Was It REALLY Medicare?

Aug 3, 2015

An interesting headline on the front page of a recent USA Today: “Drastic drop in Medicare deaths, costs.” The story cites a JAMA article reporting significant drops from 1999 to 2103 in death rates, hospitalization rates, and cost-per-patient among Medicare patients. That great news! Now, from that headline, you might infer that Medicare had something to do with the improvements, right?

No, not really. The USA Today article made no reference whatsoever to any Medicare policies and practices that might have contributed to the good results. Here are some hypotheses that might also explain them:

We’re staying healthier (other than a few too many cheeseburgers) and generally living longer.
New drug therapies, rather than hospitalization, are becoming increasingly effective for managing heart disease and cancer (a point the USA Today makes at the end).
The quality of healthcare delivery and management are improving – perhaps because of all the horror stories about expensive, poorly managed care.

In other words, this story may or may not have anything to do with Medicare – Medicare’s contribution may simply be that it has a gigantic database to be mined. What I didn’t learn from this story is:

Whether the improvements apply equally to people younger than 65
Whether the improvements apply equally to Medicare’s managed-care participants (about 29% of the Medicare population) – the study only included patients in Medicare’s more traditional fee-for-service program.

I’m writing this post to raise a question of journalistic ethics and professionalism. The real story is the improvements in American healthcare, not what Medicare has accomplished. In fact, the article’s first sentence credits “the U.S. healthcare system” – not Medicare – with “a medical hat trick.” It’s a shame that the headline is suggesting a different story.

“Painting with Numbers” is my effort to get people to focus on making numbers understandable. I welcome your feedback and your favorite examples. Follow me on twitter at @RandallBolten.