Health Care Overhaul Opponents Use Selective Stats
It's become one of the most commonly cited statistics by opponents of the health overhaul being put together by Democrats in Congress: Creating a new government-run public health insurance plan would result in 119 million people losing their private insurance.
Here was Senate Finance Committee ranking Republican Charles Grassley on MSNBC just Tuesday: "My objection to the public option is based upon the Lewin think tank ... study that says 119 million people will opt out of private health insurance."
"According to a recent study, a new public plan would cause almost 120 million Americans to lose their private coverage," echoed Sen. Orrin Hatch.
But is it really true? Yes and no.
"The number of 119 million is absolutely correct," says John Sheils, senior vice president of the Lewin Group, a number-crunching consulting group owned by Ingenix, which is a subsidiary of UnitedHealth Group.
But that number hardly represents the entirety of the report Sheils and colleague Randy Haught put out in April. The point of the study was to show that the number of people who would eventually join a government-sponsored public insurance plan would vary — dramatically — depending on how that plan is designed.
If the public plan is open to everyone and pays health care providers rates similar to those paid by the government-run Medicare program, which are lower than most private insurers pay, "you'd have a lower premium level and thus [more] people go into it," says Sheils.
But if the public plan is limited to fewer people (perhaps only those in small businesses and individuals), or if the plan pays higher rates to doctors and hospitals, fewer people would join, both because fewer would be allowed and because the plan would be less financially attractive. According to the study, the number of people dropping private coverage could be as low as 10.4 million.
The study looked at six options, says Sheils. "And five of those options are less aggressively priced than the Medicare payment level option," meaning they would attract fewer enrollees to switch from private insurance coverage.
Sheils stops short of saying that opponents of a public plan were misusing his statistics, because while "this is the extreme case, I don't think it has been stricken from everyone's agenda, as far as I can tell."
But he did add that in general, the mood in Congress seems to be moving toward a more constrained sort of public insurance program; most likely one that would pay somewhat more than Medicare and limit enrollment.
For example, Sheils says, Democratic Sen. Charles Schumer of New York "has a plan which would require the public program to pay private payer rates — the same rates that other private insurers have to pay — and under that scenario we get only between 10 and 12 million people dropping private coverage."
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: should Congress create a new government-run plan to compete against private health insurance coverage?
As NPR's Julie Rovner reports, opponents of a public plan are using some selective statistics to buttress their case.
JULIE ROVNER: There's still a lot that's unclear about what will be in the health care bill now starting to emerge from Congress. But Democrats seem pretty set on the idea of creating some sort of government-backed public health insurance plan, as one option for people to join. They hope a government plan will help drive down the cost of private insurance as well, making it more affordable to more people.
But that set off a lot of opposition. If you watch cable TV news, you may have seen this ad sponsored by a group called Conservatives for Patients' Rights. It features a giant bulldozer pushing around a graphic labeled health care choices.
(SOUNDBITE OF POLITICAL AD)
ROVNER: This government-run plan could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage, leaving no choices in health insurance.
ROVNER: And eventually, a government takeover of the entire health care system.
Republican members of Congress have been throwing that 119-million number around, too. Here's Utah Senator Orrin Hatch.
: According to a recent study, a new public plan would cause almost 120 million Americans to lose their private coverage.
ROVNER: That study comes from the number-crunching Lewin Group. It's owned by health insurance giant UnitedHealth Group, but its studies are generally well-regarded. And the 119-million number?
: The number of 119 million is absolutely correct.
ROVNER: That's John Sheils, the study's lead author. But Sheils says what opponents to the public plan leave out is that the number of people leaving their current private coverage for a new public plan would be that large only under one scenario. That would be if a new government insurance plan is open to everyone, and if doctors and hospitals get paid the same rates the government pays the Medicare program for the elderly and disabled.
: Those payments are a lot lower and you'd have a lower premium and that's the number of people who'd go into it.
ROVNER: In fact, the entire point of the study was to demonstrate that the number of people who might eventually join a public plan will vary widely depending on how it's structured. If Congress limits who's eligible, for example by size of business, then obviously, fewer people will be able to join a public plan.
In fact, said Sheils, the Senate Finance Committee...
: ...is talking about limiting it, not just to small groups, but to what they call micro groups; groups with 10 or fewer workers plus individuals. And that would even further reduce the number of people who move out of private insurance into the public plan.
ROVNER: Sheils stopped short of saying that Republicans were misusing the study because there are lawmakers who still want a public plan that would be broadly available and that would pay low rates, and a plan like that would draw many millions of people to it. But he added that most Democrats these days seem to be thinking of something more limited, for example...
: Senator Schumer has a plan which would require the public program to pay private payer rates, the same rates that other private insurers have to pay. And under that scenario, we get only between 10 and 12 million people dropping private coverage.
ROVNER: That's a reference to New York Democrat Chuck Schumer.
Meanwhile, even the emerging House Democratic bill seems to imply it will use the higher private rather than Medicare rates to set premiums for its public plan, so it seems opponents may have to scale back, if not their rhetoric, at least their numbers.
Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright National Public Radio.
