Healthcare legislation, policy and strategy often are driven by numbers. If the statistics and estimates used to guide the debate are off base, expect the unexpected.
A couple of recent cases-President Clinton's welfare reform package and HCFA's report that future healthcare spending will be much less than previously projected-underscore the need for truth in packaging when measuring and analyzing healthcare costs. At the very least, healthcare forecasts should come with appropriate warnings and disclaimers.
Many of the statistical shenanigans take place in Washington, where lawmakers and regulators rely on information to reform and refine the $1.2 trillion healthcare industry.
Nobody takes a back seat to Clinton when it comes to hyping the benefits and pooh-poohing the costs of his pet healthcare projects. That's why it came as no big surprise when the Congressional Budget Office said the president's plan to reform Medicare, including a sweet prescription drug benefit, would cost far more than the administration estimated.
Although the administration put the 10-year price tag of the healthcare package at $46 billion, the CBO said it would cost at least $111 billion. But why quibble over a mere $65 billion?
The timing of statistical reports also can bolster or crush a political strategy. Healthcare providers are hoping to capitalize on a recent HCFA forecast that tempers previous projections of skyrocketing healthcare spending in the coming decade (July 26, p. 3).
Total expenditures from 1999 to 2007 are expected to reach $14.5 trillion, some $152 billion less than the government projected last fall.
The revision can help providers in two ways. First, it shows that the Balanced Budget Act of 1997 has slowed Medicare spending more than expected. Second, it helps build the case that hospitals and other providers need relief from the budget act stranglehold.
Unfortunately, this latest HCFA report has drawn little fanfare, whereas the earlier projection of higher spending got prominent media coverage. Now it's up to providers and their lobbyists to seize this statistical opportunity by putting the numbers in proper perspective.