WaPo and A.P Fact-Check Senator Sanders' Claim About $2 Trillion Savings on Medicare For All

Discussion in 'The War Room' started by Arkain2K, Aug 7, 2018.

  1. Arkain2K

    Arkain2K Si vis pacem, para bellum

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    Democrats seize on cherry-picked claim that ‘Medicare-for-all’ would save $2 trillion
    by Glenn Kessler, Washington Post | August 7, 2018



    As our colleague David Weigel reported, Democrats have latched onto the catchy idea of “Medicare-for-all” (also known as M4A) as a way of expressing their support for universal health care.

    On July 30, the Mercatus Center at George Mason University released a working paper on the 10-year fiscal impact of the Medicare-for-all plan sponsored by Sen. Bernie Sanders (I-Vt.), which would transition everyone in the United States from a mostly employer-provided health system to Medicare over four years. The report was written by Charles Blahous, a former economic adviser to George W. Bush and a public trustee for Social Security and Medicare from 2010 through 2015.

    Gillum, the mayor of Tallahassee, was quoted in Weigel’s article as having touted, during a debate, a $2 trillion cost-savings figure that is in the report. Sanders, too, has tweeted about this $2 trillion number, sarcastically thanking the conservative Koch brothers, whose foundation has contributed to Mercatus. “Let me thank the Koch brothers of all people for sponsoring a study that shows that Medicare for All would save the American people $2 trillion over a 10-year period,” Sanders says in a video with the tweet.

    But Blahous is crying foul, saying Medicare-for-all proponents are misrepresenting his findings. Let’s take a look.

    The Facts


    We often warn readers that you can’t get something for nothing.
    In the health-care realm, even relatively small shifts can lead to major dislocation and changes; President Barack Obama discovered that, to his chagrin. As former Lyndon Johnson White House aide Joseph A. Califano Jr. once noted, congressional dealmaking during the passage of Medicaid unexpectedly led to one-third of the Medicaid budget going to nursing homes — an industry that was literally built on Medicaid funding.

    In doing his research, Blahous decided to follow the text of the Sanders plan and assume that providers — doctors, hospitals, and the like — would face an immediate cut of roughly 40 percent for the treatment of patients now covered by private insurance.

    (Note: an earlier version of this fact check incorrectly included a reference to drug companies in the sentence above. The analysis found that drug costs would be $846 billion lower over ten years from an aggressive program to negotiate lower prescription drug prices but it would not be as much as a 40 percent decline.)

    That in theory would reduce the country’s overall level of health expenditures by $2 trillion from 2022 to 2031. But he makes clear that it’s a pretty unrealistic assumption.

    In the fourth sentence of the report’s abstract, Blahous wrote, “It is likely that the actual cost of M4A would be substantially greater than these estimates, which assume significant administrative and drug cost savings under the plan, and also assume that healthcare providers operating under M4A will be reimbursed at rates more than 40 percent lower than those currently paid by private health insurance.”


    Under an alternative scenario, which assumes these cuts cannot be achieved, national health spending rises even faster than under current law because health-care demand would increase.

    “To lend credibility to the $2 trillion savings number, one would have to argue that we can cut payments to providers by about 40 percent at the same time as increasing demand by about 11 percent,” Blahous said.


    The main point of his study is being ignored by Democrats — that even by generously accepting Sanders’s assumptions that he could squeeze providers so much, the plan would still raise government expenditures by $32.6 trillion. This is in line with a 2016 estimate by the left-leaning Urban Institute of an earlier version of the M4A plan — that it would cause federal expenditures to increase by $32 trillion. (Without the provider cuts, Blahaus estimated the additional federal budget cost at nearly $40 trillion over 10 years.)

    Sanders has said his plan would cost $1.38 trillion a year, paid for in part with new taxes on employers and an income-based premium, but under Blahaus’s analysis it would be closer to $3.3 trillion.


    “For perspective on these figures, consider that doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan,” Blahous wrote. (He’s referring only to income tax collection, not existing Social Security and Medicare payroll taxes.)

    Blahous told the Fact Checker: “Every table in the study (Tables 1-5) is very explicit that the additional costs arising from higher demand are substantially higher than the potential administrative efficiencies of going to a centralized national health insurance system. So whenever proponents argue that eliminating private sector insurance profits and overhead would enable us to cover more people for less money, that conflicts with the findings of the study.”

    Congress has passed cuts to health-care providers that do not come to fruition. More famously, the 1997 balanced-budget agreement between President Bill Clinton and the GOP-led Congress included cuts that Congress deferred for 17 years with an annual provision known as the “doc fix.” It was finally eliminated under a deal Obama reached with Congress in 2015, or else providers would have faced a cut of 21 percent. Other efforts to control spending in Medicare, however, have fared better, including as part of the enactment of the Affordable Care Act.

    In 2012, Blahous wrote a study questioning the budget assumptions in the Affordable Care Act, such as the political prospects for a tax on “Cadillac” health plans. He turned out to be right: The tax keeps getting pushed off and weakened. Health-care costs did decline after the passage of the ACA, but whether that pre-dated the law or not is a subject of continuing debate.

    For the record, Blahous says the Kochs had nothing to do with his research. “It’s academic research, it goes through a blind review process, and it represents my own work,” he said. “I choose my own research subjects and follow the facts where they lead. You’d have to ask someone else about where funding comes from, I don’t follow that and it doesn’t affect me.”

    We shared Blahous’s concerns with Gillum’s campaign, which confirmed that he relied on the Mercatus study, and received this response: “The Mayor’s a proud supporter of Medicare-for-All and this study shows the potential for significant savings,” said communications director Geoff Burgan. “It would be a strong improvement over the Republicans’ attempts to destroy our current system and rip health care away from people.”

    In response to this fact check, Sanders’s office provided links to several articles, including in The Washington Post, that reported that Blahous concluded that the Sanders plan would reduce national health expenditures by $2 trillion. Blahous said these articles are good examples of the misinterpretation of his research: “It’s precisely because people have been saying that, that the correction is warranted.”

    The Pinocchio Test

    We don’t intend to pick on Gillum, who appears to have picked up a talking point that is circulating among Democrats. But we do want to lay down a marker because this goes too far.

    All too often, politicians mischaracterize conclusions that are contained in academic or think tank studies. At the Fact Checker, we rely heavily on how a study’s author says the data should be presented. In this case, it’s clear that Blahous bent over backward to accept Sanders’s assumptions, only to find they did not add up. Democrats cannot seize on one cherry-picked fact without acknowledging the broader implications of Blahous’s research.

    Three Pinocchios

    [​IMG]

    In your opinion, how realistic is Senator Sanders' plan to "save $2 trillions" on healthcare by forcing a 40% pay cut on doctors and hospitals all across the board?
     
    Last edited: Aug 15, 2018
  2. Headkicktoleg

    Headkicktoleg Steel Belt

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    I really don't want my medical care to be cut to that of medicare.
     
  3. Cooz

    Cooz Brown Belt

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    I like to cherry pick my fact checking facts.
     
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  4. georges snipierre

    georges snipierre GEORGES SNIPIERRE

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    I cant vote for someone who looks like Bernie. I dont care what he pretends to stand for. Sorry guys, just cant do it.
     
  5. Arkain2K

    Arkain2K Si vis pacem, para bellum

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  6. SBJJ

    SBJJ Gold Belt

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    Wasn’t there a 10 page thread of half the WR falling for this?
     
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  7. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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  8. Trotsky

    Trotsky Gold Belt

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  9. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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    Seriously, though, check that piece out. I think it's pretty definitive. And I say that as someone who was inclined to buy the headline on this.

    I trust the TS (@Arkain2K) will have the integrity to acknowledge the mistake and put a note in the OP. Right?
     
    Last edited: Aug 9, 2018
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  10. brothir

    brothir Purple Belt

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  11. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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    Generally pretty good. Hard job.
     
  12. Trotsky

    Trotsky Gold Belt

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    I gave it a read and agree certainly with the first two points. The third may go over my head in part.

    Hold your breath.

    EDIT: Also, the author's blind reliance on the completely unqualified speculation by Blahous that his already-demonstrably-inflated administrative cost predictions would in fact be unrealistically optimistic - all on the basis of "we trust what the author intends, not what his data says" - is not a good look.
     
  13. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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    OK, I see Kessler did correct the errors that Bruenig pointed out (to his credit). But then Bruenig noted another two (one trivial):

    https://www.peoplespolicyproject.or...s-in-glenn-kesslers-piece-gets-12-pinocchios/

    And, yeah, obviously Blahous doesn't like the fact that his work is being used against his policy goals. Tough titties for him. The results are what they are.

    I think WaPo should have spiked after the errors, rather than just modified the piece.
     
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  14. Trotsky

    Trotsky Gold Belt

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    Like I've always said, if you don't like tough shit, stop punching ass.

    @Fawlty
     
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  15. brothir

    brothir Purple Belt

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    So on balance it's probably more of a "rough day on the job" type of mistake rather than "honesty is inconvenient" type of mistake? I believe the article when it says that fact-checking is more of an art than a science: seems like these kinds of arguments can easily devolve into assertions flying in all directions. Bruenig kind of undermines that though when he presents the errors so unambiguously.
     
  16. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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    Definitely more of a rough day on the job type of mistake, as Kessler made corrections after being alerted to the errors. But he still tried to salvage the piece, even as it kind of fell apart. Understandable, still. And, yeah, fact-checking is often fuzzy, which is why Bruenig focused on areas of clear mistakes. I don't know how it is now, but it was a three-person operation last year. And they have to check facts in many different areas.

    I think the problem was partly using Blahous as a source. He didn't like that his study was being used by proponents of single payer, as he had hoped that it would be used by opponents. So he was going to spin, and Kessler understandably figured that the author of the study would be a good source.
     
    Last edited: Aug 9, 2018
  17. Mark Hunts FIST

    Mark Hunts FIST Black Belt

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    Only a complete idiot Would have thought we would be saving 2 trillion a year.


    The exact same thing they focus on here is what I said.....they are having to assume all doctors are going to take a 40% pay cut.

    Me: Im gonna go to the store and get $1000 worth of groceries for only 600.
    You: wow thats awesome. How will you do it?
    Me: I am assuming the store will give me 40% off. Duh
     
    Last edited: Aug 9, 2018
  18. brothir

    brothir Purple Belt

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    When it comes to editing mistakes, I definitely think a lot of good can be done with in-place edits but there is also a point where you have to abandon ship. I don't think articles should be deleted outright in those cases though: I'd like a clear header where it is explained that the article is erroneous, a short summary of how, and then a link to a new and improved attempt. Having a list of mistakes made in best effort is very instructive, and being able to compare side by side to a reconstructed attempt doubly so. If they're just three, then maybe they don't have the capacity to do that though while also keeping up with news in general. Still think they owe it to themselves.

    Not sure I get this. You basically have to use the author as a source, right? If the job of a fact-checker is exactly to peer through such spin, isn't that only a problem because Kessler was being naïve?
     
  19. nostradumbass

    nostradumbass Gold Belt

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    Yeah, it was a massive range the guy gave on what it would cost. Saving $2 trillion over a decade was the absolute lowest he could get it running under the assumption that doctors would all take a massive pay cut. I'm still trying to figure out how they think there wouldn't be a huge doctor shortage when it's expensive as fuck and time-consuming to become a doctor, and would be covering more patients for significantly less money.
     
  20. Jack V Savage

    Jack V Savage Secretary of Keepin' It Real/Nicest Guy on Sherdog

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    First I should say that I don't think he does a good job fixing any but the second one. Second, leaving misleading info up can be a problem. Maybe a spiking along with a note on what happened? I get your perspective here, but I think there's a danger that bad info is not recognized as such if it's left out there.

    Well, you have the report. You can have disinterested third parties take a look to settle disputes if you lack the technical sophistication to do so yourself (and it should be assumed that even a very intelligent and well-trained journalist does lack that sophistication).

    Ed: BTW, the whole episode reminds me of this:

    http://slatestarcodex.com/2018/04/26/call-for-adversarial-collaborations/

    We should do that here.
     
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