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âJohn McCainâs health plan would reduce the ranks of the uninsured by about 21.1 million people if fully put in place by 2010, while Barack Obamaâs would reduce the number by 26.6 million, an analysis predicts.â That was the lede of an AP story that circulated last week. Those numbers come from a study done by the Lewin Group, a prominent health care consulting firm that advises governments, insurance carriers, drug companies, and health care providers.
The Lewin analysis is important not for the new estimates it throws on the table, but because those estimates are likely to spur another game of âMy Plan Covers More People Than Yours,â played by Hillary Clinton and Obama during the primary campaign. Remember, Clinton said 15 million people would not be covered under Obamaâs plan; Obama said 10 million wouldnât be covered under hers.
Lewinâs report adds to the growing number of studies offering different estimates of how many would receive health care under the candidatesâ proposals. In September, the health policy journal Health Affairs published a study that indicated McCainâs plans would have little effect on the uninsured. The number indicated that initially giving people a tax credit and taxing some portion of employer-sponsored benefits would have little impact on the number of uninsured. Within five years, the number of uninsured would increase.
Last May, the Urban Institute/ Brookings Institution Tax Policy Institute said that Obamaâs plan would cover nearly half of Americaâs uninsured over a ten year period, while McCainâs plan would cover less than five percent.
All of this is just so much crystal-balling, since the numbers reflect the inputs that go into the statistical models, and sometimes those inputs are subjective. Thatâs not to say, however, that such numbers shouldnât be reported, especially if the candidates start their âMy Plan Covers More People Than Yoursâ game again. But they should be reported with context, clarity, and completeness. The AP story which was picked up by news outlets around the country fell short on these measures.
For starters, the story didnât contextualize the projected number of newly insured individuals in terms of the total number currently without coverage. A vital question, no? The latest census data show that 45.7 million people were uninsured last year, so it would appear that McCainâs plan would leave almost 25 million people without coverage; Obamaâs would leave 19 million uncovered. Whether thatâs good or bad depends on whether you want universal health coverage or donât mind that some people will be left out. Having the AP actually report those numbers, along with the 45 million stat it did use, would have made it much easier for readers to see what they meanâwithout having to fool with the math themselves.
As I read through the AP story, I saw a quote from Kenneth Thorpe, identified by the AP as an Emory University professor âwho conducts similar analysis and advice for Democratic candidatesâ health plans.â Uh, oh, I thought, some Republican or conservative outfit must have paid for the study, especially since Thorpe said: âThey pulled the same overestimates for Bush last time with a similar bill.â It turns out that the study was an independent analysis conducted by Lewin.
âWe didnât do it for anybody. We have complete control over our own work,â John Sheils, Lewinâs senior vice president, told me. Fine, but why didnât the AP tell readers it was Lewinâs own report? The release sent out on the PR Newswire noted that it was an independent study. How difficult could it have been for the AP to clue its readers into an important fact that spoke to the studyâs credibility?
The AP story shortchanged some important numbers behind the totals of those who would gain insurance under each plan. âWhat weâre struggling to illustrate is that under McCainâs plan, you get a lot of people signed up, but the ones weâre most concerned aboutâthe older and sickerâwill find it much more difficult to get coverage under the McCain plan,â Sheils told me. The AP did quote Sheils saying that sick people are going to have trouble affording coverage even with McCainâs proposed tax credit, and that Obamaâs plan would cover about half of the chronically ill uninsured while McCainâs plan would cover about a quarter of them. In the story, Sheils also said that the youngest would gain coverage.
I know editors are skittish about putting too many numbers in a story, for fear readers will stumble over them. But here was a case where numbers would have revealed more about who would and would not be covered under each of the two plans.
⢠McCainâs plan would cover 25 percent of people between ages fifty-five and sixty-four; Obamaâs would cover 52 percent. People in this age group often lose coverage when they leave the work force and are too young for Medicare.
⢠McCain would bring insurance to 48 percent of the uninsured between ages nineteen and twenty-four; Obamaâs plan would result in 59 percent of the uninsured in that group getting coverage. Young adults often find themselves with no insurance when they age off their parentsâ policies and have incomes too small to buy private insurance.
⢠Obamaâs plan covers more people with low incomes, the ones who cannot afford to by insurance now. Lewinâs projections show Obamaâs plan would cover 60 percent of those who earn less than $10,000; McCainâs would cover 28 percent. For those with incomes between $20,000 and $30,000, Obamaâs would bring in 63 percent; McCainâs would only cover 48 percent.
⢠Both plans would cover about the same number of uninsured who earn between $75,000 and $100,000.
The AP might have delved more deeply into the analysis. It would have been nice if the large number of readers who saw the story could have understood the Lewin studyâs take on how the candidateâs health plans would affect them.
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