32 Responses to New Lewin Group Study, Same Outcome: UnitedHealth says reform is bad

1. khin October 31st, 2009 at 1:11 pm «

   I haven’t looked at this study, but see no reason to doubt their conclusion. This reform doesn’t begin the change the underlying system. Costs in Massachusetts have also risen faster than in the rest of the country.
• Jason Rosenbaum October 31st, 2009 at 2:09 pm «

  Good thing we’re not getting the Massachusetts plan.
• selise October 31st, 2009 at 2:26 pm «

  Good thing we’re not getting the Massachusetts plan.

  looks like most of us will be if anything like the current bills pass. if we’re lucky.

  (MA actually has better regulation and enforcement than the rest of the country — but that was from before the 2006 reform).
• mmogu77 November 1st, 2009 at 6:07 pm «

  We all have the right to our own opinions, but not to our own facts. I attended the take 2008 Take Back America conference where HCAN was first announced and where Jacob Hacker and Roger Hickey presented their proposal for a robust public option and argued that progressives should take single payer off the table and back the public option instead. One of their main arguments was based on the Lewin Group study which they quoted from extensively as demonstrating that more than 100 million Americans would be covered by the public. I believe the Lewin Group study of the Hacker plan was commissioned by one of the groups involved in forming HCAN. It’s disingenous now for HCAN to disavow that study.
• selise November 1st, 2009 at 8:23 pm «

  wow. thanks for that info. i’m downloading the video of the presentation now. in the meantime, i found this huffingtonpost article by roger hickey from feb 2008. it’s on the feb 2008 lewin study. which apparently his organization, epi, commissioned.

  http://www.huffingtonpost.com/roger-hickey/lewin-analysis-of-hackere_b_87125.html” rel=”nofollow”>Lewin Analysis of Hacker-EPI Health Plan: Good News for Obama and Clinton

  Last week, the Economic Policy Institute released an important analysis of Jacob Hacker’s Health Care for America (HCFA) plan by the respected health economics team at the Lewin Group. As you can read in the EPI press release, Lewin found that HCFA would cover everyone in America, while saving the US economy over a trillion dollars over the next decade. And the efficiencies achievable primarily through Hacker’s public health insurance plan would save enough money that, after modest premiums from employers and individuals, the new system would cost the US government only $50 billion more than what we are paying now for a system that leaves millions uninsured or badly insured.

  A year ago, just as EPI was publishing Hacker’s HCFA plan, CAF had already gone to work, engaging everyone who would listen in public and private educational discussions about the Hacker-EPI approach — including presidential candidates from both parties. After a year-long dialogue, we can see how Hacker’s work has become the template for both Barack Obama’s and Hillary Clinton’s health care plans. And just as importantly, our allies in the labor movement, public interest and community action networks are coming together around basic health care principles that are based on Hacker’s model for health care for all. More on this soon – here at this website and at the Take Back America conference March 17, 18 and 19.

  isn’t hickey your boss at hcan, jason?

  and here’s EPI’s web page featuring the lewin report that jason is now slamming.

  http://www.sharedprosperity.org/topics-health-care.html
• mmogu77 November 1st, 2009 at 10:36 pm «

  Just my point. The Lewin Group’s original study was used by Jacob Hacker, Roger Hickey, the Campaign for America’s Future, and the founding members of HCAN to justify the more “pragmatic” strategy of taking single payer off the table and fighting only for a “robust” public option, as though the insurance, pharma, and hospital industries wouldn’t fight just as hard against a robust public option as they would against single payer. How that there is no such thing as a “robust” public option still on the table in Congress (see my Huffington Post article “The Public Option in Congress is Now a Sham. Who Cares if Lieberman Kills It?” ), HCAN seems to want to disavow the Lewin Group study they originally used to justify their strategy. This seems disengenous. Any response, Jason, or anyone from HCAN?
• mmogu77 November 1st, 2009 at 10:48 pm «

  P.S. Jason, you probably weren’t working for HCAN yet when Roger Hickey, Jacob Hacker and the other founders of HCAN were touting the Lewin Group study, so maybe you don’t know this history. But ask Roger Hickey, Jacob Hacker, Richard Kirsh, or your other colleagues who were around when HCAN was founded and they’ll hopefully tell you the truth about the original Lewin study of the Hacker plan. At least then you will be able to correct the facts in your article, acknowledging that the Lewin Group study was used to justify the HCAN strategy, not to be an argument against it. If your’s and HCAN’s opinion is that a puny public option that will cover almost nobody is better than nothing, then take your best shot at arguing for that position. But be sure your facts are correct first.
• lambertstrether November 2nd, 2009 at 6:17 am «

  Is Hickey Jason’s boss, then? I’ve always been curious about editorial policy at FDL in Jason’s silo, so maybe Hickey’s the person to talk to. Anybody got contact info?
• selise November 2nd, 2009 at 7:06 am «

  i’m not sure, that’s why i asked. i think hickey is one of the founders of hcan and more likely kirsch is jason’s boss. will have to do some more googling (can’t right now, but maybe later today) and post what i find here…
• selise November 2nd, 2009 at 7:22 am «

  ok, my curiousity got the better of me. doesn’t answer the question of who’s who. but this looks like a posting of both hickey and kirsch flogging the lewin report that jason is now panning as insurance industry propaganda:

  Debate Hinges on Public Health Insurance Plan Competing with Private Plans

  WASHINGTON – Health-care expert Frank Clemente will join Health Care for America Now director Richard Kirsch and Institute for America’s Future co-director Roger Hickey on a conference call with reporters on Thursday to release a new report showing that a public insurance option as proposed by President Obama is critical to the success of health care reforms soon to be considered by the Congress.

  With the insurance industry opposing key elements of reform embraced by President Obama, the new data and recent public opinion numbers will show that a public insurance option is crucial to controlling health care costs, achieving quality coverage and garnering significant support for reform from the public.

  The study’s author, Frank Clemente, will discuss how his analysis shows that a public health insurance plan choice is the only way to achieve the goals laid out by President Obama for health reform. Richard Kirsch will discuss new public opinion data that shows increasing support for a choice between private and public health insurance.

  Resources
  ♦ Full Report: “A Public Health Insurance Plan: Reducing Costs and Improving Quality” (PDF)

  ♦  Report chartpack (PPT)

  ♦  Public opinion data to be discussed by Richard Kirsch

  ♦  Two page brief of key findings (PDF)

  Additional Resources

  ♦  Jacob Hacker: “The Case For Public Plan Choice in National Health Reform: Key to Cost Control and Quality Coverage” (PDF)

  ♦  Jacob Hacker’s “Health Care for America” report and the Lewin Group cost analysis

  ♦  Leaders and Experts Agree that a Public Insurance Option is Critical to the Success of Obama’s Health Reform Proposals (PDF)

  if i’m not misreading this, what we have here is direct evidence of a bait and switch by hcan. am i misreading it? is there something i’m missing? it sure looks like hcan sold the public option to progressives with the lewin report (because big public option = good) — the very same report that jason is now calling false industry propaganda (because big public option = bad).
2. selise October 31st, 2009 at 1:58 pm «

   Lewin’s latest study claims that health care reform (specifically the Senate Finance Bill, but broadly applicable) would increase health care spending overall in this country. The conclusion of this study eerily echoes the conclusions of the fatally flawed insurance industry study which threatened to raise rates if health reform was passed.

   the cms (not owned by insurance industry) report on the tri-committee’s hr 3200 predicts that the bill would increase total national health expenditures.

   this is not a surprising conclusion.
• selise October 31st, 2009 at 2:02 pm «

  p.s. the initial lewin study, published in feb 2008 was based on original hacker proposal (the elephant, not the mouse, po of 2007). just skimming the july 17th memo from lewin (on the july 15th draft) seems to draw some info from that previous report. i agree that is not appropriate, but at least they stated their assumptions (the exchange would be open to all).

  i only wish congress had based their bills on the original hacker proposal. then would actually be an option to the public and not a small fraction of the population. it might also actually be viable too.

  p.p.s. i think lewin was aquired by unitedhealth in june 2007.
• Jason Rosenbaum October 31st, 2009 at 2:08 pm «

  The original Lewin study also was based on a plan without Exchanges, a curious and fatal oversight.

  As for CMS, they’re analyzing with different goals methods, the conclusions aren’t quiet apples and oranges, at least as I’ve read so far.
• selise October 31st, 2009 at 2:24 pm «

  As for CMS, they’re analyzing with different goals methods, the conclusions aren’t quiet apples and oranges, at least as I’ve read so far.

  i have no idea what you are talking about. different than what? the lewin report? the ahip report? duh, of course it’s different. it’s a gov report. that’s good right? not owned by the insurance industry?

  as for “at least as I’ve read so far” please give us some links. i linked to the cms report and i’ve read it. what are your sources?
• Jason Rosenbaum October 31st, 2009 at 2:42 pm «

  There are some noted issues in the way this particular actuary deals with these kinds of reports, not to mention that he’s scoring a bill that’s way outdated:

  http://www.politico.com/livepulse/1009/HHS_findings_do_not_represent_administration_views.html
• selise October 31st, 2009 at 4:57 pm «

  yeah, he was threatened with firing if he talked about his report because he didn’t get the false results the bush administration wanted him to. good on him for writing the report and for testifying before congress — while bush was still in office — about what happened.

  He had a high-profile run-in with the Bush White House over his cost estimates for the 2003 Medicare prescription drug program.

  Foster told Congress in 2004 that he provided the Bush White House with data estimating that the bill would cost as much as 50 percent more than the administration estimated, but was told not to share it with Congress. An HHS investigation found the administrator of Medicare, Thomas Scully, threatened to fire Foster if he told Congress that the drug benefits would cost more than expected.

  the tri-committee bill is the best thing we’ve yet to see, yes it’s being changed — it getting worse.

  jon has been posting on this report and never mentioned any problem with it. i’ve posted this cost data in comments previously with both jon and scarecrow on the thread and neither one of them questioned it’s accuracy. if you have a problem with it, be specific about the changes there’ve been to the bill and why they would be expected to lower cost (i’d think they would raise costs, but maybe i’m wrong about that). if you have a problem with the person who wrote the report, again be specific. innuendo doesn’t cut it.

  edit to add: i’ve been complaining that we needed to see the actual predicted cost data (total national health expenditure) because the cbo reports have been incomplete (or bogus depending on how forgiving one wants to be), reporting only on fed cost data which is probably the LEAST important component of total costs (household costs, employer costs, costs to state and local gov being missing). this is the first gov report about any of the current bills that i’ve seen have total cost data. it’s an important report.
• Jason Rosenbaum October 31st, 2009 at 6:41 pm «

  On the phone, so can’t respond at length, only to agree
  overall cost data is an important metric, and I’ll
  be interested to see it on the more final versions of the bill, from a less problematic source.
• selise October 31st, 2009 at 6:43 pm «

  … from a less problematic source.

  please document why this source (cms) should be considered problematic.
• Jason Rosenbaum November 1st, 2009 at 7:31 am «

  That particular CMS actuary has a history of reports outside the norm for the office. Just because he pissed off Bush doesn’t necessarily make him more credible or make him speak for his organization. In fact, the “CMS report” you refer to was basically disowned by CMS and HHS. It’s this one guy’s report.

  Now, as we move forward, I’m hoping there will be a report on the same topic by someone who speaks for CMS, or some similar organization. Hopefully that makes sense.
• selise November 1st, 2009 at 8:31 am «

  That particular CMS actuary has a history of reports outside the norm for the office

  that’s your response to my comment @12?:

  please document why this source (cms) should be considered problematic.

  dude. you have no credibilty without sources. if what you say is true, you shouldn’t have any problem providing some links to back up your claim with evidence we can evaluate for ourselves.
• Jason Rosenbaum November 1st, 2009 at 9:03 am «

  Here was the link I pointed to, with HHS disowning the report:

  http://www.politico.com/livepulse/1009/HHS_findings_do_not_represent_administration_views.html
• selise November 1st, 2009 at 9:52 am «

  “do not represent the administration views”, and “independent” are no reason to discount the report or the actuary as “problematic”. the guy reported honestly what the bush administration did not want him too. what evidence is there that he is not doing exactly the same thing now with the obama administration?

  more importantly, your link does provide any sort of evidence to back up your claims:

  In fact, the “CMS report” you refer to was basically disowned by CMS

  That particular CMS actuary has a history of reports outside the norm for the office

  your inability, or unwillingness, to provide evidence of what is increasingly looking like an unsubstantiated smear of an individual is very very wrong and an example of attacking the messenger because you don’t like the message but have no actual critique of the content of the message.

  i’ll back off if/when you back up the accusations you have made. all of them. or retract them. all of them.
• Jason Rosenbaum November 1st, 2009 at 11:36 am «

  Sigh. Here’s what the note on the report said, from that link:

  The statements, estimates, and other information provided in this memorandum are those of the Office of the Actuary and do not represent an official position of the Department of Health and Human Services or the Administration.

  That’s a pretty clear disowning of the report by HHS.

  Now, I’ll admit that I don’t know why HHS did this, and I’ve read the report myself, but not being an actuary, I can’t see the reasoning. Still, it is enough to give me pause that HHS would do this unusual thing.

  What I’m saying is that I’d expect a report studying the same topic to come out at some point in this debate that won’t require this kind of disclosure. That report I’d be more willing to believe at face value.

  Anyway, we’re going around in circles. You like single payer. You won’t change your mind. I like the reform plan being put forward, more or less. You won’t change my mind. It’s kind of silly to keep doing this, so I’ll probably stop.
• selise November 1st, 2009 at 12:02 pm «

  1. you neglected to quote the entire statement:

  The Office of the Actuary has prepared this memorandum in our longstanding capacity as an independent technical advisor to both the Administration and the Congress. The costs, savings and coverage impacts shown herein represent our best estimates for H.R. 3200. We offer this analysis in the hope that it will be of interest and value to policy makers as they develop and debate national health care reforms. The statements, estimates, and other information provided in this memorandum are those of the Office of the Actuary and do not represent an official position of the Department of Health and Human Services or the Administration.

  this is a statement of independence. to my knowledge hhs has not released any report contradicting the cms report. furthermore, you have provided no critique of the contents of the report.

  more importantly,

  2. this is not about single payer. i’m not asking you to change your mind. and we’re not going around in circles. i’m saying you have a responsibility to back up the claims you have made. you refuse to do so and instead change the subject. i return to the subject. as i told you, i’ll back off if/when you back up the accusations you have made. all of them. or retract them. all of them.

  restating, once again, the claims you have made and, absent a retraction, have a responsibility to back up with some kind of evidence — especially since one them appears to be an unsubstantiated smear of an individual.

  In fact, the “CMS report” you refer to was basically disowned by CMS

  That particular CMS actuary has a history of reports outside the norm for the office

  unless you made up these statements, it shouldn’t be too difficult to provide links to your evidence. absent that, i will, reluctantly, have to assume you made them up.
• hipparchia November 1st, 2009 at 12:01 pm «

  That particular CMS actuary has a history of reports outside the norm for the office.

  but does ‘that particular cms actuary’ have a history of being right or wrong? and does the ‘norm for the office’ have a history of being right or wrong?
• lambertstrether November 2nd, 2009 at 6:15 am «

  I like this:

  That particular CMS actuary has a history of reports outside the norm for the office.

  Sounds like a whistleblower, to me. The fact that the actuary would go ahead and publish the study in the teeth of opposition from Dem political appointees gives them more credibility in my eyes, not less. And before anybody calls the actuary a Republican mole, Bush tried to fire them too.
• lambertstrether November 2nd, 2009 at 6:22 am «

  Jason writes:

  The original Lewin study also was based on a plan without Exchanges, a curious and fatal oversight.

  As for CMS, they’re analyzing with different goals methods, the conclusions aren’t quiet apples and oranges, at least as I’ve read so far.

  I do so hate a noisy apple ;-)

  Seriously, the curious and fatal oversight on Jason’s part is to demand that the Exchanges be factored into the cost estimates, while simultaneously refusing to explain how the exchanges will be administered.

  Would Hickey know?
3. PeasantParty October 31st, 2009 at 4:25 pm «

   United Health will be against any change. They are sucking the blood out of people, literally!
4. hipparchia October 31st, 2009 at 9:25 pm «

   wait… let me see if i got this straight….

   so progressives’ idea of a strong [or robust, if you prefer] public option was at one time anyway:

   1. is open to all americans
   2. is available on day 1
   3. pays medicare rates
   4. is at least as good as what congress gets

   so lewin runs it through their model and finds that a fairly standard benefits package [one available to congress through the fehbp iirc], paying providers at medicare rates, open to all on day 1 would have substantially lower premiums than private insurance and would be so popular that more than 100 million people would enroll.

   so… the lewin group basically says that YES the hcan plan will save people tons of money and be wildly popular with the public and hcan then runs around screaming NONONONONO! lewin group is wrong! WRONGWRONGWRONG!

   does this mean that hcan has been lying all along when they say they wanted ALL americans to immediately have an affordable, quality, public-run option to private insurance?
• selise November 1st, 2009 at 9:55 am «

  looks like it.
5. hipparchia October 31st, 2009 at 9:34 pm «

   as for the ‘lewin didn’t model the exchanges’ charge, they DID model something akin to what’s expected to happen in year 1 of the exchanges: higher-than-medicare rates and available to only a small portion of the population.

   and lo and behold… lewin’s estimate of how many people would enroll in the public option under the more limited scenario is something that hcan should be celebrating if they truly wanted quality, affordable, public insurance available to at least some percentage of the population.

   really, the only sensible conclusion to draw is that HCAN DOES NOT WANT people to enroll in the public option.
6. lambertstrether November 2nd, 2009 at 6:11 am «

   Of course we can’t change your mind, Jason. That’s because you’re an HCAN staffer, and it’s your job to say what you do.

   Nobody could possibly think that your mind could be changed. What may be changed is the minds of citizens who are informing themselves on the issues.