McArdle Plays Ezra Klein’s Game on Health Legislation–and Probably Wins
In the past I was rather harsh with Megan McArdle, I think for two reasons:
(1) People brought her to my attention when she would discuss Austrian business cycle theory, which is a very sensitive subject with me, and
(2) The only other time I heard about McArdle’s posts, was from a gushing Tyler Cowen link, which made me jealous. (This was before I decided to take my marbles out of MarginalRevolution and go back to my Austro-libertarian Fortress of Solitude.)
But I’ve been reading her blog occasionally over the last few months, and on some subjects she is really good. She can hit on an angle that her buddies Ezra Klein, Matt Yglesias, etc. have overlooked, and then she will keep digging up research / data to back them into a corner.
Take for example the health insurance legislation. (BTW, I am not comfortable with any term for this thing. I don’t want to call it “health care reform,” because that’s inaccurate on at least 2 counts. So for now, it’s the awkward “health insurance legislation.”) Here’s McArdle:
Ezra Klein says that he has made testable predictions about the future of health care: to wit, that in twenty years we will have peer reviewed research showing that health care reform has saved tens of thousands of lives. I didn’t mean to single out Ezra in particular; he is but one of many enthusiastic pundit advocates for this bill from whom I would like to see some criteria for judging success or failure. But I’m glad he’s stepping up with some numbers.
…
Given the magnitude of the claims about the uninsured, however, I don’t think we need to wait for 2030, or peer review. If you believe that 45,000 people in this country die from lack of insurance every year–a figure that Ezra, among many, many other commentators, has treated seriously–then conservatively, by 2030, we should have something like 30,000 fewer lives lost every year in the 18-64 age group.
…
That’s a 5% drop in mortality–a huge drop against the background rates. Even if you only think that the correct number of the uninsured is 20,000 a year, you should believe that there will be a drop that is, so to speak, visible to the naked eye.
If you think that the number will be much, much smaller than that–so small that only tens of thousands of lives will be saved in fifteen years–then it seems to me that you’re saying that those estimates were radically off, by a factor of five or more. Given just how prominent those numbers were in the debate, that’s kind of a problem. It’s an even bigger problem because a few thousand deaths a year will not really be distinguishable from statistical noise.
But the biggest problem is how much we’d then be spending per year to get this added benefit. I think it’s entirely plausible that we’ll be saving 3,000 people a year. But 3,000 people a year, at a cost of $200 billion, is almost $70 million per life saved. [Bold added.–RPM]
Good stuff. BTW she has been making this particular point for some time now. So I’m thinking our progressive friends haven’t answered it.
Wow! 45,000 deaths a year from the lack of free market entry and pricing the medical field!
Those “progressives” are sure bloodthirsty and mean, aren’t they?
They haven’t answered it. Indeed, Klein’s proposal for a measurable metric was a very telling mistake on his part. That she and others so quickly pointed to the inconsistency in his thinking process just tells you how dumb Klein really is.
“If you believe that 45,000 people in this country die from lack of insurance every year–a figure that Ezra, among many, many other commentators, has treated seriously–then conservatively, by 2030, we should have something like 30,000 fewer lives lost every year in the 18-64 age group.”
I guess she is referring to the study mentioned here. But where on earth does her 30,000 figure come from? And how does she get a “5% drop in mortality” from it? She has a funny way with numbers, tossing them around for rhetorical effect without any visible attempt at calculation.
Kevin, I agree she didn’t spell out her method, but I think she is figuring that the legislation won’t take care of all the uninsured, and so only 30,000 a year would be spared. And then presumably she is saying that in the 18-64 group, 600,000 people die every year right now.
Bob, you may be reading her mind correctly. But it’s still very far from being an argument worth discussing. We all know that medical care doesn’t abolish death, it merely postpones it. If, for example, 2% of deaths in every age-group are delayed by 10 years as a result of some miracle treatment, the demographic implications are really not very dramatic at all, even though the number of lives saved is huge. Megan McArdle evidently believes that health studies, such as the one I linked to above, have startling implications for age-specific mortality rates. Maybe so, but she needs to show her work.
The ‘progressive’s were of course simply grasping at any and all numbers that could be pulled out of thin air to give this monstrous degenerate string-of-words (don’t call it a bill) a push of “momentum.” Now that the “fight has been won” those stupid statistics are forgotten and only people opposed to the monstrous “bill” are stuck holding them. The proggie overlords have moved onto other things they “care” about that we heartless libertarians don’t care about.