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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.

But nothing succeeds like failure and revisionist history, so yes, health care deform reform means we're going to get even more managed care, only this time it will be with sparkles on top!

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.

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Valley Girl's picture
Submitted by Valley Girl on

Ab Fab post, and I know you are very tuned into these issues.

I'll have to explain to Kip that "shrill" is a compliment, tho. *g*

But, being as you've been around "Corrente- Boldly Shrill" way longer than i have, and it took me some research to figure out the "boldly shrill" reference, maybe you could sum it up in a response here!

Valley Girl's picture
Submitted by Valley Girl on

Sez Klein: "Famously, audiences applauded when Helen Hunt broke out into a profanity-laden rant against HMOs in the movie “As Good as It Gets.”

It's a classic scene, but there is so much more in it than just "a profanity-laden rant", which was one short line in the entire scene. Trust little Ezra to miss the bigger picture.

CAROL: Fucking HMO bastard piece of shit... I'm sorry... forgive me.

DR. BETTES: No. Actually, I think that's their technical name.

Submitted by hipparchia on

in spite of the fact that people kept telling me to go.

so, i guess the lesson we can take from health care deform and its cheerleaders is that unless you've got a guardian angel who wants to pay your medical bills, you're s-o-l.

a little night musing's picture
Submitted by a little night ... on

I recently saw it on streaming Netflix. Way better than I thought it would be. It's a kind of "Christmas Carol" for curmudgeons, if that makes sense. There's a lot more to it than just this anti-HMO rant, although it would be worth it just for that!

Not a great movie, but a fun one. Where would we be without fun?

Submitted by hipparchia on

ok, now you've convinced me.

fun is good. i rarely ever see 'serious' movies anymore. or even read 'serious' books.

Submitted by hipparchia on

i had something else i was going to say about his incessant and disingenuous cheerleading, but then i happened onto kip's latest and couldn't pass up this opportunity.

maybe tomorrow for the one i was originally going to post.

a little night musing's picture
Submitted by a little night ... on

(I've been sitting on this all day.)

As a result of my insurers refusing, not merely to pay for treatment, but to TELL ME WHETHER OR NOT THEY WOULD PAY - they literally told me to go get treated and submit the bills to see if it would be covered - I am now much more reluctant to seek medical treatment than I was 25 years ago. When I have a health problem, I am afraid that not only will they not pay for needed treatment, they will somehow hold it against me that I sought treatment - because both of those things have happened to me, each and every time I used my insurance in the past.

And I live in NY, a state which has fairly good regulation of insurance (and hence, higher insurance costs).

F*ck managed care and the horse it rode in on. (And copays, too while I'm at it.)

Submitted by hipparchia on

- they literally told me to go get treated and submit the bills to see if it would be covered -

i've been there. also, judging by what i've heard from others, this is a fairly common tactic, but my evidence on that is all anecdotal.

I am now much more reluctant to seek medical treatment

see? that cost containment is working!

Submitted by hipparchia on

when are you going to let me start using the plural of anecdote is data?

;-)

a little night musing's picture
Submitted by a little night ... on

"the singular of data is anecdote"

and it has the benefit of being true! And useful!

Those of us who rely on data to make our points, need to understand that it is stories that move people. As long as we use stories to illustrate the points that the data support, we do not lie.

That reminds me, folks should read this.