Critical Condition? Lies, Damned Lies, and Statistics Confuse the Health Care Debate

© By Peter Barry Chowka

(October 1, 2008) With fewer than five weeks remaining until the U.S. elections, a lot of the reporting on medical topics reflects the larger context of the ongoing political debate about America’s health care future. Presidential candidate Sen. Barack Obama and most of his fellow Democrats running for Congress promise everyone universal health care, guaranteed and controlled by the federal government. Sen. John McCain and most other Republicans support reforms that essentially retool the status quo – the highly regulated and modified free market that coexists with a large federal role (generous government payments through programs like Medicare, Medicaid, and the Veterans Administration and major oversight of the entire medical field) that started and has grown since the end of World War II.

Critical Condition?

A new 90 minute documentary airing nationally in prime time on PBS starting on September 30, 2008 essentially represents the latest in a seemingly unending series of high profile arguments in the mainstream media and elsewhere on behalf of the establishment of a nationalized universal health care system in the United States.

Part of the long running P.O.V. (Point of View) series on PBS, the program is titled “Critical Condition” and was produced and directed by Roger Weisberg. The narration- and host-free show, presented in cinema verité style, follows the experiences of four middle class Americans – all of them employed or previously employed, and all of them with serious medical conditions – as they navigate the health care delivery system, no easy task even for people with gold plated insurance coverage. A highly personal and extremely compelling show (both technically and in terms of its point of view), “Critical Condition” suggests that a lack of easy guaranteed access to comprehensive medical insurance exacerbated the problems of the four subjects and probably hastened the deaths of the two who died during the production (one from cancer, the other apparently from advanced liver disease and diabetes).

Carlos Benitez, the individual in the program who does get better after receiving (free) help, including major spinal surgery, had a long term untreated case of ankylosing spondylitis.

All four of the principals, however, did in fact receive extensive medical treatments. Moreover, as a person familiar with the landscape of alternative medicine and its corresponding critique (at least in the past) of the conventional medical model including many allopathic treatments, it is possible to see the less than ideal outcomes (in three of the four cases the program studied) as par for the course on the part of allopathic medicine. Unlike Sicko, leftist propagandist Michael Moore’s in-your-face 2007 feature film (which I reviewed here), “Critical Condition” is a much subtler attempt at persuasion. Even for a skeptical viewer, it is difficult not to be drawn into the lives of, and not to wind up empathizing if not strongly identifying with, the four patients in the film. And that, of course, is the strategy of the filmmakers and part of the film’s problem. The leap (the filmmakers obviously expect viewers to make) from empathy to support for some kind of health care for all guaranteed and provided by the government is a deeply flawed one.

Even if one accepts the number of “47 million Americans without health insurance” (a highly inaccurate and distorted figure, by the way), and therefore accepts that the experiences of the four people in “Critical Condition” are not completely unusual, it still means that the challenges they faced are not exactly typical, either, of what most Americans encounter. Therefore, the question that should be asked, but isn’t in the film, of course, is should the whole current medical system be upended and turned over to government control so that a minority of people, without health insurance, can be “helped?” Moreover, any number of similar heart wrenching documentaries from the personal perspective of suffering patients – enduring the serious problems including rationing, long wait times, and poor quality care endemic to government-run universal health care systems in other countries (including the UK, Canada, and Australia) – could also be made. In fact, some have been produced but they are rarely if ever seen in the United States, where the “health care as a right”/universal health care meme has caught on in recent years and become an article of faith for the dominant politically correct culture.

Figures Don’t Lie But Liars Can Figure

A few words about some of the statistics cited in, and underlying the obvious pro-universal health care point of view of, “Critical Condition,” beginning with the purported “crisis” of the uninsured: On August 28, 2008, the National Center for Policy Analysis, using new data from the U.S. Census Bureau, published a brief analysis, “Crisis of the Uninsured: 2008.” This analysis largely debunks the claims that there is a growing crisis of the uninsured that requires the government to take over all medical care.

“Despite claims that there is a health insurance crisis in the United States, the number of U.S. residents without health insurance actually fell in 2007, according to new Census Bureau numbers. The Census says the number of uninsured fell from 47.0 million to 45.7 million. Furthermore, the proportion of uninsured fell half a percentage-point, from 15.8 percent to 15.3 percent. In fact, the proportion of people without health insurance was a percentage-point lower in 2007 than a decade earlier (16.3 percent in 1998). The slight increase in the number of uninsured over the past decade is largely due to immigration and population growth — and to individual choice. . .

“In 2007, according to Census Bureau data: Nearly 85 percent (253.5 million) of U.S. residents were privately insured or enrolled in a government health program, such as Medicare, Medicaid and the State Children's Health Insurance Programs (S-CHIP). Nearly 18 million of the uninsured lived in households with annual incomes above $50,000 and could likely afford health insurance. Up to 14 million uninsured adults and children qualified for government programs in 2004 but had not enrolled, according to the BlueCross BlueShield Association. In theory, therefore, about 32 million people, or 70 percent of the uninsured, could easily obtain coverage but have chosen to forgo insurance. That means that about 95 percent of United States residents either have health coverage or access to it.” [emphasis added]

On September 22, 2008, The American Spectator published health care analyst and reporter David Hogberg’s report “Death and the Uninsured,” which takes to task the oft-cited claim that 18,000 Americans a year, if not more, die from lack of health insurance. The report is difficult to summarize so I recommend that interested readers consult Hogberg’s original piece and also pay attention to the references and links that he cites.

Still from Divided We Fail advertisement

Even before the high profile financial crisis came to the fore last month, the claim that lack of medical insurance or adequate insurance is a major cause of personal bankruptcies was heard increasingly. For example, during the extensive coverage of the Democrats' and Republicans' conventions on Fox News, CNN, and MSNBC, an organization called Divided We Fail, part of the AARP, was one of the most frequent advertisers, running hundreds of commercials on behalf of “fixing” health care. All of the spots carried the incredible claim that “1.85 million Americans go bankrupt due to medical bills in one year.” It can only be assumed that tens of millions of Americans saw these ads over the eight nights of convention coverage.

The 1.85 million number, however, is completely bogus, incredibly inflated by a factor of at least 1,800 percent and maybe as much as 5,000 percent! According to the Administrative Office of the U.S. (Federal) Courts, the total number of non-business bankruptcies in the U.S. in 2007 (the year ending June 30) was 727,167 and in 2008 (year ending June 30) 934,009. Most of the claims that medical costs result in a large number of bankruptcies trace back to an article in Health Affairs, “Illness And Injury As Contributors To Bankruptcy,” published February 2, 2005. The lead author is David Himmelstein, MD, and a co-author is Steffie Woolhanler, MD. These two individuals are professors of medicine at Harvard University and are co-founders of Physicians for a National Health Program, an organization that unabashedly promotes socialized, government–run single payer health care. The article by Himmelstein et al claimed that medical problems contribute to 54.5 percent of personal bankruptcies. Even accepting that figure, the number of bankruptcies in 2007 would be 396,306 – or about 21 percent of the 1.85 million figure mentioned repeatedly as fact by the AARP.

But the 393,306 figure is also inflated. On February 28, 2006, Health Affairs published an article “Medical Bankruptcy: Myth Versus Fact” which put the figure at closer to 17 percent. Another study, “Bankruptcy Reform and Credit Cards” (Journal of Economic Perspectives, Fall 2007), argues that “the main reason [for bankruptcies] is the growth of ‘revolving debt’—mainly credit card debt.” The most recent study I could find is “Household Consumption and Personal Bankruptcy” in September 2008 by researchers at UC Davis, who estimated that five percent of bankruptcies are caused by excessive medical expenses. In 2007, that would mean a total of 36,358 personal bankruptcies in the U.S. due to medical problems – a number that is only 1.96 percent – less than 1/50th – of the AARP’s 1.85 million figure!

This correction of the inflated, hyped, politicized estimates of bankruptcy concocted by politically motivated provocateurs like Himmelstein is not isolated. The plethora of other statistics thrown around by universal health care proponents to buttress their case for socialized medicine is equally flawed and suspect. Nonetheless, agents of the left, like the previously mentioned Michael Moore, have jumped on the latest financial crisis to try to score points on behalf of socialized medicine. In a letter of September 29, 2008, Moore writes, starting with a question supposedly asked of him:

Health insurance? Mike, why are you bringing this up? What's this got to do with the Wall Street collapse?

It has everything to do with it. This so-called “collapse” was triggered by the massive defaulting and foreclosures going on with people's home mortgages. Do you know why so many Americans are losing their homes? To hear the Republicans describe it, it's because too many working class idiots were given mortgages that they really couldn't afford. Here's the truth: The number one cause of people declaring bankruptcy is because of medical bills. Let me state this simply: If we had had universal health coverage, this mortgage “crisis” may never have happened.

Equally problematic – but another threat that should not be ignored – is the contention by a growing number of universal health care advocates among the health care policy elite that the national financial crisis may open the door to an increased role for the federal government in health care including a similar bailout of the entire health care system! This is essentially the position of David Kibbe in “Will We Need a Bailout of the Health Care System, Too?,” writing at the Health Care Blog on September 29, 2008. A skeptic, however, commenting at the same blog, writes: “The [proposed] bailout will use up the fiscal margin for any subsidized solution to health reform. There will simply be no extra dollars in the federal budget for the uninsured for many years. Obama's health reform plan, which relied on new taxes, is dead as a doornail unless he is willing to push the budget deficit into Argentinian territory, or finance it from savings inside existing health spending or health related tax subsidies. Even the existing base of health spending will probably have to be re-examined.”

One can only hope.

What Does All Of This Have to Do With Alternative Medicine? (Commentary)

Over the past several years, actually going back to 1993, I have been writing about the dangers to alternative medicine represented by proposed expansions of government’s role in American health care. This expansion is now poised to take a huge, unprecedented leap into the collective unknown, with proposals for government-run universal health care or even single payer moving to the forefront of mainstream American political discussion. Obama, for example, while denying that he would immediately push for a single payer system if elected president, indicated in August 2008 that in his heart he supports single payer. (See “Obama Says Single-Payer Health Care Makes Sense.”) In a 2003 speech while an Illinois state senator, Obama said: “I happen to be a proponent of a single payer universal health care program.” (applause) “I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody.”

In the last century, it was obvious to most interested parties that big government was hardly the friend of alternative medicine. But that was before many of alt med’s new generation of leaders were willingly seduced by government and the conventional medicine system, and the new credibility and goodies that brought. In rather quick measure, alt med’s traditional healing philosophies were corrupted and its methods, at least the non-threatening, alt med light ones, were “integrated” into the large and dominant allopathic, medical industrial complex. Meanwhile, the role for primary alternative medicine has diminished to near zero. (See, for example, the April 1, 2008 article “The Study of Alternative Cancer Therapies is Almost Extinct.”)

Among the linchpins of a totally government-run or –managed system, which is now within reach in the view of its proponents, are concepts like evidence based medicine, electronic medical records, and pay for performance. All of these strategies are anathema to the freedom, autonomy, and choice that once constituted the bedrock of alternative medicine. All of them would be fully put into force in a government-run system. Indications of what the government-centric future holds for alt med are already here. In 2007, a law went into effect in Massachusetts requiring that every resident obtain government-approved health insurance. As I reported on April 15, 2007, “None of the state-approved insurance plans covers alternative or CAM (complementary alternative medicine) modalities (with the possible exception of a limited number of chiropractic treatments) and, in addition, the more ‘affordable’ ones have deductibles and co-payments, further burdening the alt med-favoring Massachusetts resident with large expenditures irrelevant to his life.” On September 29, 2008, the Los Angeles Times reported that a proposed law mandating that insurance plans in California cover acupuncture was vetoed by Gov. Arnold Schwarzenegger. Meanwhile, other proposals, which apparently have a better chance of becoming law, include tests for the HPV virus (presumably including the controversial HPV vaccine) and screening for HIV in people without symptoms (presumably including giving, or mandating, toxic drugs for people whose blood tests HIV positive).

And that, for the discerning reader, is some of what government involvement has to do with alternative medicine.

 

Peter Barry Chowka is a widely published writer and investigative journalist who writes about politics, health care, and the media. Between 1992 and 1994, he was an advisor to the National Institutes of Health. His Web site is: http://chowka.com