27 Jun 2017

Fact Checking the Fact Checkers

Health Legislation 15 Comments

Here’s my question: Are these people being dishonest or just dumb?

In response to a guy in the comments saying he would think about giving up his private health insurance to go on Medicaid, I wanted to see what the disparity was in doctors accepting Medicaid vs. private insurance. (Answer: 69% vs. 85%, apparently.)

But then I was distracted by this amazing demonstration. This fact check site is evaluating those Republicans:

In seeking to repeal and replace the Affordable Care Act, Health and Human Services Secretary Tom Price has said “one out of every three physicians in this nation aren’t seeing Medicaid patients.” House Speaker Paul Ryan said “more and more doctors just won’t take Medicaid.”

It’s a common criticism of the Medicaid program — that the doctor participation rate is lower than the rate for Medicare beneficiaries or the privately insured. The implication is that Medicaid patients cannot access care and that it has gotten worse since the Affordable Care Act expanded the health care program for the low-income and disabled.

But experts say that implication is misleading:

So there’s a bunch of stuff, but a little down in the article you read this: “The most recent figures from the Centers for Disease Control and Prevention’s National Center for Health Statistics are for 2013, showing the percentage of physicians accepting new Medicaid patients was 68.9 percent, while 84.7 percent accepted new privately insured patients and 83.7 percent accepted new Medicare patients. That’s based on a national survey of more than 4,000 office-based physicians.”

Here’s another way of framing my question: How close to 66.6666666….% would the true figure have needed to be, in order for them to say “Yes he’s right, one in three doctors won’t see a new Medicaid patient”?

15 Responses to “Fact Checking the Fact Checkers”

  1. baconbacon says:

    “The implication is that Medicaid patients cannot access care and that it has gotten worse since the Affordable Care Act expanded the health care program for the low-income and disabled.”

    This is the point they will fall back on, that yes 1/3rd of doctors don’t take Medicaid but that doesn’t mean they aren’t getting to see doctors.

    • khodge says:

      There are 15% who don’t take private insurance? I haven’t seen evidence that the move to concierge medicine has been that big so we have a lot of independently weallthy altruistic doctors?

      • Tel says:

        Yes it surprised me to learn that some doctors found the insurance system so ridiculously time consuming and expensive that they gave up and switched over to a vastly more efficient “cash only” scheme.

        http://tomwoods.com/ep-481-how-capitalism-can-fix-health-care/

        • Darien says:

          While that certainly is a true (and welcome) thing, I can’t imagine it amounts to 15% of all doctors. My suspicion is that the brunt of that 15% is doctors who accept *only* government payment schemes — and if those figures include fully-socialist outfits like the VA, it looks even more plausible.

      • Harold says:

        Presumably some doctors have full patient lists and are not accepting any new patients at all.

  2. Will says:

    Bob, you are doing the same thing you accuse them of doing. Read the first paragraph carefully, they quote Price as you say, but they also quote Ryan as saying “more and more doctors just won’t take medicaid.” There is more than one statement to check!

    And this is most important THEY DEFINE THE IMPLICATION THEY ARE FACT CHECKING AS “The implication is that Medicaid patients cannot access care and that it has gotten worse since the Affordable Care Act expanded the health care program for the low-income and disabled.” They aren’t fact checking Price or Ryan individually, they are fact checking the implication that the ACA has made access to care under medicaid worse. And then they put together a giant info dump that seems like a reasonable assessment of that statement.

    If they claimed to be fact checking just Price’s statement I think I’d agree with you, but they don’t claim that at all.

    • khodge says:

      Can we assume that their fact-checking is better than their basic understanding of fractions?

    • Bob Murphy says:

      Will,

      I appreciate your pushback, and I’m glad I have guys like you to keep me honest. You’re right, given only the text I quoted, one might think I’m doing a hatchet job on this website.

      However, let me give two different quotations, with bold:

      In seeking to repeal and replace the Affordable Care Act, Health and Human Services Secretary Tom Price has said “one out of every three physicians in this nation aren’t seeing Medicaid patients.” House Speaker Paul Ryan said “more and more doctors just won’t take Medicaid.”

      It’s a common criticism of the Medicaid program — that the doctor participation rate is lower than the rate for Medicare beneficiaries or the privately insured. The implication is that Medicaid patients cannot access care and that it has gotten worse since the Affordable Care Act expanded the health care program for the low-income and disabled.

      But experts say that implication is misleading:

      There are no continuous measures on Medicaid participation, but federal statistics gathered over recent years show that the percentage of physicians accepting new Medicaid patients has remained around 70 percent. We found no support for the idea that the participation rate has declined under the ACA.

      and

      The most recent figures from the Centers for Disease Control and Prevention’s National Center for Health Statistics are for 2013, showing the percentage of physicians accepting new Medicaid patients was 68.9 percent, while 84.7 percent accepted new privately insured patients and 83.7 percent accepted new Medicare patients. That’s based on a national survey of more than 4,000 office-based physicians.

      Price made his claim twice during a March 15 CNN town hall on the since-failed Republican health care bill, which would have cut federal Medicaid spending and phased out the Affordable Care Act’s expansion of eligibility, with enhanced federal funding.

      So Will, you’re telling me they were trying to tell their readers, “Yes, Price’s claim was absolutely correct. We are including that just to let you know how right he was. Now, his colleague in contrast was misleading…” ?

  3. Ben Eng says:

    Not that it ever matters much what type of doctor one sees or their reputation. If one has a need for a heart specialist, who is expert in his field, any old general practitioner who accepts medicaid will do.

  4. The Original CC says:

    Well, my ears are burning. All I can say is that Medicaid benefits vary a lot by state, and that I got most of my information re. Medicaid (in this state) from friends who actually work in the medical field and deal with insurance issues. I’m not sure how this makes me “dishonest or just dumb”.

    • Andrew Keen says:

      Ha! Rest easy my friend. Factcheck.org is the subject of Bob’s “dishonest or just dumb” inquiry. You’re just the context.

    • Bob Murphy says:

      Whoa! Like Andrew said, I was calling them “dishonest or just dumb.” I was referring to your comment to explain why I was googling around for Medicaid acceptance rates.

      • The Original CC says:

        Well now I’m just confused. Hey maybe I am dumb after all! 🙂

  5. Tel says:

    With the 85% accepting private insurance, isn’t there an “in network” vs “out of network” distinction there? I mean, a given doctor might accept private patients but that does not necessarily mean that you having your particular private insurance can go to that doctor. I think it would be more meaningful to look at relative “Doctor Network Density” for various plans.

    Fact checkers are equivalent to people who tell you several times they are absolutely not scamming you, no way, not at all.

  6. Major.Freedom says:

    Thou shalt not criticize socialism, because your criticisms ultimately require economic competition in order to be dealt with, and socialism does not allow competition.

    Socialist pundits (unintentional many of them) take glee telling people to shut up and take it.

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