I’ve been working on some videos concerning the healthcare reform issue over the last couple weeks and I’ve come to the conclusion that I hate this topic.

The reason I hate it is because it is so hard to find solid data on almost anything. Identifying the problem is nice and easy:

The US spends more per capita on healthcare than almost any other country, but we don’t necessarily get better results.

That statement is easy to prove with numbers.

Actually, I take that back, the first part is easy to prove with numbers. The second part of that is extremely difficult because judging the efficacy of health care is not an easy thing to do. Some metrics are easy to make judgements on. Wait times for CT Scans and MRIs are not dependent on whether or not the patient is skinny or fat, sick or healthy. How many people you can shove through a machine is far more dependent of scheduling efficiency, the availablility of personel and equipment, etc. In other words, there are few outside variables that are going to screw with your results.

But other metrics like life expectancy are heavily dependent on variables outside the health care system. Life expecancy for latinos, blacks, asians, whites, jews, arabs… near as I can tell they are different for all these groups even when other variables are controlled for. This makes it a very messy metric to use when trying to determine the efficacy of only one of those variables like health care.

As for controlling the cost of healthcare, there is one surefire way to do it: stop paying so much money. But this will result in less care and almost certainly lead some level of health care rationing.

The other ideas that have been thrown out there are not surefire ones, they are either educated guesses or “if I believe in it enough it will happen” wishes. Some of these ideas may work… but we’re not entirely sure which ones.

Which brings me to my preferred solution, which isn’t really a solution so much as it is a suggestion for identifying good policies a little more accurately: I think we should take the ideas that the Obama administration has and separate them out into a) ideas that can be applied to Medicare and Medicaid immediately and b) ideas that require a larger scale implementation.

Medicare and Medicaid are enormous programs with more than 70 million beneficiaries. It is absurd to say that they aren’t big enough to introduce some cost reduction programs without adding another 39 million people to government insurance programs (which is essentially what the Obama administration is saying).

Second, I think the government should set up some kind of public health care metrics program to gather the data that is currently so difficult to gather. Imagine if you could go online and look at hospitals around your city to see which ones deliver better outcomes and how much different procedures cost at different hospitals. This would go a long way toward inspiring competitive pricing in health care.

Third, I think we need to do away with the tax exemption for employer provided health insurance. Not a popular position, but it seems obvious to me that this policy has led to a large part of our health care overconsumption.

So… that’s all I’ve got for now.

I’m still working on some concepts that can be boiled down into something that is both accurate and striking. But the fact of the matter is that in healthcare we can trust very few of the numbers being tossed around right now. They are educated guesses at best and the Obama administration has a pretty bad track record at being able to predict the future.

I’ve been pretty quiet recently because 1) I’m on vacation and 2) I’m trying to wrap my head around the health care issue before I talk about it at length.

But today I saw something on healthreform.gov that bothered me:
Combined PPO

Here’s the thing, Mr. President. There is such a thing as visual lying. That is when you show a graph and you show the numbers but the two things are not in any way related to one another.

That is the problem here. If someone looks at this graph, they see that the sky is falling because the bars have increased so dramatically. On the left, your team has represented a 30% increase with a graphic that shows a 966% increase. On the right, your team has represented a 63% increase with a graphic that shows a 308% increase.

And are the two sets bars related in any way? You might think so, given that they show up next to each other and are supposed to measure the same thing. But from a data perspective, they are not even remotely close to being right.

It is possible to use graphs and numbers in such a way that is honest. That’s an important part of transparency. So, I fixed your graph for you.

You’re welcome.

UPDATE: In the comments section, James quickly identified the problem… the graph starts the y-axis at 1000 instead of 0. I double checked and it looks like he is spot on. Thanks!

With that in mind, the graph is more of a rookie mistake than a conscious attempt to deceive. I’ve edited my post to reflect that (I left my original comments in so everyone can see what a smart-ass I tend to be).

I’m pretty excited, it should be fun.

I’ll keep as much as possible updated via Twitter (@PoliticalMath) and the blog.

In this video, I take a look at the economic predictions that President Obama made in February regarding the stimulus plan and how those predictions are corresponding to reality.

The answer is: Not well.

But first, some references.

OK… now into the math. The chart that everyone is using does not have a corresponding table with hard number (at least no table that I could find), so I had to guess-timate what they were predicting the unemployment rates would be in May. I assumed that, because their graph divergence began immediately after the Q1, 2009 line, that that line represented the beginning of Q1 2009 (as opposed to the middle). So I estimated that the May would be just a shade before Q3, which is about the same place that Geoff put his May data.

Based on that, I estimated the points on the line like so:

Unemployment Rate Unemployed Population
Predicted Unemployment without the Stimulus 8.7% 13,492,000
Predicted Unemployment with the Stimulus 7.9% 12,251,000
Actual Unemployment with the Stimulus 9.4% 14,511,000

Now… here is the problem. In order to make our data symmetrical, we would have to have another row… a row called “Actual Unemployment without the Stimulus”. This, of course, is a row we cannot have because we sadly live in a space-time of collapsed quantum possibilities. We can never know what that row would hold.

This is where I start getting a little less analytical and a little more irritated. The president’s predictions have been shown to be completely off the mark… almost laughably so. And yet he acts as if he alone knows what would have happened if we hadn’t passed the stimulus because he keeps making statements like “we’ve saved 150,000 jobs“.

It is clear that, if he is referring to the chart we were presented with above, such a claim is absurd. What the president is doing is ignoring the fact that his predictions in the past were horribly inaccurate and simply moving ahead with new predictions. The big difference is that his new predictions can’t be judged against any set of objective reality. He is pitting the actual universe in which the stimulus bill passed against the imaginary universe in which it did not pass. Not surprisingly, the imaginary universe is worse that the real universe and the result is that the President is a hero for saving us from that imaginary universe.

I am not a very anti-Obama person. Predicting the future is tricky business and I think his team should get some leeway on this.


Their predictions were not just kinda wrong. They were horrifically, disasterously wrong. If President Obama is going to use statistics and charts to push nearly $800 billion in spending, I think we should be able to expect his numbers to at least kinda match the reality that comes out of his policies.

At the very least, I’d like to know how his team got those numbers. More importantly, I’d like to know how they have changed their method of prediction. President Obama is fond of saying that we tried tax cuts and they didn’t work, so we should try something else. In that same vein, his team tried predicting the effect of the stimulus and that didn’t work. So I would like to know if they are using the same failed methods they used before or if they are doing something different.

Hat tip from Greg Mankiw for the pointer to Donald Marron’s post on keeping the current economic downturn in perspective.

Marron states:

The economy would have to fall much, much further than economic forecasters expect for the losses to come anywhere near those experienced in the Great Depression.

And then we get to see this graph, which is a fantastic way of trying to put things in perspective.


I try to keep this graph in my head whenever people talk about “the worst economy since the Great Depression” and especially when they talk about how crisis requires the government to spend enormous amounts of money.

The difference between this economy and the economy of the Great Depression is nearly the difference between a day trip from New York City to Washington DC and a cross country trip from New York City to LA.

I love the way Freddie introduced a post on abortion late last year. He titled it “you know what we don’t talk about enough? Abortion“. 

I kind of feel the same way about the level of discussion going on with it. I probably would never have mentioned it at all on this blog if it hadn’t been for the incident on Sunday in which a man shot and killed Dr. George Tiller “one of the nation’s few providers of late-term abortions”.

In the fourth paragraph of the AP article, I came across this line:

“But the doctor’s violent death was the latest in a string of shootings and bombings over two decades directed against abortion clinics doctors and staff.” 

After reading that, I decided to look into the statistics of abortion violence with a view toward perhaps creating a visualization about it.

Sadly, there are few things more skewed than abortion violence statistics. I found this pdf on “Abortion Violence and Disruption Statistics” done by the National Abortion Federation and it is mainly propaganda dressed in numbers. But it looks like their numbers on shootings and bombings are verified by legal authorities, so I assume they are pretty accurate. 

Let’s use those statistics to deal with the “string of shootings and bombings over two decades” that the AP talks about. (In order to give the AP the benefit of the doubt, let’s assume that all the “Attemped Murders” of abortion clinic staff involved shooting of some kind. )

According to the NAF document above, this is that the “string of shootings and bombings” looked like over the last 15 years:


Did you know that this is the first abortion related murder since 1998?

I didn’t.

I was under the impression from the AP that abortion killings were like school shootings… the kind of thing that we tragically see on an ongoing basis. (I thought about a graph comparing school violence to abortion violence, but it seemed kind of apples-to-organges to compare sociopathic, psychotic and suicidal teenagers to politically motivated terrorists.) 

Given the actual data, the characterization of this incident as “the latest in a string of shootings and bombings” is deeply dishonest. It embeds into people’s minds the idea that this is a very common tragedy, like school shootings, hurricanes or gang-related violence. In fact, until I looked at the data very recently, I was under exactly that impression. 

It would be much more accurate to say something along the lines of:

This incident has shattered an eight year lull in anti-abortion related shootings, an activity that spiked to record levels in the 90′s.

UPDATE: Upon re-reading my post I realized that it sounded very dry and unfeeling… very matter-of-fact… when I talked about the recent murder. I hope no one got the impression that I’m wholly unphased by this crime. Nothing could be further from the truth. I hope that the fact that referred to crimes of violence against abortion clinics and the staff as acts of terrorism would indicate how I feel about the topic.


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