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On his appearance on Kudlow and Company, Stuart Browning claimed that Ezra Klein was advocating for health-care systems (such as Canada) in which people are not allowed to spend their own money on their own body. Klein said “that’s a lie,” and that people should be able to spend their own money on themselves.
I’ve already taken a skeptical look at Klein’s veracity before, but it is worth taking another look now that he accusing others of lying.
During that interview Klein said, “Take Medicare. Medicare has a slower rate of spending growth than the private system in this country.”
Here are the numbers from the Kaiser Family Foundation. From 1970-2005, Medicare grew at an annual rate of 8.9%, while private insurance grew at a rate of 9.8%. That’s not a huge difference. If we were to switch to a system of Medicare for all, we’d still have a growth rate higher than inflation and wages. In short, we’d still have a system that is unsustainable.
Furthermore, it is hardly clear that Medicare’s slightly lower rate of growth is due to Medicare being more efficient. According to researchers at Heritage, private insurance has been far better at providing benefits than Medicare. The higher rate of growth in private insurance may also be due to “cost-shifting.” There is an extensive literature on how Medicare pays less than the cost on many medical procedures, and providers make up the difference by charging more to private insurance. Surely Klein is aware of the cost-shift phenomenon. (You’ll notice that Kuldow didn’t let Klein get away with that one.)
Next, Klein claims that consumer-driven products like health savings account (HSAs) don’t work. Referring to a Kaiser Family Foundation survey, Klein says on Kudlow, “people are not taking them up. People don’t want them.”
But let’s look at that Kaiser Family Foundation study. True, it found only 1.4 million people with HSAs. However, the Kaiser survey only looks at firms, not individuals who purchase health insurance on their own. Furthermore, what Klein leaves out is that the Kaiser report (page 103) found that the “estimate of workers enrolled in an HSA qualified HDHP is higher than the 0.8 million enrollees we reported for 2005.” In other words, HSAs increased from 0.8 million to 1.4 million from 2005-2006, an increase of 75%. A 75% increase doesn’t seem like “people are not taking them up.”
Klein finished that comment by challenging Kudlow: “I’d like you to spit me back a number that’s different.” Kudlow didn’t, but I will. America’s Health Insurance Plans release an annual survey on HSAs, and its latest iteration found that 4.5 million had enrolled in HSAs, a 43% increase from the previous year. A recent study from Information Strategies, Inc. found that HSAs now comprise about 5% of the insurance market, which would mean that close to 10 million people have HSAs. But, as usual, Klein cherry picks the data to try to prove his point.
Then there is the matter of anecdotes. In his Cato presentation last week, referring to Browning’s movies, Klein said, “But anecdotes don’t do it here. We can go to war with anecdotes…The question really tends to be the numbers.”
Except when the question can best be answered by anecdotes. Here is Klein using the anecdote of Deamonte Driver to answer the question of what is bad about U.S. health care.
Although Michael Moore’s new film Sicko is basically one long string of anecdotes, there is no objection from Klein in his review of it. Indeed, Klein has effusive praise for Moore’s anecdotes:
Every story, every tale, every vignette asks the same question: “Who are we?” Who are we that our fellow citizens have to decide which fingers they’ll pay to get reattached? Who are we that our hospitals push the ill and indigent into cabs, and drop them off, disoriented and clad in a paper-thin gown, on skid row? Who are we that we let insurers deny coverage to our neighbors because they are too tall, or have too many seasonal allergies? Who are we that we don’t guarantee paid sick leave, or vacations, or child care, leaving that all instead to the whims of employers? And most of all, who are we to have let national pride blind us to these better alternatives, and let moneyed interests and powerful lobbies construct a country that best serves their needs rather than ours?
Distorting and cherry picking the data. Saying on thing and then doing another. That’s quite a track record Klein’s compiling. Perhaps he should be a bit more careful before he throws around terms like “lie” next time.