Newtown, CT- August 26, 2016
It’s sometimes amazing how many statements of “fact” are all but that – There are roughly three categories of these types of statements. One is policy statements that present a twisted version of the truth as fact. For example, recent statements by the Administration and others that the health insurance exchanges are alive and well completely ignore the real fact that without a legislative fix to funding the risk corridor for insurers, the exchanges are all but dead. They’re already more or less in a death spiral, and that spiral will only accelerate without the fix. Failure to face into this fact and help the American people understand the urgency of addressing this problem does everyone a disservice. Another is the liberty with factual interpretation that vendors to the health care industry continuously take to avoid their trough from being reduced. The latest example of this behavior comes from Mylan, the maker of EpiPen, whose CEO recently stated that high deductible health plans and benefits managers were responsible for the increase in the price of EpiPens. We all know the facts in this case, and realize that the only reason EpiPen prices have gone up is because Mylan can increase them with all impunity and therefore potentially put the lives of children and adults at risk. And finally there are pseudo-scientific assertions that are presented as facts with such aplomb that most take them as such when they shouldn’t. For example, the assertion that models that adjust for patient characteristics by using various forms of regression aren’t as effective as hierarchical clinical classifications of patients. It’s an absurd assertion and yet it forms the basis for many payment reform efforts.
What this means to you – We all expect politicians to lie and they rarely disappoint us on that score. We also expect trough-gorging industry vendors to deceive, bribe and whore in order to slurp as much of the money served into the trough as possible. And that’s what makes the third category of fact distorters the most dangerous, and what makes spotting them, calling them out and shaming them increasingly important. In academic circles, few pay attention to these lesser scientists because their statements are so absurd that it’s taken for granted that no one will believe them. But that’s not what’s happening. And, increasingly, the false patina of pseudo-academics is inserting twisted facts into the fabric of reform. From claims that transparency can’t help the health care market to assertions that there is only one valid method to adjust for patient severity or set prices, the prophets of falsehoods are gaining ground and potentially threaten the outcome of the battle to reform American health care. When we dig into the origin of these purveyors of false facts, we quickly find conflicts of interest, but somehow these conflicts are ignored by the larger audience that is the target of the statements. We plan to see that change because the stakes are far too high to let lies stand as facts.
Francois de Brantes