Tuesday, January 12, 2016

What's a healthcare article without a touch of Levitty?

It is a fact universally acknowledged among healthcare reporters that there are two ways to structure an article.

The first is to give Kaiser's Larry Levitt the lead quote to articulate or validate an asserted trend.

The second is to use other authorities to assert said trend -- and deploy Levitt about two-thirds down to inject a note of skepticism or a reality check. Today offers a perfect specimen of plan b: Gaming Obamacare, by Politico's Paul Demko.  The thesis is brought to you by the nation's insurers:
Obamacare customers are gaming the system, buying coverage only after they find out they’re ill and need expensive care — a trend insurers warn is destabilizing the fledgling health law marketplaces and spiking premiums for everyone.
700 words in, we're well prepped for the Levitt Reality Check:

Some are skeptical the numbers are as bleak as health plans say. Through June of last year, about 10 percent of total enrollees through HealthCare.gov, or about 940,000 individuals, had signed up for coverage through special enrollments, according to administration figures. But there's no obvious reason why certain insurers would attract a disproportionate share of those enrollees.

"It's still a small minority of enrollees," said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation, a nonpartisan research group. "It's overstating it to say people can simply sign up whenever they want."
This is not to say that Special Enrollment Period validation procedures are not too lax, or that those who enroll via SEPs are not more expensive or more short term. It's just to recognize that insurers in all lines of coverage are forever bitching about fraud and exaggerating its impact, that businesses of all types (like humans of all types) blame their tribulations on forces beyond their control and the rules of the game, and that while some data as to how people are using SEPs exists and more can be collected and analyzed, we really don't know yet how prevalent the "gaming" is. 

I'm not trying to knock Paul Demko here -- although I do think the insurers' claim is stated too positively in the lead. The article voices key caveats, after all. And the insurers' claims are partially validated by CMS's acting administrator Andy Slavitt, who yesterday evening promised to tighten criteria for granting Special Enrollment Periods (SEPs) to would-be plan buyers outside the yearly Open Enrollment period.

It does seem to me, though, that when we get Reality Check Larry rather than Claim Validation Larry, the essential caveat often comes further down the column than a lot of readers are likely to go.

As to why Mr. Levitt is so ubiquitous, that's one trend that's not hard to explain. First, the Kaiser Family Foundation is the most prolific, complete and trusted source of healthcare data outside of government. Second, Levitt is endlessly patient, always responsive, has all the data at his fingertips and is universally recognized as a fair arbitor. Easy peasy!

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