Today I’m going to give you access to a paper with as many as 100 references that you almost never see cited in Health Affairs, or in the Journal of the American Medical Association (JAMA), or in the New England Journal (at least not in their public policy articles). In fact, if you are a regular reader of these publications, I think you are going to be very surprised.
My colleagues Linda Gorman, Devon Herrick, Robert Sade and I discovered that public policy articles in the leading health journals (especially the health policy journals) tend to cite poorly done studies over and over again in support of two propositions: (1) Our health care system needs radical reform and (2) the reform needs to be modeled along the lines of the systems of other developed countries. At the same time, these articles tend to ignore contravening studies – often published in economics journals and subject to much more rigorous peer review.
I can see clearly now
In our rest-of-the-story literature review, we focus on eight questions:
- Does the United States spend too much on health care?
- Are US outcomes no better and in some respects worse than those of other nations?
- Is the large number of uninsured in the US a crisis?
- Does lack of health insurance cause premature death?
- Are medical bills causing bankruptcy?
- Are administrative costs higher for private insurance than public insurance?
- Are low-income families more disadvantaged in the US system?
- Can the free market work in health care?
This paper was written over a year ago, in response to JAMA’s call for papers on health reform and may not include the most recent material. Nonetheless, since the national health care debate is well underway, since the peer review process (at least for our paper) is so inordinately long, and since the issue is so important, we are taking these unprecedented steps:
- We are ignoring the journals and publishing the paper online.
- We are posting the reviewers’ comments from Health Affairs so that readers can see why the critics thought this paper should not be published at all, and a link to the JAMA issue that excluded our paper here.
- We are inviting everyone – regardless of political views – to comment and cite additional evidence that has bearing on any of these questions.
In a completely independent effort, Stanford University Professor Scott Atlas has made many of these same discoveries. His findings are summarized in this NCPA Brief Analysis.