My goodness, but Kip Sullivan is waxing increasingly shrill these days
And with good reason.
In a post titled Does Ezra Klein really think “managed care didn’t kill anyone”? Sullivan deconstructs this argument, starting with Didn't kill any one? Oh yeah? and moving on to Controlled spending? Prove it!
Short and [not so] sweet: managed care has killed people, managed care is not the reason health care spending didn't rise very much during the Clinton administration, and in spite of the fact that people fucking hate managed care, it has not gone away.
Sullivan [no, he hasn't stooped to dropping the f-bomb, that was my choice of words]:
Klein actually wrote:
This [the 1990s] was the era of the managed-care revolution, which most remember as a horrifying failure. Famously, audiences applauded when Helen Hunt broke out into a profanity-laden rant against HMOs in the movie “As Good as It Gets.” The popular backlash was so intense that by the turn of the century the managed-care experiment was virtually over. The problem with this historic failure? The data showed the experiment to be a tremendous success.
What data might this be? Klein offers none.
Instead he offers this sleight-of-hand:
From 1989 to 1995, median wages actually fell a bit. Then, managed care kicked in. Annual growth in health-care costs fell from more than 10 percent in the early 1990s to less than 5 percent in the late ’90s. Meanwhile, wages shot through the roof, rising more than 11 percent from 1995 to 2000. Then we ended the managed-care experiment, and health-care costs resumed their normal speed of growth. Predictably, wages slumped back down from 2000 to 2006. “By every observable indicator,” says Harvard’s David Cutler, “managed care was a huge success. It cut spending, cut the growth of spending and didn’t seem to kill anyone. And yet everyone hated it.”
There are at least four errors in this sloppy and specious paragraph:
(1) Managed care in fact did inflict enormous harm on many patients;
(2) the test for whether a health care “reform” proposal is acceptable needs to be a tad higher than “it didn’t kill anyone”;
(3) managed care did not “kick in” in 1995, it did not disappear in 2000; and
(4) the evidence does not support Klein’s claim that managed care caused the temporary decline in the annual growth rate of health insurance premiums that occurred in the 1990s.
Srsly, who needs old people and working stiffs who just plain refuse to pay their share anyway? They can be manged right out of existence and all will be just hunky-dory. It would be unethical to spend money on people who would probably just overburden the planet's carrying capacity, doncha know.