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Bringing attention to those reading

Posted by jhsu125 on 03 Feb 2020 at 17:10 GMT

Hi Christopher.

First of all, I wrote you an email two weeks ago noting that Dr. Blahous has publicly stated that your analysis (along with many others) is heavily misinterpreting his data. You have not responded. His statement can be found here: https://economics21.org/b...

This is an egregious mistake and needs to be addressed.

Secondly, 8 out of the 9 highest estimates for total savings come from 3 authors. And the paper is missing important studies such as the CRFB study... and the Urban Institute study, which you even cited, but did not include (?!).

The mistakes are apparent and just that at best. But at worst, I cannot help but to think that given your conflicts of interest and who sponsored this research, this is a biased piece of work.

I hope you have time to respond to these claims.

No competing interests declared.

RE: Bringing attention to those reading

jhsu125 replied to jhsu125 on 03 Feb 2020 at 17:21 GMT

I want to add that the funding source, pnhp, has openly criticized one of the institutes (CRFB) whose study has been omitted from this article:

https://pnhp.org/news/crf...

"The Committee for a Responsible Federal Budget is an influential organization that professes to advance bipartisan concepts that would place controls on the federal budget, but if you check the list of Directors (on the first page of their report) you will see that those on the left are predominantly neoliberals, with a stark absence of authorities with more progressive views – at best some may be classified as neutral academics."

Frankly, I have a hard time trusting an organization who leads an attack with ad hominem partisan rhetoric, much less a paper that it paid for.

No competing interests declared.

RE: RE: Bringing attention to those reading

ccai replied to jhsu125 on 03 Feb 2020 at 19:31 GMT

Hi !

Thanks for your comment. We appreciate the your attention and debate is healthy!

The concerns you raise are addressed in our paper . I'll highlight a few points
-We only included papers that accurately modeled the legislation they were seeking to study. The Mercatus study you are referring to had many scenarios. The 2017 bill it was studying assumed Medicare payment rates. Therefore we included the scenario that most closely mirrored the legislation.
-You may think it is unrealistic for the government to pay Medicare rates. However, the goal of our study was to understand true single-payer bills and we cannot change the legislation.
-Moreover, both current Congressional bills propose to pay hospitals via global budgets, not Medicare payment rates. Concerns over whether Medicare payment rates are “realistic” may not accurately reflect the substance of the legislation, at least for hospital financing.
https://www.healthaffairs...
-What's more, there is empirical evidence hospitals will pay less under global budgeting
https://www.healthaffairs...
-The Urban institute study includes private intermediaries so it did not meet inclusion criteria. We address this in our discussion and introduction
-PNHP had no role in study design data collection or decision to publish. The funding ($3000) is small compared to the value of the work that went into this paper: 9 people working part time over two years

No competing interests declared.

RE: RE: RE: Bringing attention to those reading

ccai replied to ccai on 03 Feb 2020 at 19:33 GMT

Hi !

Thanks for your comment. We appreciate the your attention and debate is healthy!

The concerns you raise are addressed in our paper . I'll highlight a few points
-We only included papers that accurately modeled the legislation they were seeking to study. The Mercatus study you are referring to had many scenarios. The 2017 bill it was studying assumed Medicare payment rates. Therefore we included the scenario that most closely mirrored the legislation.
-You may think it is unrealistic for the government to pay Medicare rates. However, the goal of our study was to understand true single-payer bills and we cannot change the legislation.
-Moreover, both current Congressional bills propose to pay hospitals via global budgets, not Medicare payment rates. Concerns over whether Medicare payment rates are “realistic” may not accurately reflect the substance of the legislation, at least for hospital financing.
https://www.healthaffairs...
-What's more, there is empirical evidence hospitals will pay less under global budgeting
https://www.healthaffairs...
-The Urban institute study includes private intermediaries so it did not meet inclusion criteria. We address this in our discussion and introduction
-PNHP had no role in study design data collection or decision to publish. The funding ($3000) is small compared to the value of the work that went into this paper: 9 people working part time over two years

No competing interests declared.

RE: RE: RE: Bringing attention to those reading

jhsu125 replied to ccai on 04 Feb 2020 at 13:00 GMT

Hi.

Sorry. I cannot just accept these answers. Mercatus, Blahous, and RAND are probably the three most talked-about studies out in the field right now.

A meta-analysis on a topical subject cannot simply remove two and make a lower-bound assumption (that the author straight up rejects in a blog post) based on some exclusion criteria that look suspiciously like they were applied post-hoc. Especially seeing as you are all students in a single-payer advocate student club, and likely acutely aware of these studies prior to starting research.

And seeing how much effort you put in your reply to clarify that the study is attempting to mirror the Sanders M4A as much as possible, I find that you would have to contort reality to believe that, objectively, studies done 25 years before the bill (White 1991, Grumbach 1991) are somehow more accurate reflections of the proposed 2016 M4A than Holahan 2016 or Liu 2016.

How can you freely accept a paper written before you were born, but reject the one that's all over national news based on a footnote in your Supporting Information???

No competing interests declared.

RE: RE: RE: RE: Bringing attention to those reading

jhsu125 replied to jhsu125 on 04 Feb 2020 at 14:12 GMT

I did mean Mercatus, Urban*, and RAND.

No competing interests declared.