Friday, September 21, 2012

Fact Check: Access to Physician Services

In reviewing the transcript of the President’s speech before AARP, there was one dubious statement we overlooked, and it’s this: “A new study says that under their [premium support] plan, if just 5 percent of seniors switch to private plans, 40 percent of doctors who currently take Medicare would stop accepting it.  So think about that.  Millions of seniors would be forced to change doctors.”  As one might expect, there are several problems with this statement:

  • First, it wasn’t a “study” in any sense of the term – and it certainly wasn’t independent.  The President was referring to a back-of-the-envelope calculation by his former budget director in a Bloomberg column this weekOne might argue that the author of the study, Peter Orszag, might be slightly biased towards the President this November, seeing as how he used to work for him.
  • Second, Obama himself mis-characterized the Orszag column.  Here’s what Orszag actually wrote: “About 10 percent of the U.S. population is now enrolled in traditional Medicare, and an additional 5 percent has private Medicare plans.  Let’s assume, for the sake of argument, that the Ryan plan would cause another 5 percent of the population to shift…”  Orszag based his conclusions on 5 percentage of the entire American public switching away from Medicare, whereas the President said Orszag’s conclusions were based on 5 percent of seniors switching away from Medicare – a much lower bar.  So the President over-stated the impact of Orszag’s “study” and its effects on physician access.
  • Most importantly, Orszag’s conclusions – which were over-estimated by the President – aren’t borne out by recent evidence.  Medicare Advantage enrollment HAS gone up by leaps and bounds in recent years – since 2003, it has more than doubled in both absolute terms and as a percentage of Medicare beneficiaries.  In other words, seniors have switched plans, as the chart below shows.  Yet the Medicare Payment Advisory Commission said this year that “overall, beneficiary access to [Medicare physician] fee schedule services is good.”  If Orszag believes that beneficiaries switching to private plans would cause doctors to stop seeing Medicare patients, then why did a 100 percent increase in Medicare Advantage enrollment not have a significant effect on access to physician services in traditional Medicare?

Peter Orszag has made ludicrous claims before.  He previously said that Obamacare’s CLASS act would be “on a firm financial footing of its own,” only to watch as the program collapsed even before it began.  Given the evidence above, his claims about physician access appear as logical as his claims about the CLASS Act, and should be taken just as seriously.