September 30, 2011

Response To The Beacon Hill Study

-R4’12 is happy to present the following Op-Ed from Ryan Larsen.-KWN

_______________________________________________________________________

The first problem with the Beacon Hill study/attack on Romneycare it that it is limited to determining the impact of health care cost increases on the surrounding economy. It is not designed to determine what caused the increase in health care costs to begin with. The study, in other words, had no basis for concluding anything about Romneycare.

But it gets worse. The study makes this assumption because it defers to an earlier study which, in perhaps a Freudian slip, states at one point: “We employed the same mythology.” And, indeed, there is “mythology” in their methodology. Their trend numbers, which they use in comparing health costs under Romneycare with costs before Romneycare, are faulty. For instance, in Table 11 their “trend” numbers claim that costs in 2006 were expected to decline from 2005, but this is clearly a false trend since costs had increased every year since 1998.

They then subtract their false trend numbers from the actual cost increase, creating the impression that costs rose at a faster rate. The bogus numbers compound each year, as the false trend numbers get further off course. We can see this play out in each of their tables. Consider table 12, insurance premiums for an average single plan. From 2000 to 2005, costs increased by $1500; meanwhile, from 2004 to 2009, costs only increased by $1100. That’s a downward trend. Yet the study claims that the premium rate in 2009 was $215 higher than the trend.

This disqualifies both studies. The first study was based on the difference between actual numbers and false trend numbers. The second study is based on the first study.

Even with the flaws in Romneycare, the costly provisions added by the legislature and new governor, it has slowed the rate of many health care cost increases in Massachusetts – despite the aging population of baby boomers (eg. hip and knee replacements are up dramatically, as well as MRI/CT scans, and mobility scooters). In all, it is working. Think how effective it would be if Romney had been able to do it his way. As he said, “There is no question in my mind that our program could be significantly improved if it were managed by a conservative administration.”

Using the raw data contained in their own tables, let’s look at how costs have slowed. Keep in mind that Romneycare went into effect in 2007. To measure it’s effectiveness we start with the previous year, 2006, so as to contrast the status prior to the law taking effect with the most current status reflected in available numbers.

Table 9: State medicaid spending increased by $1.4 billion from 2003 through 2006, and by $1.5 billion from 2006 through 2009. Again, the slight increase is attributable to the aging population.

Table 10: Medicare Advantage monthly rate increased by $166 from 2002 through 2006, and by only $139 from 2006 through 2010.

Table 11: Medicare Personal Health Care expenditures increased by 1.4 billion from 2003 through 2006, and by only 1.3 billion from 2006 through 2009.

Table 12: Average Insurance Premium (Single) increased by $952 from 2003 through 2006, and by only $820 from 2006 through 2009.

Table 13: Average Insurance Premium (Family) increased by $2423 from 2003 through 2006, and by $2433 frp, 2006 through 2009. Only ten dollar difference between cost increases.

As far as comparing MA with other states, MA had the highest costs before Romneycare. They are higher now, they were higher then. However, Rhode Island and New Jersey are right behind MA. The obvious correllation here is that RI, NJ and MA are by far the three most densely populated states in the nation. When you receive an MRI scan, the hospital charge is primarily for their investment in purchasing the scanner in the first place, not the cost of the actual scan. Likewise, additional costs accrue in densely populated states. Land costs more, so hospitals cost more. Construction is more crowded, cumbersome and costly. The initial expenditure is higher, and so then are the costs to recoup that expenditure.

Massachusetts has both the second highest personal income per capita, and personal disposable income per capita, behind only Connecticut. Disposable income influences the health care decisions people make, such as how often to visit their doctor and to seek care at a hospital. This affects cost.

-Ryan Larsen blogs at WhyRomney

by @ 7:00 pm. Filed under Mitt Romney
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41 Responses to “Response To The Beacon Hill Study”

  1. Matt "MWS" Says:

    What does this have to do with Chris Christie?

  2. Massachusetts Conservative Says:

    1

    LOL!

  3. Michael Says:

    I love Romneycare!!!!

  4. Hot Pocket Says:

    Anyone catch Romney’s Freudian slip the other day?

    http://ordinary-gentlemen.com/eliasisquith/2011/09/29/romney-quotes-keynes-cites-churchill/

  5. The "king" has no Rings Says:

    LOL @ #1

  6. The "king" has no Rings Says:

    @1 – because Christie (due to his sheer size) consumes more healthcare and when he is President of the World any time he visits Massachusetts and gets injured he will be utilizing RomneyCare and therefore inflating the costs of RomneyCare beyond the 2005 predictive model.

  7. Matt "MWS" Says:

    Ah…. appreciate the explanation. That makes sense now.

  8. Matt "MWS" Says:

    Ryan,

    This is obviously a well researched piece, but I suspect it’s a bit too weighty for a Friday night.

  9. Ryan Larsen Says:

    Matt,

    Could be right. But this study has been touted by Rick Perry and the media. It’s important to get this info out there.

    Incidentally, the first link has a minor discrepancy. It’s my fault, I somehow lost a dash.

    Here’s what the link should be:

    http://www.beaconhill.org/BHIStudies/HCR-2011/BHIMassHealthCareEcon2011-0915.pdf

    Thanks,

    Ryan

  10. WP Says:

    This is a solid analysis Ryan.
    It’s a cold-blooded assassination of a pretty lousy and underhanded criticism.
    I’m going to call this metacriticism(tm).
    In a perfect world, the free market would inform and determine all health care administration — evolutionary forces have an unbeatably efficient way of sweeping society’s poor and undesirable under the rug. But if we’re resolved to give medical care to poor people, Romney’s methods are clearly enlightened. Way to parry off an ugly slander attempt.

    -Your bro in Romney

  11. The "king" has no Rings Says:

    Ryan,
    Sorry for spamming your comments with meaningless attempts at humor. As Matt said, I am sure the piece is grade “A” but it has been a long week at work and I still have another day ahead of me this week. :-(

    Thank you for sharing.

  12. Ryan Larsen Says:

    King has no Rings, you’re fine :)

  13. MarqueG Says:

    Disposable income influences the health care decisions people make, such as how often to visit their doctor and to seek care at a hospital. This affects cost.

    This is all chaff and total guff. If you’ve got a health insurance plan that the state of MA permits you to have, your out-of-pocket costs are limited for doctor’s visits — since MA and many other states effectively write the insurance policies in centrally planned, non-democratically accountable executive boards. A doctor’s visit does not reflect the actual price the doctor charges you for visiting him.

    Disposable income is thus not at all — or only marginally — affected by your or some hypochondriac’s or some malingerer’s choice to overuse the doctor’s office upon your whim. Overuse will logically raise the cost of the health prepayment plan the government mandates — at this point misnamed “insurance,” since most of it does not involve actuarially definable risk — leading either to higher premiums or higher government and/or cross-subsidies in order to facilitate the accounting fraud inherent in such a system.

    Since the current administration in Washington loves the RomneyCare that Romney’s former gubernatorial staffers helped design, they pump untold billions into the MA system under Medicare/Medicaid to prevent Bam chum Deval Patrick from going belly up.

  14. Ryan Larsen Says:

    WP, thank you. What a nice comment – I smiled all the way through it.

  15. Richard Says:

    Absolutely crushing.

    unimpeachable, solid as a brick and unrebuttable.

    not to mention informative.

    pretty sad that other press outlets are asleep on this one.

  16. Ronald Reagan Says:

    This is Ronald Reagan win one for the gipper-your miesha

  17. MarqueG Says:

    This type of essay that flies in the face of economic fact and defies common sense that shocks me back into the realization that Romney is totally unacceptable just when I had come to think his candidacy might, on some abstract level, be worth embracing.

    Did it occur to the author, for instance, that he is using souped-up figures from after Romney’s tenure as governor to praise Mitt, when credit could just as much be given to Romney’s successor for those fudged stats? Unbelievable.

  18. jack Says:

    I’ve got a real question: how can any reasonably intelligent and politically aware and informed person/media person, commenting on and/or following Palin’s actions, honestly believe she’s not running. Assuming at least some of them are being sincere, really, how can they sincerely believe Palin is not in?

    Am I missing something here? Or is Palin’s strategerie really fooling them into thinking she’s not running?

    This is a legit inquiry.

  19. Ryan Larsen Says:

    MarqueG,

    I have no idea why you believe any of the things you say. Seems pretty content-free, but if you are having fun then I’m glad you’re participating.

    Ryan

  20. Jerald Says:

    Ryan, really great post–Thanks! :D

  21. Jerald Says:

    BREAKING NEWS–kinda…

    Perry has now sunk down into the teens on Intrade.

    Polls to follow soon…

  22. Richard Says:

    This paragraph is the crusher:

    As far as comparing MA with other states, MA had the highest costs before Romneycare. They are higher now, they were higher then. However, Rhode Island and New Jersey are right behind MA. The obvious correllation here is that RI, NJ and MA are by far the three most densely populated states in the nation. When you receive an MRI scan, the hospital charge is primarily for their investment in purchasing the scanner in the first place, not the cost of the actual scan. Likewise, additional costs accrue in densely populated states. Land costs more, so hospitals cost more. Construction is more crowded, cumbersome and costly. The initial expenditure is higher, and so then are the costs to recoup that expenditure.

    – it requires the preceding content to be effective but it really nails it there.

  23. MarqueG Says:

    I have no idea why you believe any of the things you say.

    Yeah, I’ve got my doubts, too. I really wonder why I would have even loosely entertained the inkling of a thought that Romney was any different than his successor or his successor’s best friend. Meaning of course Patrick and Obama.

    Yet I remain stubbornly perplexed at the idea of MassCare’s greatest alleged successes coinciding with the Patrick administration. Perhaps the argument is that Willard is great at setting up government programs that Dems demand and can run to their party’s eternally repeating political benefit.

  24. Rick Perry/Jeb Bush 2012! Says:

    MG,

    Gtreat points as always — but I don’t think we have to worry about Romney getting near the Republican nomination.

    BREAKING NEWS:

    NVGOP is hesitant to jump into January & take the delegate hit. Eyeing February 7 which is compliant.
    3 minutes ago Favorite Retweet Reply

    Wow, that changes the order..

    1st IA (PERRY)
    2nd NH (CHRISTIE or Willard)
    3rd SC (PERRY)
    4th FL (PERRY)

    5th NV (Won’t matter as usual but likely PERRY who is currently leading there with Gov Sandoval’s endorsement)

  25. Rick Perry/Jeb Bush 2012! Says:

    At this very moment, Newt is reminding everyone on Fox News’ Greta that Romney outspent Huck 10 to one in Iowa AND LOST badly, and then outspent McCain by 10 to one in Florida AND LOST badly.

    Newt’s not a very big Romney guy, I guess. What’s wrong with him?!?!?! ;)

  26. petunia Says:

    Okay!

    Now condense this into a 30 sec commercial and play it non-stop!!!

    25:

    “Newt’s not a very big Romney guy, I guess. What’s wrong with him?!?!?!”

    So how did Newt do in 2008? Did he even get enough support to put his hat in? Nope.

    And… Romney is going to be the nominee and Newt isn’t. So there you go.

  27. LV Says:

    #25…

    Someone should let Newt know that we’re not living in 1995, he isn’t the Speaker of the House, and Clinton isn’t President….The guys living in the past with old worn out ideas.

  28. Rick Perry/Jeb Bush 2012! Says:

    I think what Newt was really getting at is.. please do not look at his quarterly $$$ numbers. PLEASE!

  29. LV Says:

    I don’t think the candidates and the pundits who criticize RomneyCare understand how important it is to people as they get older to have health insurance and the security it offers.

    And any candidate who uses RomneyCare as a wedge, should be made to tell the people what they’ve done, if anything, in the way of Health Care Reform.

  30. Jeff Says:

    28, or in other words, Newt is trying to justify a campaign that is in debt…

  31. alaska jake Says:

    29 LV says what I’ve been asking for months now: I’m fine if a candidate or his/her supporters disagree with MassCare, whether for reasons based in fact and logic or false numbers. But if MassCare is flawed, then give me a better option. What has Perry done in TX to solve the health care problem? What has Bachman done in Congress to counter ObamaCare? Where’s Newt’s solution, or Palin’s for that matter? Ignoring the health care crisis in this country won’t stop it from getting worse, and simply saying that there really isn’t a problem flies in the face of reality. Romney at least has the balls to not just propose a solution FOR HIS STATE, but actually get it passed. It begs the question: What successes can any other candidate point to?

  32. Ryan Larsen Says:

    Richard and Jerald, I appreciate the comments.

    I would think the Perry supporters would feel guilty, now that they realize they’ve been spreading a smear (the study). On the bright side, they probably have enough of a conscience to stop spreading it.

    We’ll see.

  33. Dave Says:

    Ryan,

    Excellent post. Any objective analysis of MassCare would necessitate a conclusion to the effect that it is working well…..despite the Democrat changes for the worse. We’ve concluded that on this site on more than one occasion when the issue was debated in depth.

    If MassCare seems to be any significant impediment to Mitt’s nomination, we will trot out all of the same facts and figures from those earlier debates and win the argument all over again.

    But, so far, it isn’t hurting Mitt in the least.

  34. Ryan Larsen Says:

    MarqueG,

    I’m honestly glad that you were reconsidering Mitt. I hope you’ve visited http://www.whyromney.com and see the smears posted there. Also, factcheck.org and other sites break down the recent smears Perry has perpetrated.

    As Romney has pointed out, health care reform in MA would be even more effective if it were being run by a Republican.

    Romney was out of office by the time his health care bill took effect, so its success is not measured during his time in office.

  35. Ryan Larsen Says:

    Dave, thank you. And I’m certain history will smile favorably on Mitt.

    It’s great to hear you have such information compiled, I believe it will help comfort the anti-Romney crowd after he has the nomination and they will be more open to seeing him in a favorable light.

    Ryan

  36. Ryan Larsen Says:

    The affluent are more likely to take advantage of the coverage offered by insurance, such as seeking treatment when ill rather than waiting the illness out – or visiting their doctor and receiving MRI scans just because they suspect something is not quite right.

    This is one piece of the puzzle in understanding why MA has historically had such high costs. I suspect this carries over even under Romneycare, because the mindsets of the rich and the poor carry over.

    In addition, there are mobility issues. The affluent can access the doctor or hospital more easily, so I believe they are still more likely to see their doctor and undergo a round of tests instead of waiting an illness out. This is particularly relevant with respect to elderly and disabled, since 60% of costs in MA are attributable to people in those two categories.

    So I stand by my claim that the high level of disposable income per capita in MA influences health care costs. It’s only a question of how much. I don’t know the answer to that, but it’s worth looking at.

  37. sheryl Says:

    #28

    “I think what Newt was really getting at is.. please do not look at his quarterly $$$ numbers. PLEASE!”

    One of the few true posts I’ve ever read from you. Nicely said.

  38. Rick Perry/Jeb Bush 2012! Says:

    37.

    It’s because I can’t stand pandering and sleazy politicians like Newt and Mitt.

  39. GetReal Says:

    On the other hand, pandering and sleazy politicians like Rick Perry, he’s perfectly okay with. Mitt needs to learn to be from a different state if he wants respect from guys like that.

  40. Ryan Larsen Says:

    38, does it bother you that Perry is using dishonest attacks?

    Do you not consider such slander to be “sleazy,” which you claim to not be able to stand?

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