ed, Atlas is entitled to his opinions. But it’s always aggravating when pundits support those opinions with “facts” that are wrong or have been discredited, without noting that for their audiences.
Two “facts” Atlas uses fall into that category. He argued that if the Court does not strike down the health reform law, “it will trigger a dramatic response by employers to eliminate the health insurance benefit: About 30 percent of employers anticipate dropping health insurance—more than 50 percent of employers with higher awareness of reforms.” Whoa! Atlas didn’t say where those numbers came from. But the source is a flawed and discredited study by the consulting firm McKinsey and Co. The report, released last June, caused a stir among the Affordable Care Act’s supporters and its opponents, who cited it as proof the law would not do what advocates promised.
The study found that one-third of employers would “definitely or probably” stop offering insurance once health reform was fully implemented in 2014. That number contradicted other studies, which did not find as many employers planning to drop health benefits for their workers. To quell the furor, McKinsey walked back its study, claiming it “was not intended as a predictive economic analysis of the impact of the Affordable Care Act.” Only after an inquiry from Senate Finance Chairman Max Baucus, a Montana Democrat, did the firm release some of its methodology. Julie Rovner, as credible a journalist as there is, reported in National Journal that employers were asked leading questions that made it seem logical to stop offering insurance. For example, they were told the new exchanges would become “an easy, affordable way for individuals to obtain health insurance,” and then gave example of how little those with low and moderate incomes could pay in the exchanges.
At the end of his op-ed, Atlas trotted out the old canard about America having the best health care in the world, and invoked the specter of government-controlled health care. “Continued access to the world’s best medical care.” he wrote, “is certain to dramatically decrease if the momentum for government-controlled health care is not stopped.” Campaign Desk has repeatedly noted that these same words were used to fight against single-payer health care during the run-up to the reform debate. Now opponents of reform are again using these terms to fight against the health reform law. One can only conclude that pollsters find such phrases resonate with voters.
Yet again we refer Campaign Desk readers to seminal studies by The Commonwealth Fund, which show how the U.S. lags behind many other countries when it comes to quality of and access to medical care. (Disclosure: The Commonwealth Fund has been a funder of CJR.)
The McKinsey study not only made the rounds in Politico this week but in an Atlantic blog post by Avik S.A. Roy, titled: “If Employers Stop Paying Health Care, Who Wins? (Maybe, Everyone).” In advancing his argument, Roy mentioned what he called the “now famous McKinsey survey that found that 50 percent of employers with a ‘high awareness of reform’ would ‘definitely or probably’ stop offering employer-sponsored insurance after 2014. Famous or infamous? There was no mention of the controversy surrounding the report. And there was no mention of Roy’s affiliations. He is a health policy writer for Forbes and National Review, and a senior fellow at the Manhattan Institute, a conservative think tank.
The lessons here are obvious. Mother Jones noted in its coverage of the McKinsey report that given the never-ending controversies over the reform law, lawmakers, bloggers, and partisan pugilists should beware of “predictions predicated on less-than transparent data.” And, we would add, making assertions that the facts don’t support.
For the record: the Congressional Budget Office just announced another take on the number of employers that would drop health coverage. In typical government fashion, the CBO offered different scenarios. Under the worst case, it estimated that 20 million people could lose employer coverage. But the CBO also said it didn’t think the worst-case scnario was likely, predicting only between three and five million people might lose coverage. Basically, that’s been the agency’s estimate all along. Nevertheless, the CBO gave the law’s opponents new ammo, and, like the McKinsey report, the 20 million figure will probably roll through the media, peppered with statements like this one from Utah senator Orrin Hatch: the 20 million estimate “exposes more of the real costs of the president’s unconstitutional, deeply flawed, health spending law… this law keeps getting worse and worse: it needs to be repealed.”
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.