Friday, June 26, 2009

The Art of Statisticulation

David Harsanyi has a column in the Denver Post entitled, How to lie with statistics — again:

Did you know that around 300 million Americans went without food, water and shelter at some point last year?

I am a survivor.

If you were blessed with the prodigiously creative and cunning mind of a politician, that kind of statistic — meaningless, but technically true — could be put to good use.

In the entertaining 1954 classic, "How to Lie with Statistics, "Darrell Huff writes that "misinforming people by the use of statistical material might be called statistical manipulation . . . or statisticulation."

One of the most persistent examples of modern-day statisticulation is the sufficiently true claim that 46 million (it becomes 50 million when senators really get keyed up) Americans are without health insurance.

Set loose on the public's compassion, this number is a powerful tool in the hands of eloquent orators like President Barack Obama when peddling government-run health care reform. And no matter how often the figure is debunked, no matter how many studies point to its inexact nature, it's just too politically inviting not to embrace.....

These facts does not undermine the argument for nationalized health care (history and common sense do that already). They do, however, point out that many statistics, to quote Huff again, get by "only because the magic of numbers brings about a suspension of common sense."


I think that when stats "confirm" people's worldview, it is not the numbers themselves that are "magical", but rather the magical thinking a person engages in that allows them to believe the numbers are true.

46 Comments:

Blogger Francis W. Porretto said...

Thomas Sowell made a similar point in The Vision Of The Anointed:

"One of the common methods of getting alarming statistics is to list a whole string of adverse things, with the strong stuff up front to grab attention, and the weak stuff at the end to supply the numbers. A hypothetical model of this kind of reasoning might run as follows: Did you know that 13 million American wives have suffered murder, torture, demoralization or discomfort at the hands of left-handed husbands? It may be as rare among left-handers as among right-handers for a husbands to murder or torture his wife, but if the marriages of southpaws are not pure, unadulterated bliss, then their wives must have been at least momentarily discomforted by the usual marital misunderstandings."

Food for thought.

12:27 PM, June 26, 2009  
Blogger fred said...

The figure I encounter, over and over, is about 46 million Americans without health insurance. Adding to this figure is anticipated given the growing job losses (people will lose coverage) and dropping through non-payment of insurance (recession).
You can now do what you will with that approximate figure: suggest an answer, a plan, or just assume that is not so bad.

12:49 PM, June 26, 2009  
Blogger I R A Darth Aggie said...

You can now do what you will with that approximate figure: suggest an answer, a plan, or just assume that is not so bad.

Ummm, no.

How about: more data. How many of those folks are financially capable of getting health coverage? how many of the rest will qualify for Medicaid?

The remainder? that's the real number of uninsured and apparently uninsurable. Do you know how many those are, Fred?

1:07 PM, June 26, 2009  
Blogger br549 said...

I never bought the 47 million. I figure somewhere around 30 million, half of which just don't want to pay for it.

Figure out a way to insure the uninsured, and otherwise get off my ass about it. I've GOT insurance. I pay for it already. I fight poverty - I WORK. That's my message to Obama and congress.

As we have all read by now, the three branches of government as well as all federal workers, would not be under the same crappy plan as proposed for the rest of us.

1:53 PM, June 26, 2009  
Blogger tomcal said...

You are attempting to provoke me into an obsessive episode, wherein I would write for days on end about the ways lying cheating sack-of-sh** politicians continuously deceive the ignorant electorate.

I refuse to take the bait.

2:38 PM, June 26, 2009  
Blogger J. Bowen said...

I never bought the 47 million. I figure somewhere around 30 million, half of which just don't want to pay for it.

Here's some information for you (I've compiled some of the information on my free file-hosting account online so that I wouldn't have to track it all down, so don't be alarmed that it's not coming from the sites where I found them at (I believe the first two were from the SSRN while the third was from Cato's website)):

The Impact of Immigration on Health Insurance Coverage in the United States, 1994-2006, by Paul Fronstin - a study which, among other things, notes that immigrants, both legal and illegal, account for 26.6% of the uninsured population (largely because of the fact that immigrants are more likely to have lower-paying jobs and jobs that don't offer health insurance).

Is Health Insurance Affordable for the Uninsured? by Kate M. Bundorf and Mark V. Pauly; a study in which the authors find that "depending on the definition, health insurance was affordable to between one-quarter and three-quarters of the uninsured in 2000."

Counting the Uninsured by Michael F. Cannon, Cato Institute's Director of Health Policy Studies (not exactly a non-partisan source, but generally pretty informative IMO); a podcast in which Mr. Cannon discusses the generally cited Census Bureau statistic on the uninsured and what's wrong with it (he mentions the study that I just linked to). Towards the end of the podcast, he puts the number of the truly uninsured (the chronically uninsured who can't afford insurance and who want it) at around 8 million.

Uninsured in America by Stuart Browning; a 9-minute video in which he breaks down the Census Bureau statistic into its relevant parts (at the end, he references a book that pegs the number of people who are truly uninsured at around 8 million people (I'm going to guess that he's using the same source as Mr. Cannon, but I can't be sure as I don't know what source Mr. Cannon uses)).

Besides the widely-available information that breaks down the oft-cited Census Bureau statistic (the USDHHS did a breakdown of the 2005 CPS estimate but I find it a little disconcerting that the HHS's analysis of the 2007 CPS estimate either misreads the 2005 CPS estimate or is using other information (the figures don't match up between the two, so either the former one is wrong or the latter is)), there are three other estimates that put the number of the uninsured in the mid-30 millions. The only way that I know that is because of what Mr. Cannon says in that podcast, but I'm not assuming that he's lying (in other words, take it for what it's worth).

Basically, I've come to realize that the figures is not only probably not all that accurate in the way that it's being used, but that it is provably not all that accurate in the way that it's being used. There's an old saying that goes something like this: figures never lie but liars always figure. Well, there are a bunch of liars out there using some shoddy figures to push their agenda. Unfortunately, too many people seem all-too-willing to not check the facts for themselves.

3:37 PM, June 26, 2009  
Blogger Josh said...

I don't see the manipulation.

So the census bureau data is unreliable. How many does he think are uninsured? 30 million is still a lot.

Then he suggests that insurance is only unaffordable for 25-75% of the uninsured population. Firstly, I don't find that acceptable. Secondly, the whole point of universal coverage is to have young, healthy individuals to purchase insurance. Thirdly, because pre-existing conditions can be used to deny coverage in many states, insurance is unaffordable precisely to those who need it.

Having insurance is only part of the struggle. Medical problems partly caused about 62% of bankruptcies in 2007, according to this article. Many of the bankrupt were apparently well-insured. And because many people receive insurance through their employers on the group market, they lose their insurance along with their jobs when they fall ill. Yes, it can happen to you or someone you love, even if you work hard and play by the rules.

In the individual market, the situation is even worse. Insurance companies routinely engage in post-claims underwriting, a process that involves looking for omissions on insurance applications after a large claim. Doubtless many of these omissions are fraudulent ones made by desperate individuals. Many, however, are innocent mistakes made years ago regarding conditions that had nothing to do with the large claims. I recently applied for individual insurance. Most insurance applications ask for detailed information going back 10 years, and all of the applications I saw had a catch-all question similar to this one in the BCBS application:

Has any person applying for coverage ever been hospitalized or been treated in the emergency room or had any physical impairment, deformity, congenital anomaly, sickness, operation, injury or hospitalization other than admitted to on this page?

The applicant is asked to list each illness, condition, injury, etc. on the next page. In other words, list every time you've ever been sick. And if you miss anything, even by accident, and if we find out about it, your coverage will be rescinded retroactively if you need to use your insurance.

No reasonable individual would purchase a policy like that if there were a choice. The trouble is, there isn't a choice. No, it's not because of government regulation. No, it's not because the group market is subsidized. It's because health insurance has increasing returns with the size of its provider network and the number of its subscribers, which respectively allow insurers to negotiate better prices and smooth their risk. Furthermore, most people just don't have the expertise to rationally apply for medical insurance, thereby holding insurance companies accountable to the market. Insurers run circles around them.

That's not to say that a mandate for universal coverage and a public plan is the only option. But blindly relying on market competition that is not there and never will be there will continue to lead to suboptimal health outcomes.

3:38 PM, June 26, 2009  
Blogger Master Doh-San said...

73% of all statistics are made up on the spot.

3:57 PM, June 26, 2009  
Blogger DADvocate said...

Medical problems partly caused about 62% of bankruptcies ...

How is this figure arrived at and who are the people going bankrupt?

If I were to have a severe medicial problem, I might well go bankrupt. But, is that because of the medical problem or my earlier divorce that drained me of many assets.

Pay attention to the "partly" part. Here the statistics are: Two out of three bankruptcy filers have lost a job (That's 66%.); 40% of bankruptcies result from medical crises, unemployment or divorces (that's three causes at much less than the 62% for medical cited in Josh's article); etc, etc.

Yes, statistics are made to tell lies to support agendas and appeal to magical ideas and magical reasoning. And, all this magic is costing us mucho dinero.

4:33 PM, June 26, 2009  
Blogger DADvocate said...

Also, some people intentionally go bankrupt in order to avoid paying medical bills and/or other bills.

4:35 PM, June 26, 2009  
Blogger br549 said...

Josh, you and anyone who feels as you do can give the government all the money you want out of each pay check you get. I am certain the government will be happy to relieve you of it.

Depending on where in the country one is, the government is paying for automobiles, cell phones, and god knows what else.

By "going Smith" (humor!) I should be able to drop down into the tax category where I too will get a free cell phone, free car, free mortgage payments, health insurance, food, clothes, etc.
And if I don't, because of the color of my skin, then I'll sue for discrimination.

4:51 PM, June 26, 2009  
Blogger J. Bowen said...

Then he suggests that insurance is only unaffordable for 25-75% of the uninsured population. Firstly, I don't find that acceptable.

Do you have a better source that shows differently?

Medical problems partly caused about 62% of bankruptcies in 2007, according to this article.

I would love to read that study. What the article doesn't clearly state is whether medical bills were the proximate cause of their bankruptcy or the ultimate cause. How many of those people's spending and investing strategies were little different than the morons in the coastal areas who bought houses using ARMs that they ridiculously never thought would go up or the morons in the midwest who refinanced their existing debt using HELOCs with teaser rates? How many of those people were single mothers, divorced or otherwise? How many of those people have bigger houses than they need, bigger and less-efficient vehicles than they need, more luxury items than they can afford (like expensive televisions and computers, boats, cable television, expensive cell phones (or cell phones at all), name-brand clothing, and so on), and are poor savers to begin with? The difference between the proximate and ultimate cause of a person's bankruptcy can be huge.

And because many people receive insurance through their employers on the group market, they lose their insurance along with their jobs when they fall ill. Yes, it can happen to you or someone you love, even if you work hard and play by the rules.

Whose fault is that (hint: it has something to do with tax codes and regulations written decades ago that provided a huge incentive for people to get insurance through employers rather than through the private market (not to mention requirements placed on employers to offer it in the first place) at a time when the family structure was very different and when people tended to stay with one or two employers for their entire adult working life)?

Furthermore, most people just don't have the expertise to rationally apply for medical insurance, thereby holding insurance companies accountable to the market. Insurers run circles around them.

What's stopping them from going to an insurance agent? Or reading books?

But blindly relying on market competition that is not there and never will be there will continue to lead to suboptimal health outcomes.

Perhaps you meant to say this: But blindly relying on market competition that is not there because of the government and will not be there without the government getting out of the way will continue to lead to suboptimal health outcomes.

By the way, you didn't think anyone would let this pass, did you? What suboptimal health outcomes?

5:28 PM, June 26, 2009  
Blogger fred said...

That rough figure is in fact the approx figure that shows up no matter how many searches you do in how many places. I can say this from my own experience:
people who have lost jobs mostly have no coverage. People who have poor paying jobs seldom have coverage of any kind or very poor coverage. To suggest that people ahve money but simply do not buy coverage is to suggest that they would rather take ill and perhaps die rather than spend the money--a strange suggestion with no proof.

More to the point: I know some folks who have no coverage or insufficient coverage. When they get ill, they go to emergency rooms. They get treated, free. The hospital then passes on costs to patients with coverage. The bills mount so insurance raises its rates to take care of those costs.

Just today I had coffee with tow Viet vets, both using local VA hospital. They get free prescriptions, blood test etc and they tell me the service is fast, good, polite and very good. They deserve it and I am happy for them. I qualify for this help but do not take it since I am on my wife's plan.
ps: bankruptcy is above listed as a trick used by not nice folks. No. It is built into the system and is also used by major corporations. That is ok, though, right? Check the history of how the poor were treated--In England and in the US, and you will discover why the new laws made so much more sense.
Sorry to say these things. I know you would like to believe there are all those bad people out there gaming the system . Why not simply say: no health coverage, edie then and good riddance. More parking spaces available.

5:36 PM, June 26, 2009  
Blogger J. Bowen said...

People who have poor paying jobs seldom have coverage of any kind or very poor coverage. To suggest that people ahve money but simply do not buy coverage is to suggest that they would rather take ill and perhaps die rather than spend the money--a strange suggestion with no proof.

To suggest that people have money that they could be spending on health insurance but instead spend on things that are, to a person who wants health insurance coverage, less important is accurate. If you have cable television, a cell phone, internet service, anything less than the least expensive fuel-efficient car, or anything else that you could do without but don't have health insurance, then you have absolutely nobody to blame but yourself for your not having health insurance and I say boohoo to you when you find yourself in need without it. Millions of people can afford health insurance if they stop spending money on other things that are by no means necessities. Politicians and lobbyists are simply not interested in that fact. They want Americans to keep making reckless financial decisions.

Since we're telling stories about people we know who are exemplary of the points that we're trying to make, why don't I tell one? I know a single mother of two who makes far less than poverty-level wages at her job at Wendy's but yet has a cell phone, eats nothing but processed foods, and has designer clothes and shoes. A mother of two before she turned 20, she is not only not using any birth control (the guys she has sex with use condoms sometimes) because she doesn't want to get fat, but she also wants to have another kid within five years so that she can possibly have a girl (she had two boys that she's "okay with" but really wants a girl so that she can dress it up). Care to guess how far she went in school (the fact that she's 22, has two kids aged 3 and 6, is overweight (she actually wants to have one of those gross rears that black women often have), lives with her grandmother, and works at Wendy's ought to give you a clue).

5:54 PM, June 26, 2009  
Blogger br549 said...

Again, fred - no one is stopping you and those who think like you from voluntarily paying for anyone and everyone you desire to pay for. Have at it. Every illegal who sneaks across the border is counting on you. The government will gladly take your money. I think you're a swell guy for it, and I'm sure Obama sees you as useful to his cause. They are going to have to make me do it. I see it as heading for a cliff with the governor jammed full throttle. We'll see just what malicious obedience brings, down the road.

6:01 PM, June 26, 2009  
Blogger TMink said...

Josh wrote: "30 million is still a lot."

Not compared to the population of the US: 304,059,724.

You were suckered Josh. It is less than 1 in 10. Given the number of those who are without insurance so that the can spend the money elsewhere, it is less than 10%.

Besides, you tithe right? You are other people who are concerned should just tithe and put your money in a pool for the uninsured or give it to Christian hospitals.

Trey

6:52 PM, June 26, 2009  
Blogger Acksiom said...

Secondly, the whole point of universal coverage is to --h--a--v--e-- FORCE young, healthy individuals to purchase insurance, EFFECTIVELY REDISTRIBUTING THEIR WEALTH TO OTHERS.

Fixed that for ya.

6:55 PM, June 26, 2009  
Blogger TMink said...

Acksiom, a good axiom.

Trey

6:57 PM, June 26, 2009  
Blogger jimbino said...

Most every American expatriate or one who travels overseas is without Medicare, Medicaid and his health insurance while overseas.

So what?

8:26 PM, June 26, 2009  
Blogger davod said...

A similar distortion occurs with the number of homeless. During the Clinton years the collection method was changed so that those reporting the numbers were in fact the homeless shelters. Let's see -the more homeless reported, the greater the funding.

4:48 AM, June 27, 2009  
Blogger fred said...

In fact as good as some health plans etc are in America the cost and the waste are terrible and could be fixed. Basically those commenting here, seems, are rationalizing to the effect: I got mine...screw the others. See this, from a conservative and highly respected journal

http://www.economist.com/opinion/displaystory.cfm?story_id=13900898

7:31 AM, June 27, 2009  
Blogger br549 said...

That's not it at all, fred. And you know it.

8:18 AM, June 27, 2009  
Blogger DADvocate said...

Yeh, right, fred. The government controls waste and expense so well. That's why we have $400 toilet seats on Navy ships. Anyone with half a brain knows the Feds set the pace in waste and cost overruns.

One reason health care is so expensive is that Medicare and Medicaid set a minimum cost that providers cannot go below whether or not a patient is on MC/MC or not. Maybe you're not old enough to remember pre-MC/MC. Health care was very affordable.

You put up a nice little strawman, "I've got mine...screw the others." As an author of several books, I'll guarantee you have more than me. Why don't you give me some. My house in Appalachia needs repair (part of my gutter fell off in a storm the other day plus other things). Put up or shut up.

I know better than to depend on the government and I value freedom. It has nothing to do with screwing the other guy. That's your realm. Obama has no real health care plan but it will screw many more people than are getting screwed now.

9:57 AM, June 27, 2009  
Blogger Josh said...

A few people asked about the medical bankruptcy study. You can find the article here.

Josh, you and anyone who feels as you do can give the government all the money you want out of each pay check you get. I am certain the government will be happy to relieve you of it.

Since we live in a democracy, we are also free to support policies designed to redistribute wealth from healthy individuals to unhealthy ones. I support such policies because I believe alleviating suffering is more important than luxuries, even if they have the same dollar value. That's just my opinion, of course.

"Furthermore, most people just don't have the expertise to rationally apply for medical insurance, thereby holding insurance companies accountable to the market. Insurers run circles around them."

What's stopping them from going to an insurance agent? Or reading books?


nothing. I assume most of them do. I spent time discussing a lot of issues with an insurance agent, including under what circumstances an individual policy could be rescinded retroactively. I've spent weeks researching it and still don't understand jurisprudence in this area. By the way, when you apply for insurance, you are not allowed to read the contract until after you have agreed to it and paid your first bill. Only then will you receive the contract and have the opportunity to cancel your policy for a refund. To give you a practical example of how difficult it can be to navigate this area, my parents recently switched from one insurer to another and wanted information about how much their copay would be for a very specific medication. After hours on the phone with both insurance companies, they were given misleading and contradictory information that led them to choose incorrectly. And that was for someone who knew ahead of time what they wanted. The average individual has no idea what medical problems are likely and need to be insured against. I think many strict libertarians want to pretend that choosing medical coverage is a financial decision made by individuals. The truth is that individuals would have to be well-trained experts in medicine, law, and finance to make these decisions even close to rationally. The result is that these decisions are made unilaterally by health insurance companies.

Perhaps you meant to say this: But blindly relying on market competition that is not there because of the government and will not be there without the government getting out of the way will continue to lead to suboptimal health outcomes.

Nope! I meant what I said. The government has nothing to do with the increasing returns I mentioned. I've offered these increasing returns as a hypothesis to explain market concentration in the health insurance industry. You may be correct in suggesting that some government regulation has the effect of discouraging competition, but I don't know of any such regulation. If you could be more specific--that is, if you could provide a specific example of regulation and explain how it limits competition--I'd be interested.

You were suckered Josh. It is less than 1 in 10. Given the number of those who are without insurance so that the can spend the money elsewhere, it is less than 10%.

I find 10% unacceptable. Again, preventing the suffering of a small group is more important to me than improving the quality of life of a large group of individuals who are already well off. That's my own personal policy preference, of course.

2:39 PM, June 27, 2009  
Blogger DADvocate said...

I find 10% unacceptable.

I have no problem with that. I have a problem with government forcing us to attain health care services/insurance according to how they tell us under force of law.

Again, preventing the suffering of a small group is more important to me than improving the quality of life of a large group of individuals who are already well off. That's my own personal policy preference, of course.

Who's talking about improving the quality of life of a large group of individuals who are already well off. We're talking about being able to lead lives free from government control. Leading lives where we're free to make our own choices with others who are also free to make their own choices.

Provide health care for those who can't afford it or want Big Brother to control their lives and leave the rest of us alone.

2:50 PM, June 27, 2009  
Blogger orthodoc said...

Josh and Fred,

It's hard for me to believe that you can be this resistant to information, but the numbers you continue to cite are demonstrably false.

The 46 million number counts anyone who went without insurance for even a day, and also counts people in the country illegally, people who can but won't sign up for existing programs (guess Oprah was too interesting that day), people who can afford insurance but don't feel like getting it, and so forth.
The illegal ones shouldn't be depending on citizens to fund their health care, the lazy ones should get off their butts, the ones who can afford it should buy it themselves and stop freeloading.

As for the bankruptcy numbers, I assume you’re using the Himmelstein/Warren/Woolhandler findings, which are odd to say the least. The data comes from 1,250 personal bankruptcy cases, assumed to be representative of the almost 1.5 million households that filed for bankruptcy in 2001. The data on each bankruptcy were abstracted from court records and supplemented with 931 telephone interviews. The paper's conclusions about illnesses in households were based on medical interviews conducted with 391 people. The paper does not specify how those people were selected. It does say that Himmelstein and Woolhandler (H & W), both MDs, coded the diagnoses given by debtors into the categories used for the analysis.
The classifications used to determine a medical bankruptcy were odd. Only 28.3 percent of the sample cited self-reported illness or injury as a cause of bankruptcy. However, H & W managed to almost double that figure (to 54.5 percent) by counting the following as "illnesses":
1. A birth or addition of a new family member
2. A death in a family
3. A drug or alcohol addiction
4. Uncontrolled gambling
5. Loss of at least 2 weeks of work-related income due to illness or injury by anyone in the household
6. Out-of-pocket medical bills of $1,000 in the two years before filing by anyone in the household
7. Mortgaging a home to pay medical bills.

Gambling, booze, and drugs are not a medical problem of which I’m aware. And bills of $1000 over two years are hardly onerous – that’s 40 bucks a month.

Josh and Fred, you are very nice people to offer to help pay for the trials and tribulations of these people. I draw the line at your belief that you are justified in forcing me to do so. If that makes me a horrible person, so be it.

5:02 PM, June 27, 2009  
Blogger Acksiom said...

Since we live in a democracy, we are also free to support policies designed to redistribute wealth from --h--Wealthy individuals to un--h--Wealthy ones. I support such policies because I believe alleviating MY PERSONALLY CHOSEN EMOTIONAL EXPERIENCE OF suffering OVER THE DIFFERENCES IN OUTCOMES AND SITUATIONS BETWEEN OTHERS RESULTING FROM THEIR FREE CHOICES is more important than --l--u--x--u--r--i--e--s-- NECESSITIES FOR A JUST AND FAIR AND FREE CIVILIZATION AND SOCIETY SUCH AS PERSONAL LIBERTY, PRIVATE PROPERTY, THE BILL OF RIGHTS, AND SO ON even --i--f-- THOUGH --t--h--e--y-- THE LATTER have --t--h--e-- --s--a--m--e-- FAR GREATER --d--o--l--l--a--r-- value, TO SAY NOTHING OF HOW STATE-FORCED UNIVERSAL MEDICAL CONSCRIPTION HAS CONSISTENTLY LOWERED BOTH THE QUALITY AND AVAILABILITY OF MEDICAL CARE IN VIRTUALLY EVERY NATION THAT HAS ATTEMPTED IT.

Again, preventing, THROUGH THE STATIST TOTALITARIAN CONTROL OF OTHERS RATHER THAN JUST THE MERE SIMPLE SELF-CONTROL OF MY OWN FEELINGS THAT IS EXPECTED OF ANY NORMAL ADULT PERSON --t--h--e-- MY PERSONALLY CHOSEN EMOTIONAL EXPERIENCE OF suffering --o--f-- --a-- --s--m--a--l--l -- --g--r--o--u--p -- OVER THE DIFFERENCES IN OUTCOMES AND SITUATIONS BETWEEN OTHERS RESULTING FROM THEIR FREE CHOICES is more important to me than --i--m--p--r--o--v--i--n--g-- PROTECTING the quality of life of --a-- --l--a--r--g--e -- --g--r--o--u--p-- AN ENTIRE NATIONAL POPULATION of individuals who are already --w--e--l--l-- --o--f--f-- FACING OTHER SERIOUS THREATS TO THE PERSONAL LIBERTY, PRIVATE PROPERTY, THE BILL OF RIGHTS, AND SO ON UPON WHICH THAT QUALITY OF LIFE NECESSARILY DEPENDS
.

Fixed that for ya. . .again.

7:22 PM, June 27, 2009  
Blogger Acksiom said...

Or, to put it more readably --

Since we live in a democracy, we are also free to support policies designed to redistribute wealth from wealthy individuals to unwealthy ones. I support such policies because I believe alleviating my personally chosen emotional experience of suffering over the differences and outcomes and situations between others resulting from their free choices is more important than necessities for a just and fair and free civilization and society such as personal liberty, private property, the Bill of Rights, and so on even though the latter have far greater value, to say nothing of how state-forced universal medical conscription has consistently lowered both the quality and availability of medical care in virtually every nation that has attempted it.

Again, preventing, through the statist totalitarian control of others rather than just the mere simple self-control of my own feelings that is expected of any normal adult person, my personally chosen emotional experience of suffering, over the differences and outcomes and situations between others resulting from their free choices is more important to me than protecting the quality of life of an entire national population of individuals who are already facing other serious threats to the personal liberty, private property, Bill of Rights, and so on upon which that quality of life necessarily depends.

The bottom line, Josh, is that you are comparing the wrong things. It's NOT a choice between richer people's luxuries and poorer people's necessities.

It's a choice between what you personally choose to feel -- by failing to choose to control your emotional state, which is expected of any normal adult -- and the objective best interests of everyone in general.

You are of course right to point out that you are entitled, due to living in such a marvelously free nation, to attempt to get the rest of us to put your poow poow pwethiouth feeeeeeeeeeewingth ahead of our own best interests.

And we, in turn, are entitled to call you out on it and mock you for it and generally castigate you for acting like such a weepy weeny willfully ignorant statist totalitarian control-freak douche.

8:51 PM, June 27, 2009  
Blogger tomcal said...

Hey Ack:

I consider myself to be fairly intelligent and multi-cultural. I also know for sure that I speak and write in 2 languages fluently.

I am no writing professional, but my advice to you is that if you want to make a point, use the language you chose in a way that most readers can understand.

I have no idea whether I agree with you or not; and I won't waste my time deciphering your code. I doubt if many others will either.

8:56 PM, June 27, 2009  
Blogger Master Doh-San said...

Since we live in a democracy, we are also free to support policies designed to redistribute wealth from healthy individuals to unhealthy ones.

Wrong. We live in a constitutional republic; not a democracy. Democracy is nothing more than mob rule.

Democracy: two wolves and a sheep voting on what's for dinner.

~~~~~
Again, preventing the suffering of a small group is more important to me than improving the quality of life of a large group of individuals who are already well off. That's my own personal policy preference, of course.

If it saves just one life, enslaving you will be worth it.

.

10:16 PM, June 27, 2009  
Blogger br549 said...

Exactly. We live in a constitutional republic. We are a nation of laws. It is designed to protect us from each other and outside influence, but not from ourselves. We are, within reason, free to succeed and free to fail. And free to try again and again.

One is free to help the less fortunate if that is their desire. We all do to an extent. Who hasn't given to charity?

There are 24 hours in a day. Everyone alive has those same 24 hours. No more, no less. What one does with those 24 hours at a pop is, and should be, the main determinate on how that person's life goes. Not how much of the results of my daily effort can be taken from me and handed over to someone else. Read the first paragraph again.

I do not mind, really, paying my fair share of feeding the goose that lays the golden eggs. Part of what a government is, is being a sponge. It should be controlled, not possess control over a nation's people. Those working inside beltways of the nation and the individual states, are the ones who are getting it wrong.

Between the bailout, the highway robbery of cap and trade, and the upcoming health care fiasco, we will all be the worse.

Personally, I want the same health care, days off, vacation time and retirement package congress gets. Who else gets a pay raise by not voting no?

Better yet, I want them to have the same they're ramming down my throat.

5:16 AM, June 28, 2009  
Blogger TMink said...

Josh, you DO tithe don't you? You could put your 10% toward health care for indigents, or whichever group you wanted to.

This month, I gave money to my church, AIDS treatment in Africa, feeding a family in Africa, and Bible translations for the most Christian country in the world, China.

My church does other good things with the money.

What do you tithe to Josh?

Trey

8:57 AM, June 28, 2009  
Blogger Josh said...

It's hard for me to believe that you can be this resistant to information, but the numbers you continue to cite are demonstrably false.

no need to yell. I've been fortunate enough to have a number of replies, and I haven't had time to respond to them all.

The 46 million number counts anyone who went without insurance for even a day, and also counts people in the country illegally, people who can but won't sign up for existing programs (guess Oprah was too interesting that day), people who can afford insurance but don't feel like getting it, and so forth.

My understanding is that the number represents a snapshot. That is, when the census was taken, 46 million reported being uninsured. Of course many of them may have been uninsured for a short period of time, but I don't see why that's important: it still suggests that a large part of the population is constantly uninsured. Let's say no one is uninsured for more than 10 days but 10% of the population is constantly uninsured. If we assume that illness falls evenly across the population, 10% of all illnesses will still strike uninsured individuals. Furthermore, if what I suspect is true and seriously ill individuals are more likely to be uninsured, then illness is even more likely to hit the uninsured.

And, of course, many do not have enough insurance due to loopholes and other nonsense.

As for the bankruptcy paper, it does say how the bankruptcies were chosen (randomly from the set of all bankruptcies). They had a pretty high nonresponse rate but did a reasonable job addressing it; see the paper for details. I don't have access to the 2001 paper, but the 2007 paper I referenced has far different criteria than the one you mentioned. See Table 2 on page 3. Also note that there is a lot of overlap between the categories: many people, for example, had large medical bills and reported them as the reason for bankruptcy.

9:30 AM, June 28, 2009  
Blogger Josh said...

As for the general philosophical talk, my understanding is that the United States is both a constitutional republic and a representative democracy, as democracy is defined in modern usage, as opposed to the usage of the founding fathers. I'm not a political scientist or a philosopher, though, and I certainly could be wrong. My point is that we have the right to elect representatives who may pass laws within the confines of the constitution. If you feel that a law requiring individuals to buy insurance would be unconstitutional, please say why. I know of no reason why this type of tax would be any more unconstitutional than any other.

9:43 AM, June 28, 2009  
Blogger orthodoc said...

Josh, the 46 million number has been debunked. Repeatedly.
Again, about a quarter (8-10 million) are in the country illegally. About 12 million already qualify for public assistance but haven't signed up. About 10 million make enough money to buy their own, but don't.
The result is that there are about 10 million who are in the country legally, do not presently qualify for public assistance, and who can't afford insurance. That's 3% of the population.

There is no reason why we cannot work to help them, without destroying options for everyone else.

12:28 PM, June 28, 2009  
Blogger orthodoc said...

Josh, the Himmelstein study you cite is shoddy work. They surveyed about 2300 filers, and then called bankruptcies "medical" based on debtors’ stated reasons for filing, income loss due to illness, and the magnitude of their medical debts.

First, they had a 50% nonresponder rate. That alone makes their study suspect - anything over 20% in medical literature is considered useless.

Second, anyone who didn't work for 2 weeks for a medical reason was put in this category.

Third, debtors who gave no answers regarding reasons for their bankruptcy were excluded.

Last, the authors of this study have made no secret of their strong preference for a single-payer system. Part of performing good science on the part of the investigator is the need to put preconceived ideas aside. This study is not hypothesis-driven, it is agenda-driven, and as such is highly suspect.

The authors themselves state that "Teasing causation from cross-sectional data is challenging.
Multiple factors push families into bankruptcy." Clearly, these authors have decided that the only factor worth looking at is medical bills.

12:47 PM, June 28, 2009  
Blogger Art Deco said...

The study Josh quotes indicates that those classified as 'medically bankrupt' have at the time of their filing a mean of about $18,000 of outstanding medical bills. The 'medically bankrupt' are said to be 62% of their total sample. Would that indicate that their total sample has a mean of $11,000 in unpaid medical bills? Their total sample is a mean of $41,000 in the whole to their creditors, so it would appear that unpaid medical bills account for 27% of their deficit. Perhaps I missed it, but the study does not seem to indicate what the mean liabilities of their sample was, merely the mean of their net worth. If I am not mistaken, the costs of private medical insurance and out-of-pocket expenses amount to about 14% of personal disposable income, on average. If the ratio of unpaid medical bills to total liabilities is in that range, it would seem that outstanding medical bills by their size are not an abnormal contributor to bankruptcy, though perhaps the unexpectedness of medical expenses might make them so.

5:40 PM, June 28, 2009  
Blogger Art Deco said...

Excuse me,

The study does indicate that market value of the homes of the 'medically bankrupt' is a mean of $141,000 and that these filers are a mean of $44,000 in debt. That suggests that their mean liabilities are somewhere north of $185,000. This group had a mean of $18,000 in outstanding medical bills and those uninsured at the outset $27,000 in outstanding medical bills. If the mean liabilites of those uninsured at the outset are similar to those of all 'medically bankrupt' (they may not be), their outstanding medical bills amount to about 15% of their outstanding liabilities. I suspect it is the obtrusiveness and unexpectedness of medical bills that induces so many people to attribute their bankruptcy to them. (On the public policy question, I think I am closer to Josh than to Dr. Helen).

5:57 PM, June 28, 2009  
Blogger Josh said...

orthodoc, you've raised valid points.

Bear in mind the following sentence from the study:

"Here we report the first-ever national random-sample survey of bankruptcy filers."

It doesn't look like this area has been studied very thoroughly, which just seems rotten to me. No, the study isn't perfect, but it certainly deserves a reading by those who think the status quo is acceptable just because the number of uninsured is some small percentage of the population. (Your statement above regarding the uninsured is only true, by the way, if there is no overlap between the three groups you mentioned.)

Second, anyone who didn't work for 2 weeks for a medical reason was put in this category.

I'd like to point out that there is a large overlap between those reporting loss of income and those reporting large medical bills.

Last, the authors of this study have made no secret of their strong preference for a single-payer system.

Are you referring to this paragraph?

"Medical impoverishment, although common in poor nations, is almost unheard of in wealthy countries other than the US. Most provide a stronger safety net of disability income support. All have some form of national health insurance."

Is that really strong support for single-payer health insurance? Papers don't exist in a vacuum; they typically have introductions and conclusions that place them in context and explain why they are important.

Try to keep in mind that the number of people who will actually need to make large medical claims will hopefully be low. The point is that those individuals, many of whom have worked hard and paid into insurance for their entire lives, shouldn't be completely ignored just because they're not 51% of the population.

9:40 PM, June 28, 2009  
Blogger 1charlie2 said...

$18,000 in medical bills and they went UNDER ?!?! Good golly.

My own family gained $14,500 in uncovered medical bills (Thank you, United Healthcare) in 1996 following a series of setbacks.

It took 5 years to pay it (amd the other debts incurred then) back. But we did. I worked two jobs to make it happen. Do NOT presume to tell me what is "necessary."

When wife was going thru Grad school in the early '90s, grad students working on campus were eligible to buy health care (they were union). Of the 10 my wife knew, NONE purchased it, though all drove cars no more than 3 years old. Why ? "Other things to spend my money on" was the excuse for (IIRC) 7 of them, the other three (and my wife) were covered under other policies (generally their spouses). Since then, I've understood the manipulation going on.

The whole flipping "46 million" number is a bald-face lie, statisticulation at its finest.

It counts anyone who went without health insurance during any part of the previous year -- like those who change jobs and don't COBRA. It counts 10.2 million illegal immigrants. It counts 14 million eligible for public health care. It counts nearly 10 million with household incomes of more than $75,000. Many, perhaps as many ad 10 million are 18-34 years old -- they don't WANT to pay for it. Like the grad students. Okay, but I sure won't pay for it FOR them.

What are we left with ? 13-15 million ?

Thanks, I don't want the government-run health-care system of many European countries, or our own VA (see recent events).

11:16 PM, June 28, 2009  
Blogger Tether said...

TMink brags: "This month, I gave money to my church, AIDS treatment in Africa, feeding a family in Africa, and Bible translations for the most Christian country in the world, China."

--

You're a really swell guy, TMink, and you are never going to let us forget how great a man you are.


TMink further spouts: "What do you tithe to Josh?"

-----

Please leave your combination of religion and bullying out. You and Chuck Pelto don't seem to get that pushing your religion in other people's faces as a badge or means of being superior is ... not what Jesus would have done, for starters. And it's also idiotic.

8:39 AM, June 29, 2009  
Blogger Tether said...

I get the same impression from TMink as I get from some guy bragging about his Bachelor of Arts degree. While there are other people in the room who don't mention that they have further degrees.

He thinks he's impressing other people; other people mostly think he's a self-important twit who doesn't even have much to brag about.

8:41 AM, June 29, 2009  
Blogger Josh said...

It counts anyone who went without health insurance during any part of the previous year -- like those who change jobs and don't COBRA.

Actually, my understanding is that it counts everyone uninsured at a specific time. There's a huge difference. See this CBO paper for details.

8:33 AM, June 30, 2009  
Blogger Art Deco said...

Please leave your combination of religion and bullying out. You and Chuck Pelto don't seem to get that pushing your religion in other people's faces as a badge or means of being superior is ... not what Jesus would have done, for starters. And it's also idiotic.

There is nothing inherently inappropriate about discussing matters of religion, as that is part of public life. (There is something inappropriate about stringing together personal insults. Doesn't stop people though).

12:09 PM, June 30, 2009  
Blogger br549 said...

Drive by trolls.

6:21 PM, June 30, 2009  
Blogger Roismhaire said...

If things don't change I think most people will know at least one person that HAVE insurance that have been made bankrupt because of medical expenses. I know 2 - one was a teacher that got a brain tumor, the other had a kid that was in a bad car crash - and I don't know that many people!
I think people pay more attention to people's situations than they do to statistics. At least I do.

11:04 AM, July 04, 2009  

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