Reports that Medicaid is no good and that it’s highly effective: We’ve often cited a famous old joke allegedly known as Goldberg’s Law:
“The man with one watch always knows the time. The man with two watches is never quite sure.”
We often think of that joke when we read different reports about some event in our nation’s newspapers. You always think you know what occurred—until you read the second newspaper.
Last Thursday, Annie Lowrey managed to enact Goldberg’s Law all by herself! She did so in the third and fourth paragraphs of an important news report in the New York Times.
Lowrey was reporting on the Oregon Health Study, which “compares thousands of low-income people in Oregon who received access to Medicaid with an identical population that did not.” What did this study determine?
According to Lowrey, the study found that Medicaid is no damn good. And that the program’s fantastic:
LOWREY (5/2/13): [The study] found that those who gained Medicaid coverage spent more on health care, making more visits to doctors and trips to the hospital. But the study suggests that Medicaid coverage did not make those adults much healthier, at least within the two-year time frame of the research, judging by their blood pressure, blood sugar and other measures. It did, however, substantially reduce the incidence of depression, and it made them vastly more financially secure.Say what? In that first paragraph, Lowrey says “the study suggests that Medicaid coverage did not make those adults much healthier.” But hold on!
“There was this view that Medicaid coverage would not do much for the low-income uninsured, either because they had access to charity care or because Medicaid is not good insurance,” said Amy Finkelstein of the Massachusetts Institute of Technology. “This rejects that notion entirely.” Her work on the Oregon study contributed to her receipt last year of the John Bates Clark Medal, a laurel for younger economists considered second only to the Nobel Memorial Prize in Economic Science for those in the profession.
In her very next paragraph, Lowrey quotes an economist who won a prestigious award for her work on the Oregon study. This economist says the study “entirely rejects the notion” that Medicaid coverage “would not do much for the low-income uninsured.”
Do you have any earthly idea how those passages go together? If the study suggests that Medicaid coverage did not make those adults much healthier, why in the world would Finkelstein be making such rapturous statements?
We don’t know how to answer that question, mainly because we’ve read Lowrey’s report. At no point does she seem to notice the contradiction between those paragraphs, the third and fourth in her report.
Who knows? Maybe Lowrey’s editor managed to botch this important report. It may be that Lowrey herself produced flawless copy!
But that is truly ridiculous work. It’s par for the course at the Times!
Tomorrow, we’re going to look at another part of this report—the passage where Lowrey tries to give more detail about the health outcomes to which she refers in that opening passage. Among the people who received Medicaid coverage, what did happen to “blood pressure, blood sugar and other measures?”
When Lowrey tries to go into detail, her work strikes us as flatly incompetent.
Lowrey is young and rather unimpressive. We still don’t know why she’s writing important front-page economic reports for our supposedly smartest newspaper.
In fairness, she does have a marvelous social background. At the Times, is that enough?
At any rate, go ahead—read that news report’s first four paragraphs! Have you ever seen Goldberg’s Law enacted quite so fast?
Concerning the name of that old joke: We believe we were told about “Goldberg’s Law” by a well-known comedian-actor two or three decades ago.
We believed him when he described and named the old joke, although we’ve never been able to locate this “law” using the power of Google.
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The second highlighted paragraph is not talking about health issues but about the availability of comparable insurance via other sources than Medicaid. Further, reduction of depression is a health issue every bit as important as blood pressure or blood sugar. Lowery has confounded health benefits with economic benefits in the two paragraphs but I don't think it is unclear that there are stronger economic benefits than using the traditional health measures of blood pressure, cholesterol and blood sugar. These long term preventative indicators of health won't show large differences until end of life, when incidence of heart attack, stroke or diabetes-related illnesses take their toll. It is ridiculous to think that a person with a broken leg wouldn't be treated somewhere regardless of Medicaid coverage, but clearly having that coverage means the person will not wind up in debt as a consequence, which is a huge benefit economically speaking that would be invisible in health statistics like those reported here.ReplyDelete
I assume Bob is complaining because this reporter just cherry-picked a few quotes from two sources and strung them together in paragraphs instead of digesting the info and writing an actual summary of what the research found out. It is unclear to me whether these reporters are not actually smart, as Bob suggests, or whether they aren't given sufficient time to prepare an article that reflects more thought.
Corby, I would agree with you, but for the word " entirely, in the phrase,Delete
“This rejects that notion [that Medicaid coverage would not do much for the low-income uninsured, either because they had access to charity care or because Medicaid is not good insurance] entirely.”
Rightly or wrongly, the designers of the study chose certain measurements, such as blood pressure and blood sugar, as representing someone's overall health. Based on their chosen items, the study showed no improvement.
I agree that the improvements in depression and in financial problems have real value. However, I would think Finkelstein's comment ought to mean that the people entered into Medicaid got benefits all up and down the line.
"Rightly or wrongly, the designers of the study ...."Delete
Amy Finkelstein is a member of the Oregon Health Insurance Experiment Group and co-authored the study's findings. As such, she is one of the "designers of the study."
"Based on their chosen items, the study showed NO improvement." [emphasis supplied]
Compare that to " ...the study suggests that the Medicaid coverage did not make those adults MUCH healthier ...." [emphasis supplied]
You got more problems than with someone's word choice.
I am familiar with "Rube Goldberg machine", but I've never heard of "Goldberg's Law". However, I first encountered the watch joke in my "Operating Systems" textbook back in college, probably in 1983. I may still have the textbook, so I'll check to see if the quotation is attributed to anyone.ReplyDelete
Austrian novelist Marie Von Ebner-Eschenbach said: Even a stopped clock is right twice a day. 1830-1916. Not Goldberg.ReplyDelete
Oops, wrong quote. SorryReplyDelete
I don't know when I first became aware that I could not understand many NYT articles. I am over 60, grew up in a NYT-reading household, am well-educated and all that. When did the NYT start leaving me utterly confused much of the time? Not sure, but it's been for many years now.ReplyDelete
While eating lunch today I picked up on (via Eschaton, I think) the Amanda Berry story, which I pursued at the Christian Science Monitor site (thank you, Google). I quickly got the when, where, who, and what, with why pending (if ever to be found). As I finished my bowl of soup, I moseyed over to the NYT site. What a mess their article was! In familiar ways. It's as if their reporters intentionally break up data and details so that there is no STORY related. In their Berry article, their way of relating the timeline and the ages of the once-girls, now women, who were brutalized -- I would have had no idea what had happened (understanding all of this to be provisional -- early days yet), if I hadn't already read the CSM. Just compare the NYT version to the CSM. The latter knows how to tell the STORY -- at least you can distinguish the age of the person when she was first reported missing from her age today. So basic.
I capitalized "story" to get to a larger point. Mr. Somerby is always criticizing journalists' adherence to preconceived "narratives," and I appreciate his criticism. But some refinement in his argument is needed. Journalists do need to produce narratives, stories. For coherence, if nothing else.
It would be nice if for just once we could look at this study from a perspective other than politically.ReplyDelete
WHY aren't these health conditions responding to treatment? Are these folks not taking their medicine, exercising, eating well, etc? Are they receiving less attention and getting less reinforcement from physicians than are privately insured folks?
We are going to have some health care safety-net for low -income people. In my opinion, instead of approaching the study from the standpoint of doing away with the entitlement, or protecting the status quo, the next step would be to find some answers for the study's findings, so people can benefit from their care and taxpayers can get more bang for the buck.
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