Who really won the ACA debate?

Last night an all-star cast debated whether “the nation needs the Affordable Care Act.” The formal square-off pitted two of the nation's leading health system leaders who support the law against critics who claim the ACA does little to tamp down outrageously high healthcare prices or promote true competition.

You can view the debate and judge for yourself whether Dr. Glenn Steele, CEO of Geisinger Health System, Danville, Pa., and Dr. Gary Gottlieb, CEO of Partners HealthCare, Boston, successfully fended off attacks by journalist Steven Brill, who authored Time magazine's “Bitter pill” expose of the chargemaster rate-setting system, and Dr. Avik Roy, a senior fellow at the Manhattan Institute and former healthcare advisor to Gov. Mitt Romney during his run for the presidency.

The audience at the Riverside Theatre in Vero Beach, Fla., clearly leaned against the law both before and after the debate, based on an electronic tally solicited by moderator Susan Dentzer, a former editor of Health Affairs who now is policy adviser to the Robert Wood Johnson Foundation. At the outset of the debate, 61.9% of the 367 people in attendance opposed the law and 22.9% supported it with 15.3% undecided. After the debate, 67.5% opposed the law, 27.2% supported it and just 5.3% were undecided.

But does that mean the opponents won the debate, as Dentzer proclaimed after reading the final tally? A closer reading of the numbers suggests not. The final tally was based on just 342 votes. Apparently, 25 people took off or failed to vote after the 90-minute debate ended.

By looking at the raw vote totals, the undecided vote dropped from 56 to 18. The proponent vote rose to 93 from 84. The opposition vote also rose, but only to 231 from 227.

Some people may have switched sides because of the debate, of course. But if you look at the net results, Steele and Gottlieb succeeded in winning more people to their side than did the opponents, which means they won the debate.

It's hard to blame Dentzer for the miscount. She had only the percentages to work with in the few seconds she took to proclaim a winner. Of course, it probably wouldn't have mattered to the largely opposition audience in Florida, a state with a checkered history when it comes to counting votes.

Follow Merrill Goozner on Twitter: @MHgoozner