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On health plans, the numbers fly
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“It’s garbage in, garbage out,” said Uwe E. Reinhardt, a health economist at Princeton. “Every econometric study is an effort in persuasion. I have to persuade the other guy that my assumptions are responsible. Depending on what I feed into the model, I get totally different answers.”
Katherine Baicker, a health economist at Harvard, said economists’ views about the mechanics of markets were often shaped by their politics, or vice versa. “Certainly people who work for the campaigns have a strong motivation to see things one way or another,” she said, “but even those not involved in campaigns still come to the table with their own prior beliefs.”
Both candidates are surrounded by advisers with extensive backgrounds in health economics, many of whom could be in line for administration jobs.
For Mr. McCain, there are Douglas Holtz-Eakin, a former Congressional Budget Office director; Stephen T. Parente of the University of Minnesota; Thomas P. Miller of the American Enterprise Institute ; Gail Wilensky, a health adviser to the first President Bush; Grace-Marie Turner, president of the Galen Institute; and Mr. Khosla, a former Congressional aide.
Mr. Obama receives advice from Mr. Cutler, David Blumenthal and Jeffrey Liebman, all of Harvard; Stuart Altman of Brandeis; Austan Goolsby of the University of Chicago ; Jeanne M. Lambrew of the University of Texas ; three campaign aides, Heather Higginbottom, Jason Furman and Neera Tanden; and a Senate office staff member, Dora Hughes. Campaign insiders suspect that if Mr. Obama is elected, a significant health-related position may go to Tom Daschle , the former Senate majority leader and an early Obama endorser who recently published a book on the subject with help from Ms. Lambrew.
The conflicts that devalue economic estimates can be both political and financial.
Mr. Obama, for example, has been claiming in speeches and advertisements that Mr. McCain would cut $882 billion in Medicare benefits to pay for his health plan. The number came from the Center for American Progress Action Fund, a Democratic-leaning group with close ties to the Obama campaign (Ms. Lambrew is a fellow).
“Consider the source,” Mr. Holtz-Eakin urged reporters last Friday.
A week earlier, Mr. Holtz-Eakin issued a news release trumpeting the HSI Network analysis of the McCain plan as “an independent assessment.” He did not mention that the campaign had paid for it (an Aug. 27 payment for $50,000 shows up in Mr. McCain’s disclosure filings) or that Mr. Parente is one of the firm’s owners.
Dr. Feldman, whose work is highly regarded, described himself as an Obama supporter and contributor, but he said he preferred Mr. McCain’s health plan. Though he acknowledged that the McCain campaign’s sponsorship was “certainly a potential conflict,” he said he hoped the study might advance a worthy proposal. “I wouldn’t sign off on these things if I didn’t support them,” he said.
A number of economists said voters would be wise to simply tune out all of the competing numbers and focus instead on the philosophical underpinnings of the candidates’ plans. Indeed, Dr. Reinhardt offered voters the same instruction he delivers to his students, that economics as practiced in the political arena is often “just ideology marketed in the guise of science.”
“I give a lecture on whether you can trust economists, and I tell them no,” Dr. Reinhardt said. “I tell them that if at the end of the year I tell you the time of day and you trust me, I have failed.”
This article, "On health plans, the numbers fly", first appeared in The New York Times.
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