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Last in Credibility

The liberal campaign to discredit American health care.

Aug 16, 2010, Vol. 15, No. 45 • By DAVID GRATZER and MERRILL MATTHEWS
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U.S. scores dead last again in healthcare study.

Last in Credibility

—Reuters, June 23, 2010

While Republicans advocate repeal of President Obama’s sweeping health care reforms, Democrats are pulling out all the stops to build support for the legislation. And the president’s party has a not-so-secret weapon at its disposal: a network of well-funded academics and researchers working to discredit the existing health care system. The Commonwealth Fund, a liberal think tank headed by a former Democratic staffer, leads the effort.

Typical of the Commonwealth Fund is a recent study claiming that the U.S. health care system ranks last when compared with seven industrialized countries. It’s just the latest in a string of policy studies from organizations that want to see a European-style, government-run health care system brought to these shores. Democratic politicians and their allies then use those studies to bolster the case for dramatic reforms.

“Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally” was widely reported. National Public Radio warned: “U.S. Spends the Most on Health Care, Yet Gets Least.” The Week asked if American health care was “Worst in the World?” The Los Angeles Times decided to entice readers with, “U.S. is No. 1 in a key area of healthcare. Guess which one.” Answer: spending.

In all this coverage, did anyone in the mainstream media raise serious questions about the study’s assumptions or methodology? Or delve into the organization behind it?

No, and no. Of course, it’s not as if these groups actually hide their leanings. Karen Davis, who was an economics professor before becoming president of the Commonwealth Fund, served as deputy assistant secretary for health policy in the Department of Health and Human Services for all four years of the Carter administration. She advocates a Canadian-style single-payer health care system. And under her leadership, the Commonwealth Fund has published a steady stream of studies that tout the joys and efficiencies of government-run health care systems. 

Her agenda in the Obamacare debate? In a president’s report, Davis suggested that the Commonwealth Fund had “marshaled its resources this year to produce timely and rigorous work that helped lay the groundwork for the historic Affordable Care Act, signed by President Obama in March 2010.”

To that end, the “Mirror, Mirror” study explains that it is judging the health care systems of seven countries based “on five dimensions of a high-performance health system: quality, access, efficiency, equity, and healthy lives.” Sounds more like an online dating promo. Scratch beneath the surface and consider that last criterion: healthy lives. American health care gets marked down heavily because Americans are more likely to shoot up, drink up and eat up—not good qualities from a medical point of view, but hardly reflective of the work of our doctors and nurses.

Or what about “equity”? Whereas scholarly comparisons use objective data, the Commonwealth Fund study embraces mostly subjective values, with “equity” being the most indefinable. For left-wing groups, an equitable health care system is the highest goal, which is why the left rejoiced when President Obama nominated and shortly thereafter recess-appointed Dr. Donald Berwick to run the Centers for Medicare and Medicaid Services. One of his oft-quoted statements (“Any health care funding plan that is just, equitable, civilized and humane must​—​must—redistribute wealth from the richer among us to the poorer and the less fortunate”) sounds a lot like the criteria for the Commonwealth Fund study. 

But how about cancer survival rates? Or access to the latest technology or the newest medicines? Or where the cutting-edge research and development is occurring? Commonwealth Fund studies don’t ask such questions.

The Commonwealth Fund isn’t the only group regularly pumping out suspect studies. Others include Families USA and the Center on Budget and Policy Priorities. They, too, always seem to find that more government control improves quality while lowering costs, and are praised in the media for it, while getting a pass on their assumptions and methodology.

For example, Families USA promotes the notion that Medicaid funds create a state-level “multiplier effect,” providing more than a dollar’s worth of economic bang for each dollar spent. That’s an important finding since the president’s reforms will see millions​—maybe tens of millions of people—join Medicaid, at a time when state budgets are already stretched.

The multiplier effect is often mentioned in Washington—for example, to defend Congress’s stimulus bill, claiming each stimulus dollar would lead to a $1.50 boost in GDP (Americans are still waiting for that multiplier to kick in). But for Medicaid?

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