Thursday, November 28, 2013

Regarding the Claim that the ACA Bent the Health-Care Cost Curve Downward: A Proposition of Know-it-Alls vs. Know-Nothings?

One might consider taking a moment and reading the opinion piece by David Cutler, Obama Administration advisor, regarding his claim that the ACA bent the cost curve downward for health-care:

“But the focus on insurance coverage obscures other parts of the ACA that are working well, even better than expected. It is increasingly clear that the cost curve is bending, and the ACA is a significant part of the reason.” - The health-care law’s success story: Slowing down medical costs, David Cutler, professor of economics Harvard, opinion, Washington Post, 11/08/2013

Link to the entire Article appears below:

Now examine Charles Blahous essay refuting Cutler’s claim:

One particularly egregious example is White House advisor David Cutler’s op-ed published November 8 in the Washington Post, entitled, “The health care law’s success story: slowing down medical costs.” This piece contains the following paragraph:

“Before he was criticized for his statements about insurance continuity, President Obama was lambasted for his forecasts of cost savings. In 2007, Obama asserted that his health-care reform plan would save $2,500 per family relative to the trends at the time. The criticism was harsh; I know because I helped the then-senator make this forecast. Yet events have shown him to be right. Between early 2009 and now, the Office of the Actuaries at the Centers for Medicare & Medicaid Services has lowered its forecast of medical spending in 2016 by 1 percentage point of GDP. In dollar terms, this is $2,500 for a family of four.”

To see why this is wrong, it is useful to break down this paragraph’s thesis into its component parts. Specifically, it claims that:

The President’s previous assertions that his “health-care reform plan” would “save $2,500 per family” have been “shown” “to be right,” and that;
This is proved by the fact that the CMS actuaries have lowered, between early 2009 and now, their forecast of medical spending in 2016 by $2,500 per family.

For this paragraph to be correct, the ACA must be the reason the CMS actuaries have lowered their 2016 health spending projections. That is flatly untrue.’

‘The obvious point that leaps out from this graph is that the chief CMS actuary found that the ACA would increase national health expenditures through 2016. Not content to let the tables speak for themselves on this point, CMS was explicit in the text of its memorandum that the ACA increased the near-term cost projections:

“The estimated effects of the PPACA on overall national health expenditures (NHE) are shown in table 5. In aggregate, we estimate that for calendar years 2010 through 2019, NHE would increase by $311 billion or 0.9 percent, over the updated baseline projection that was released on June 29, 2009. Year by year, the relative increases are largest in 2016, when the coverage expansions would be fully phased in…The increase in total NHE is estimated to occur primarily as a net result of the substantial expansions in coverage under the PPACA…” '

‘But no one can rightly claim that CMS has revised their near-term cost projections downward because of the ACA. That is simply false.’ - No Grounds for Claim that Obamacare Lowers Healthcare Costs, Charles Blahous, Manhattan Institute, 11/25/2013

Link to the entire article appears below:

Who is right and who is wrong? Comparing the two presentations, Cutler’s argument appears as a notional proposition whereas Blahous’s argument appears based upon empirical information that pointedly refutes Cutler.

But maybe, just maybe, one might be asking the wrong question about the two claims regarding the health-care cost curve. What question should be asked? Maybe the real question is: Why is the Obama Administration, and advisors thereof, either all-knowing or not knowing? How so?

The Obama administration, taking claim for lower health-care costs, is based upon the implicit assumption of: They knew all along, where completely abreast of the situation, were the rain maker. That is, when they claim something positive regarding Obamacare (ACA) they also claim they were well aware of the situation. The proverbial: “Told you so!”

Conversely, when something is negative e.g. web site mess, cancellation letters, narrow networks (aka "Medicaid-Plus") etc., regarding Obamacare, then in these situations, they implicitly and explicitly were unaware, never knowing and not knowing. The proverbial: “We are as surprised as you!”

How very odd for the Obama Administration and advisors thereof to be so very, very well aware of supposed positive aspects of ACA and simultaneously to be completely and totally unaware of negative aspects of ACA.

Hence one is faced with a situation in which, Obamacare, in its action phase, considering the authors and advisors thereof, is an all-knowing intentional consequence while simultaneously being a know-nothing unintentional consequence. Stated alternatively, the authors and advisors of Obamacare knew all along, where completely abreast of the situation, were the rain maker and simultaneously knew-nothing, not abreast of the situation, and not responsible.

Which leads one to think that the authors and advisors of Obamacare designed and studied Obamacare, in such a particular way, that they are either know-it-alls or know-nothings.







No comments:

Post a Comment