The only textbook I can remember from my college days—certainly the only one I kept—is “How to Lie with Statistics,” a slim volume that was first published when I was a toddler.
Atlantic magazine called it “A pleasantly subversive little book, guaranteed to undermine your faith in the almighty statistic.”
Author Darrell Huff wrote the book to help folks understand how data can be sliced and diced in ways that intentionally mislead people, that get them to believe things that are simply not true or, at best, only partly true, in the service of advancing a usually hidden agenda.
I regret having to admit this, but I became what Huff would have called a swindler through my slicing and dicing skills. But don’t think for a minute that I was the only swindler. Many of my former colleagues in the health care flackery business are carrying on the work I used to do and, in fact, taking it to new heights.
Sometimes swindlers like the old me make little if any effort to even try to provide honest facts and figures. A perfect example of that is the first video the health care moneyed interests graced the Internet with a few weeks ago to make us think that our employer-based health care system is off limits to reform, that Medicare for All, which a rapidly growing number of policymakers are embracing, would abolish something so sacred and essential to American life, to our very identity, that legislation to hasten it onto the ash heap of history must be stopped at all costs.
As Joe Biden might say, that’s a bunch of malarkey. Beginning with this post, I will explain why it’s malarkey. I’ll pull the curtains back to show you just how the industry’s PR consultants have set out to swindle us yet again, to cheat us out of a health care system that, admittedly, might yield thinner profit margins for insurers and drug companies but that would be a huge improvement for the rest of us.
Let’s start with the video’s opening sentence: “Today, nearly 180 million Americans with employer-provided coverage have access to affordable, quality health care.” First, that number. The source of the 180 million is not cited, but it appears to be from a September 2018 Census Bureau report. The problem is that the Census Bureau clearly double counts a lot of folks. It owns up to that in the footnotes. If you add up all the people the report says have some form of insurance, public or private, you get 367.5 million people. That’s about 42 million more than the total population of this great land.
But if you just take it as gospel that 180 million of us have employer-sponsored coverage, that would mean that about 56% of us are in such plans. But wait! A few seconds into said video, the narrator tells us that “most people get their care from employee-sponsored (sic) plans.” (Sic because I suspect she means employer-sponsored, not employee-sponsored, but on the other hand, with employees paying more and more of cost of their coverage as a percentage of premiums, not to mention out of pocket costs, employee-sponsored coverage might be a term we all should start using.)
Partnership for America’s Health Care Future’s “Working Together” video
But I digress. As the narrator makes that “most people” claim, a graphic on the screen says “49% Employee Plans.” Last I checked 49% isn’t most.
So, what is it, 56% or 49%? Both can’t be true.
The 49% might be from the Commonwealth Fund. The Commonwealth Fund’s Sara Collins told members of Congress yesterday that about 158 million Americans get their coverage through an employer. Here’s the math: 158 million divided by 325.7 million, the estimated population of this great country, is just shy of 49%.
The Kaiser Family Foundation, another nonprofit that keeps track of trends in employer-based coverage, puts the number at 152 million. Whatever the actual number is, research by both the Commonwealth Fund and the Kaiser Family Foundation shows that our employer-based health care system has been eroding, slowly but surely, for several years. And there is no reason to believe that erosion will stop.
In 1999, according to KFF, the percentage of nonelderly Americans enrolled in employer-sponsored coverage was 67%. By 2014 it was down to 56%. A big reason for that decline, as I noted in a column earlier this week, is that small employers can no longer afford to offer subsidized coverage to their workers.
Bottom line: employer-based coverage is not what it used to be. Nor is it providing anywhere close to the same level of protection it once did. So, to say that “180 million Americans with employer-provided coverage have access to affordable quality health care” just ain’t true in more ways than one. I’ll elaborate in my next post.
P.S.: I encourage you to seek out a copy of Huff’s book. Here’s what he said about it the introduction he wrote 65 years ago: “This book is a sort of primer in ways to use statistics to deceive. It may seem altogether too much like a manual for swindlers. Perhaps I can justify it in the manner of the retired burglar whose published reminiscences amounted to a graduate course in how to pick a lock or muffle a football: The crooks already know these tricks; honest men must learn them in self-defense.”
