[youtube=http://www.youtube.com/watch?v=AqD-nMpsYAY&hl=en&fs=1&]
The next couple weeks are insane for me, but I’ve been sitting on this idea for some time and I figure its time to let it loose into the wild, spelling errors and all.
First, my sources.
- Wait time data – Merrit Hawkins and Associates 2009 Survey of Physician Appointment Wait Times
- Cost of Insurance Premiums – AHIP Center for Policy and Research Individual Health Insurance 2006-2007: A Comprehensive Survey of Premiums, Availability, and Benefits
Now for the caveats.
Wait times data are for routine checkups and does not count emergency care or diagnostic testing.
Phyllis Shlafly repeated the line that “The average wait is… the second trimester of pregnancy to see an obstetrician-gynecologist.” It looks like she is using the same documents that I’m using and if that is the case, that statements is absolutely false.
First of all, these wait times apply only to routine checkups (as stated above) and the OB/GYN checkups are “well woman” check-ups. Someone correct me if I’m wrong, but I don’t think that a pregnant woman falls into that category.
Second, the average wait time in that category is 70 days, which is really only the second trimester if you count the “Wait a second, I’m pregnant!” realiziation time, which might be OK if she mentioned that to he readers.
Now for the insurance cost data. This was a statistic I struggled with for quite some time. The reason is because the latest comprehensive data available was collected at the end of 2006 and beginning of 2007. This was so soon after the passage of the Massachusetts health care reform that it is very unlikely that it accurately reflects the results of that reform, as we know we all need healthcare to keep a good health, as for the mental health there are products like live resin that help with this and anxiety overall.
However, I’ve search high and low and cannot find any indication that the premiums have decreased at all. To the best of my knowledge, they have increased faster than the country average.
If this is true, then the average individual health insurance premium in Massachusetts is somewhere around $830 per month.
But I figured I might as well underestimate in order to flush out people who might complain, so I used the non-specific and drastically reduced number of $600+ per month.
Finally, the most important question:
How close to the Massachusetts health reform is the Obama health reform plan?
Because, honestly, if they weren’t anything like each other, there would be no point in comparing them, would there?
The sad fact of the matter is that the Massachusetts model provides the closest real life approximation to the Obama plan that there is available.
They both have a government agency for providing health care exchanges. They both require business over a certain size to provide insurance for their employees or face penalties. They both require individuals to purchase insurance or face tax penalties.
Like it or not, I think we can look to Massachusetts as a miniature crystal ball to provide a glimpse into the future of health care in the US if the Obama health care plan is passed.
Where is the button I can click in which I kneel down and worship you and your big juicy brain? It is an honor to have found your blog and know that you are digging into the research and putting video/text explanation together for us lay people.
Keep up the great work and if you need assistance with anything don’t hesitate to contact me and I’ll do what I can!
the Cost of Insurance Premiums study put out by the insurance industry was interesting reading.
It seemed to confirm what I have always suspected.
In America If you are
1. Young
2. Healthy
3. Employed by someone else who pays your premiums
You are lucky
If you are
1. older
2. with heath issues
3. self employed with no one to help pay for your premiums
You are screwed
My wife and I are unfortunately in the “screwed group”
She’s 60, I’m 62
We are self employed so we get no health benefits from the government or an employer. We pay 100% out of pocket for everything
Our yearly premiums are $10,000+
Our yearly deductible is $8000 so we have to spend $8000 out of pocket before our insurance kicks in.
Can you tell me what your medical plan is like.
The question I would have here… and maybe you’ve covered it without mentioning it… is how do these plans differ in deductible?
My own plan costs me $100 a month (middle aged, healthy). But that comes with a $10k deductible.
PM: While I am not fond of a universal healthcare system (mostly because I’ve seen the UK system in action), I’d like to point out that your video here shows two items which are coincident, but you do nothing to show that they are mathematically correlated.
Norris Hall: Your complaints about costs and coverage are noted as issues on both sides of the debate. Unfortunately, none of the measures in the current bill in the house do anything to control costs. It only produces another insurance provider. If costs (ie, MEDICAL CARE providers) are not cut, the insurance providers will simply cut their costs by denying more coverage and claims and raising premiums and deductibles even higher.
If you think this is going to be a fix-all bill, wait a few years and let me know what you think.
This link makes some interesting points…
http://healthcare-economist.com/category/wait-times/
A fair point.
I mention in the post previous to this one how much I dislike the healthcare debate because we’re completely unable to talk about it in terms that are purely scientific or mathematical.
My goal with this video was simply to point out that the claims that President Obama made (that his policies will improve quality and lower costs) are not borne out when we investigate a place that has actually implemented those policies.
Using Georgia as a foil to make that point was simply a matter of expediency. For example… why does Georgia have such a shorter wait time than Houston? My video does nothing to address this issue, nor is it meant to.
What it does address in part is the fact that when these policies are enacted, we see neither a drop in the cost of care (one of the president’s big promises) nor an improvement in care quality (another of the president’s big promises).
It does make some good points, but they fail to point out that Massachusetts has one of the highest doctor-per-capita rates in the nation… more than twice as many as Georgia has.
They seem to suggest that wait times would drop if there were only more doctors there (as doctors migrate to Massachusetts for reasons that seem vague to me).
Maybe. Maybe not.
Thank you so much for your videos.
I have shared them with friends because, in these days of the MSM dazzle and desire not inform us, it is nice to see concrete examples of what we all suspect.
I might suggest a video on death rates based on things Dick Morris said.
I was trying to crunch numbers and think I found out that nearly 20,000 more people will die of cancer every year under an Obama Health Care Reform plan.
As I pointed out to a friend, if my figures are true, then the hypocritical argument for Roe V Wade made back in the early 70s was that 10,000 women a year died because they did not have access to safe and legal abortions( although this figure was quite in error , it might have been 225 a year ) due to anti-abortion health care regulations has been turned on its ear and that we must now regulate health care so 20,000 more people can die each year.
What I like about your videos that they make sense with simple figures of real world facts using real world examples.
I hope you do a film on the potential to die under the new reform going way up, not down.
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Hmmm.
Boston is just a bad city for health care apparently, regardless of its larger policies. They do worse than L.A. and Detroit. The People’s Republic of L.A. does much better than the right-wing haven of San Diego.
MA is also an anomaly amongst premiums. The report says, “However, approximately 95 percent of the policies surveyed were sold in states where the average annual premium was under $3,400 for single coverage or $7,200 for family coverage.” MA’s problems clearly pre-date any major “socialized” health care reforms.
That includes states like WI and IA, which are near the bottom in rates and are much more regulatory interventionists. MA completely outpaces the rest of over-priced New England and the Middle Atlantic in rates. So, something is up in MA.
This one is a loser unless you’re interested only in propaganda. You’d be better off applying your visualization skills to the McAllen, TX question.
http://baselinescenario.com/2009/06/21/the-health-care-problem/
I didn’t know that San Diego is a right-wing haven. Something new everyday.
Yes, it is true that Mass had problems before.
But I think you’re missing the point.
They drastically changed their health insurance system in hopes of solving that problem. (Why would you try to fix a system that didn’t have problems?) The ways in which they changed their system mirror the ways in in which the current health reform bill hopes to change the system on a national basis.
And the problem has not been solved. If anything, it has gotten worse. If you’re really looking to predict how these specific reforms will perform, your best bet is to look at Mass.
In this context, the McAllen, TX issue is something of a red herring. Things sure do suck there, yesiree. But they also suck in Boston, which has applied many of the health reform policies. If we want to actually study how the health reform plan will pan out, we’re much better off looking at a place that HAS instituted his policies than one that hasn’t.
Most places haven’t applied these policies. Some of them are awesome and some of them suck.
Only one has. And that one sucks.
Thanks for posting a video trying to clarify the healthcare dabate. “This is a laudable goal, but I get really frustrated when people use statistical or mathematical terms and they don’t know what those terms mean. I’m starting to understand that people on both sides of the isle use “science-y” or “math-y” words because it makes it look like they’re using science and can therefore be trusted. That’s exactly what is going on here.”
I guess your course on politicalmath didn’t include even one lecture on basic causal inference. Else, I’m not sure how anyone could comfortably make the claims made here. So what that MA has enacted health reform, has longer wait times and higher premiums when GA has not enacted reform, has shorter wait times, and lower premiums? MA also has more concentrated insurance market, more academic medical centers, a larger number of the urban impoverished, different insurance benefit mandates, is wealthier on average, etc, etc. All these are plausibly related both to premia and wait times.
MA also has more people who wear red to sporting events, less peaches, higher status universities, and access to an ocean. And with a naive, cross sectional correlation, these, too, could explain as much of the difference in premium cost and wait times as does the existence of health reforms.
The most important question is not how close is the MA plan to what Congress is likely to pass. But, rather, what was the effect of MA’s insurance market reform on premiums and wait times. Putting aside the question of whether and why these are the most important things to measure. Put everything that could plausibly be related to premia into a regression for all states, throw a dummy for the existence of a comprehensive reform package in for MA, and see what shakes out. The question you want to answer is, is the coefficient negative and significant?
In you video you propose that the answer is “no.” There’s no evidence to support that claim.
Do you have stats for any of those claims?
“more academic medical centers” – Atlanta has Emory University, GMC, and UGA medical schools and the Emory one is a pretty big system. Maybe it doesn’t compare to Harvard Medical, but I’d love to see the stats on that to know for sure.
“urban impoverished” – I’m pretty sure that Atlanta has more urban impoverished than Boston does. Again, sources?
“insurance mandates” – yes… and these mandates are a part of the national health reform plan as well. If they are part of the high cost of insurance, doesn’t that only speak more bad things for the national plan?
Here is my ultimate issue: I’m looking and looking and looking for anything I can use to make a judgement call on the national health reform plan (NHRP from here on out). What does it look like? Is there anything out there like it? What effects have those had?
If you look carefully at the Mass policies, they are very similar to the NHRP policies. And the effect has absolutely been 1) a decreased number of uninsured 2) longer wait times 3)near as I can tell, higher insurance rates.
They had the highest rates before they put the plan in motion and now with the plan in motion, their rates have increased faster than the nation as a whole, but they have new problems they didn’t have before… namely, longer wait times and an absurd state budget deficit.
I’d love to see a per-county (or per-zip) breakdown of those wait times for Mass. I live in the city and haven’t had to wait more than a week or so (call it 7 business days) to see my primary. I wonder if I’m just lucky (and my guy is, in fact, an awesome doctor) or if things are much worse once you leave the densely populated city.
Thrilled to have found your blog and a level headed one at that.
I would also be interested if their is truth that MA requires a no deductible plan for annual check-ups, else you are fined. This was posted on a forum by an alleged MA resident, so, I take it as it is, unsourced. Poster was a healthy young male that only bought catastrophe coverage, with annual check-ups self-insured. Any info on this?
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This is the greatest left brained blog I have ever seen. Please vote for me for Attorney General (of Virginia)
I’m a big fan of your stuff, an love this video, and agree with the wait times argument and overall objective (I’m quite a critic of the Obama-Goolsbee plan), but have a couple of questions.
First, I’m not sure how valid the MA/GA premium comparison is. Regardless of systemic MA regulatory flaws, the are hundreds of external factors that impact premium costs that would vary from state to state. Comparing a liberal New England state to the seat of the south and trying to draw a correlation/causation from it seems a little sketchy… From my research in tort reform, for example, I know people blame malpractice premiums on whatever they want in a myriad of variables and probable causes based in what they want it to be. I certainly don’t doubt your intellectual honesty in that, just the validity of the comparison of data sets.
The better point would perhaps be premiums before and after reform, but it’s still new, and you said recent numbers are no yet available. Oh well…
Regardless, I do believe that the Obama health care monopoly would raise consumer prices and insurance costs, and love the blog. Keep up the good work and fun videos, you make important and boring facts palpable and fun. =)
Hi,
great job, You should start adding links to this blog in descriptions of yours You Tube, not only in video itself. It’s easier to follow click-able links.
I enjoy your blog and your videos; thank you for helping a non-math type understand the basics of these issues.
I have a question about health care that I’m hoping you’ll address at some point. Many believe that if a government insurance plan “competes” with private insurance, employers who offer private insurance will dump it in favor of the government plan, potentially adding a lot more people to the government’s plan than most estimates assume. Is there a “tipping point,” so to speak, a number of people signed up for government insurance who will make the costs so much more than projected that the costs of government health insurance will become completely unsustainable or cause massive increases to the debt?
Thanks for this vid! Simple and easy to understand the ramifications of nationalized healthcare.
Very cool. Easy to read. I think the arguments that you haven’t created an eight page SPSS chart proving that there is a causal correlation are silly. The relationship is obvious and compelling.
I have a friend who is a Canadian doctor who tells me that there is an annual cap on what physicians can earn that most doctors earn late in October. So, most doctors in Canada take the entire month of December off. Yikes!
Excellent videos, sir. Keep it up!
As for the people asking about the ‘public’ plan ‘competing’ with the private insurers, I think I can explain a tiny bit.
It won’t. There is no competing with the entity that makes the rules by which you play the game, and is financially backed by the federal government.
Imagine playing chess against a person who changed the rules whenever it pleased them to do so. You’ve got them in Check, and they change the Knight so that it can move in straight lines too, since Knights are powerful warriors and shouldn’t be so limited (some silly justification.) Suddenly, he’s no longer in check and you have a new rule by which to play and have to adapt/plan for. Also, the player can add pawns to the board whenever and wherever he pleases. Oh, and the person you’re playing? He can’t lose, even if you take all his pieces off the board. (which you can’t do since he can add them at any time anyway!)
Private insurers *can’t* compete with a public option since they don’t have the pool of money available to them (Well technically our government doesn’t either (they’re out) but they don’t seem to care that much) and are the ones that make the rules. I believe this is by design, as Obama has stated he is a proponent of the “Single Payer System.”
Hope that helps, or someone can expand upon my example.
I was only being humorous about SD vis-a-vis L.A. in terms of reputation, but I know that doesn’t always tranlate well on the web.
I think the discussion of wait times is rapidly becoming irrelevant. I worked for a Congressman who was instrumental in the failed Grandy-Cooper legislative health care compromize of the early 1990s. In fact, he was one of the two whose name was on the bill. He told me all those years ago, that special interests would block all forms of health care improvement for so long that eventually enough Americans would conclude that bad government-provided health care is better than none at all.
I think you’re wait time angle plays into that prediction. Who gives a $h!t about wait times when you have no insurance or you’re afraid of losing it? I grew up in military hospitals where I rarely saw the same doctor twice and wait times are worse than I ever see in the civilian world. My parents have no love for Tricare even today, but people will put up with it for “free.”
I think the big question is not why health care in McAllen is so expensive, but why health care in El Paso is so much cheaper. Two towns with similar demographics in the same state. Now that’s interesting.
Anyhow, I appreciate your response.
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Here is my totally unsubstantiated opinion, but I think parts of it are valid.
What business will do is what businesses usually do: they will run a quick cost/benefit analysis of the issue and choose the most effective course. For some businesses, this will mean dropping employee insurance because it is cheaper for them to pay the penalty than to opt into insurance for their employees.
But what I think will happen is that the government option will stink like a dirty diaper, so you’ll start seeing employers offer private insurance as a perk of the job for upper-middle class positions.
Again, just a theory, totally unsupported by any observable facts as far as I know. 🙂
Thanks! I hope you’re right…it’s better than the alternative.
Very interesting, but note that progressives are in heated battle with the Democrats regarding national reform. We want to bypass the private insurance companies either via single payer or a good public option. We regard the health insurance industry as mere lice on our health care system, costing hundreds of billions per year without providing as much as a band aid.
Since MA married itself to the insurance companies, subsidized them but did not regulate them (if they are to exist they should be treated as a public utility), it naturally followed that costs would explode along with the insurance bureaucracy.
“MA also has more people who wear red to sporting events, less peaches, higher status universities, and access to an ocean.”
Emory is indeed an incredibly medical university. They are experts in Oncology – having saved my Aunt from terminal cancer using the same procedure that treated good ole Uncle Teddy!
As for not having access to the Ocean – you got us there! I guess Savannah is just a shanty-town anyways.
Mark, realize that non-progressives think of government bureaucrats as the lice on all industry. I’m amused that progressives believe that government bureaucracy is good, but innovative business and profit is evil. I have so much more respect for anachists than I have for progressives.
I’m ripping my hair out trying to understand the numbers that are being used in the debate. The number $60k per person is being used, but not in accord with any time frame or service. Are they saying government could provide limitless healthcare for $60k per person per lifetime? What a great deal! Are they suggesting (as I’m certain they are) they can insure 1 person per year for 60k? How do they think they’ll pay for this? Congress makes my head hurt. I need healthcare.
I haven’t seen the $60k number.
But here’s a fun one in the UK: If it costs more than about $20k to extend a life more than six months, the government won’t pay out. This is the scary side of rationing.
http://bit.ly/4cuNzT – WSJ article “Of NICE and Men”
nice information about health care at obama goverment?
i hope they can performe that isues
I find it weird that the US seems incapable of getting a decent healthcare system that caters for everyone (or nearly everyone), even though quite a few other western countries manage to do so just fine. Canada seems to have a good healthcare system, so does the Netherlands. And yet all I read about the US system is how the current system leaves 20% of the people uninsured, and still bankrupts plenty of people who do have some kind of coverage. And any new system that gets conceived, whether by Obama or anyone else is somehow equally bad or worse. Are the Canadians simply that much smarter or is someone lying to us about the possible upsides and downsides of various healthcare systems?
Mal, Canadian healthcare is a mess. Check out this video where EVERY nurse these guys run into recommends they pay for a private health clinic. http://www.youtube.com/watch?v=q2jijuj1ysw Also, they are told it will take them two to three years to get a simple cholesterol test (she also says “It’s a good thing you’re young…”) BTW: in case you’re not in the US, realize that we are each given a free cholesterol test by red cross anytime we give blood.
I’m sorry, but that video does not really seem to come from any kind of serious or unbiased source.
Which source that I used do you think is biased and why do you think that?
Sorry, not referring to you politicalmath, but to the youtube video that Carolynp linked.
I am personally of a reasonably open mind about the whole issue I think (I’m not American btw, I am Dutch), but trying to follow the debate is rather difficult due to the absence of what I would consider objective information.
So far I understand that the current system is obviously not perfect, as it leaves about 50m people uninsured, and some people who are insured still have to pay a lot themselves for healthcare. I don’t fully grasp the system Obama is proposing, but it seems to include some kind of public option as an alternative to private healthcare. I am not sure why there is such opposition to it, if people can stay in the private system if they prefer.
I also see a lot of fearmongering about any kind of public system, and while I certainly agree that government is not a solution to every problem, from my experience and knowledge of some European healthcare system, I do not agree with the assertion that an effective public healthcare system is impossible.
What I would really like to see is more delving into facts, rather than people just trying to tear the other side down. My main questions would be:
1. Why is the US system so expensive, yet fails to cover all US-citizens properly?
2. Reasons I have heard so far is the litigation/tort system and the ‘defensive medicine’ that it causes, and excessive bureaucracy in the private healthcare system. Can anyone provide reliable figures on how much these things actually cost?
From an outsiders point of view it seems that both sides are heavily entrenched in ideological positions and not that interested in the truth. Perhaps the best question to start with, to both sides, is exactly what the problem is that they see with healthcare (or if they see a problem at all).
And to be clear, I am not specifically referring to this website, but rather to the debate as a whole as far as I can follow it on CNN, Fox, NYTimes and various websites.
Going more into detail into the discussion about the difference between Georgia and Massachusetts, I have a few remarks/questions. I browsed the AHIP study a bit, might have missed a few things, but what would be interesting to know is:
1. Is the average healthcare insurance in Massachusetts different from Georgia? I.e. average higher/lower deductibles, different/more/less types of health related problems covered?
2. You mentioned it too in your comments, but the comparison of Massachusetts premiums before and after the reform are very important to determine the effects of the new system.
3. Is it possible to correct for a difference in the make-up of the population between the states? I.e. are there significant differences in the number of older people between the states, or other factors that could influence healthcare premiums?
4. Most difficult, but still relevant I think is correcting for certain adverse selection effects that will occur with a statebased system, but which could be much reduced in a national system. If I lived just across the border outside of Massachusetts, and Massachusetts introduces universal healthcare while I have say a diabetic condition that requires a lot of healthcare, I might be inclined to move a few miles and benefit from it. The effects of adverse selection can even affect waiting times. If I am a doctor living in Massachusetts, and this new healthcare system they introduced cost me 20% of my annual income, i might be inclined to move to a state where there is no such change.
5. The level of healthcare cost in Massachusetts is quite staggering, and should certainly give pause before proceeding with any type of national healthcare. What I think would be really important is to get a breakdown of those costs, and compare them to other states. What exactly is causing the costs to be so much higher? Is it government bureaucracy? Something else?
I am not familiar with the merits of private or public health care one way or another, but would just like to point out that as a Canadian, I can get a same day appointment with my doctor. Maybe 2 days if he’s swamped. I don’t know about surgeries and stuff though.
Also, what “CarolynP” says about cholesterol tests is BS. You get your doctor to write you a “prescription” for the test, and take it to the blood clinic and get tested. You get your results back inside of a week.
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Hello, I love your blog, being a bit of an anti-democrat, not because im “racist” as democrats accuse me. I think they’re more racist, most of them only voting for obama cuz hes black. I think that we need a republican congress and republican president, because Obama is clearly the wrong choice for america. I Converted a lot of strong Obama believers into Anti-Obama people. I just showed them your videos! Great job and i hope to see more 10000pennies videos in the future. Well Its a great blog, but if you allow me i can help make it better. I think wordpress is great, but wordpress self-hosted is better. I can get you a free domain that is instead of politicalmath.wordpress.com, it can be politicalmath.co.cc or politicalmath.tk. Also WP self hosted has other benefits above regular wordpress. email me at king0nothingCP@aol.com for more information, and i would be honored to set up your blog for you!
-King Nothing
PS: I dont need to be an author on your site or anything for this. All i need to do is download a few files and upload them to A host. You do the rest! Consider it.
Hey there – just a couple of points.
First off, I live in Boston, am privately insured via the public option, and no person I know in Boston regardless of where they get their insurance, has experienced anything like either those “average” costs or those “average” wait times.
Secondly, the Merritt-Hawkins data for wait times in Boston for Family Practicioners are based on a whopping 17 responses, with an obvious outlier of a 365-day wait. Think that’s a valid sample to be reported as fact and norm?
Finally, as far as costs go – you’ve already pointed out the timing flaw in your caveats. You don’t bother to point out the difference in COL or average income between Atlanta and Boston, which are prodigious to say the very least. Costs are too high EVERYWHERE in the US, really ridiculous when compared with other countries that do and don’t offer universal coverage. If we’re gonna spend so much, let’s make sure that people who need an appointment get it. After all, even if I DID have to wait 50 days for an appointment, it’s an appointment I would never be able to make without the coverage I have here in Mass.
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Are you the same guy that does the homeschool math curriculum (Teaching Textbooks)? You sound just like him anyway.
Nope… not me.
Continued success to you, but I’d urge you to get a self-hosted blog man. You need to capitalize on your recent exposure by getting off the .com. Your blog really isn’t yours as it stands now.
You might want to check into the Thesis Theme man.
Love the vids by the way.
Regards,
Shane
Great video. I live in Georgia and I am proud of my state’s advances in the medical field.
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Love it. One thing: the typo bothers me. Univeral -> Universal. I know you had the little sign, but can you fix it? Pleeeeeease?