Health Care for All PA in Healthcare Finance News

Healthcare for All PA outgoing president, David Steil, has been profiled in Healthcare Finance News by by Tammy Worth on the state of the movement.  It can be read at the link below.

The single payer movement expands

Correlation of the Concentration of Hate Groups with Health Outcomes

This post is a cross post with other blog on the concentration of hate groups in each state (adjusted for population) and their health outcomes.  Pennsylvania is slightly ahead of the national rate at 3.12 groups per million.

This is a follow up on the last post on the number of hate groups (such as the Ku Klux Klan and the Westboro Baptist Church) in each state that are being watched by the Southern Poverty Law Center.  Some may not agree with the inclusion of African American separatists like the Nation of Islam.  If these groups are excluded from the national total (115 out of 939). Computing the population adjusted rate per million gives a rate of 2.62 groups per million for the US.

The state with the highest previous rate of 23.72 groups per million was the District of Columbia.  One possible criticism is that they have a large African American population and that they are not technically a state.  If the four black separatist groups in DC are excluded from their total of 15, it still has a rate of 17.40 groups per million which is well above the national rate.  I decided to look at which other state level variables are correlated with the rate of hate groups in each state.

I combined this data set with a state level health and income data set and several of them are significantly correlated with the health measures.  The strongest of these effects was the one between infant mortality and hate groups per million accounting for 40.9% of the variability.  In the chart on the left, DC is an outlier on both variables. 

The correlation was rerun with DC excluded.  The relationship was still significant but with 12.3% of the variability accounted.  This indicates that the relationship is weaker with DC excluded but still present.

The relationship between hate groups and state level life expectancy was also significant with 29.4% of the variability accounted in a negative relationship where as the number of hate groups increases, the state's life expectancy decreases.  Like the previous graph, DC is an outlier on hate groups per million.  When DC is removed from the graph, 30.2% of the variability is accounted for in a relationship that is still negative.  This suggests that  DC has high influence but is not poorly fit to the data.

There was no significant correlation between state level per capita income and the rate of hate groups.  Other health related outcomes were significantly associated.  These individual correlations are not described in detail here for space considerations.

There is a more advanced method that can identify clusters of highly correlated variables.  It is called factor analysis.  There were two factors extracted which account for 68.8 % of the variability.  They are presented in the table below.

Rotated Factor Matrixa
	Factor
	Health (46% of var explained)	Income (22% of var explained)
Infant Mortality 2007 Deaths/1000	.909
Life Expectancy	-.817	-.462
% Low Birthweight Babies	.735	.245
Hate Groups per million	.709
Percent under age 65 in 200% of Poverty	.411	.862
Income	.140	-.727
Percent Uninsured in Demographic Group for All Income Levels	.140	.644
Expanding medicaid		-.314
Extraction Method: Principal Axis Factoring.  Rotation Method: Varimax with Kaiser Normalization.a
a. Rotation converged in 3 iterations.

The first factor extracted has the health related variables loading on it and accounts for 46% of the total variance.  Infant mortality, life expectancy, % low birth weight babies, and the rate of hate groups load most strongly on this factor.  Percent within 200% of poverty, income, and % uninsured load most strongly on the second extracted factor (called an income factor) while accounting for 22% of the variability.  

The hate group rate does not load on the income factor but it does on the health suggesting an association with health related outcomes.  One must always be careful about inferring a cause and effect relationship based on correlational data. When DC was removed, the factor analysis did not run.

**Related Posts**

 

A Wave of Hate Groups in California? No in Washington, DC

 

How do the States Stack Up on Infant Mortality? (Cross Post with PUSH)

A Statistical Profile of the Uninsured in Washington, DC, New Mexico, and Texas

In Denial

Political scientist Brendan Nyhan was on All In with Chris Hayes last night (March 11) for a discussion of the Julia Boonstra television ad. The political ad, which was financed by the Koch Brothers' PAC, Americans for Prosperity, is running in Michigan in an early attempt to discredit Democratic Senatorial candidate Gary Peters. In it, Ms. Boonstra, a cancer patient, claims that her health insurance was cancelled due to the Affordable Care Act, that she can't afford the alternative policy offered to her, and that she is afraid she will die as a result. The ad was awarded three Pinocchios by the Washington Post after it was discovered that the alternative policy actually would save her $1200 a year. Her response was, “I personally do not believe that,” and that it “can't be true.”

This ad is part of a larger campaign in which Republican organizations trot out Obamacare “victims” to tell stories that are almost always misleading. Journalists eventually debunk these stories, but many more people hear the lie on television than read the truth in a newspaper, and even those who are told that the story is false often refuse to believe it.

Brendan Nyhan has been doing research for several years which shows that attempts to correct misinformation fail when they oppose people's deeply entrenched political ideologies. In fact, they can backfire and produce a boomerang effect—attitude change in the direction opposite to that intended by the speaker. Dr. Nyhan's latest study, released just last week, was an attempt to dispel the myth popular among conservatives that the measles, mumps and rubella vaccination (MMR) causes autism. Here's some background on the controversy from Aaron Carroll.

In the study, a nationally representative sample of 1759 young parents were randomly assigned to receive one of four pro-vaccine messages or a control message, delivered via the internet. The pro-vaccine messages, all taken from the Center for Disease Control (CDC) website, were:

1. Autism correction—written scientific evidence debunking the vaccination-autism link.
2. Disease risks—written descriptions of symptoms and risks associated with measles, mumps and rubella.
3. Disease narrative—a dramatic narrative in which a mother tells how her baby almost died from the measles.
4. Disease images—photographs of children suffering from symptoms of the three diseases.

The control group received an article about the costs and benefits of bird feeding. Nyhan measured the belief that the MMR causes autism, the belief that the MMR has serious side effects, and whether the participants intended to have their next child vaccinated, both before exposure to one of the messages and again about two weeks later.

The results were disappointing. Compared to the control group, the autism correction message significantly reduced the belief that the MMR causes autism. That was the only intended effect. The other three significant results were all boomerang effects. The disease narrative increased the belief that the MMR has serious side effects. The disease images increased the belief that the MMR causes autism. And finally, the autism correction resulted in parents reporting that they would be less likely to vaccinate future children. This latter effect was strongest for those parents who initially believed that the vaccine causes autism.

Ordinarily we should not make too much of studies that demonstrate no significant change. After all, the CDC messages could have been ineffective for a variety of reasons not immediately apparent to a reader of the study. It's also possible that different messages or combinations of messages might have worked. However, these were statistically significant backfire effects, and they should probably be taken seriously. The tendency of beliefs to persist or grow stronger even when the evidence for them is shown to be false is known as belief perseverance. The widely-accepted explanation for perseverance effects is self-persuasion. When people hear a message they disagree with, they counterargue with it. In the process, they expose themselves to their own counterarguments and persuade themselves to change their attitudes in the opposite direction from the message.

In the short run, at least, social scientists are becoming known in the media for delivering a depressing message: Factual information is ineffective in changing people's ideologically-motivated attitudes. So far, we have been unable to propose effective strategies for breaking through the barriers imposed by politically-inspired misinformation.

You may also be interested in reading:

Death By Anecdote, Part 1

The Open and Closed Mind

Motivated Reasoning

A 1993 Clinton Memo on Talking Points to Single Payer Advocates

The Clinton Presidential Library has released memos from 1993 which gave instructions on how members of the administration should talk to single payer advocates "to bring them into the fold" on the 1993 reform bill.  Here is a snippet of the advice on how administration officials were advised to talk to Congressman Jim McDermott.

"As with all Members, and particularly Congressman McDermott, the goal at this meeting is to make him feel we are listening to him and desirous of his guidance. In this vein, you should consider throwing anything he throws at you as a complication right back at him with a question. Then, if you have concerns about his suggested approach, you can address it with him directly. (This way, you don't allow him the opportunity to pick apart anything before you have had a chance to hear and analyze his alternatives)."

The full document can be read here.


Here is a Daily Show Clip on talking points for the masses on healthcare vs. reality.  The state page has a new page on where the candidates for Governor of Pennsylvania stand on single payer.

The Daily Show
Get More: Daily Show Full Episodes,The Daily Show on Facebook

 

**Related Posts** 

 

Good Studies Go to the Back of the Bus

Death By Anecdote, Part 1

 

Death By Anecdote, Part 2

Policy By Anecdote

The Coverage Gap:  The Real Failure of Obamacare

NEW ECONOMY CELEBRATION! Panels,Workshops,Marketplace,Catalyst Awards

The New Economy Working Group is having a celebration of innovators with panels, workshops, and awards on March 20-22 at Baker Hall on the Carnegie Mellon University Campus and other locations.  Details are below.  A single payer system is integral to a new/more efficient economy as Dr. Gerald Friedman showed in his economic impact study.

REGISTER for these FREE EVENTS here:
>>> Thursday March 20 - NEWG Sponsors MARCH GREEN DRINKS ! http://tinyurl.com/NEWG-green-drinks

>>> Friday March 21 - Seminar with Gar Alperovitz: http://tinyurl.com/NEWG-solutions

>>> Friday March 21 - Evening Discussion with Gar Alperovitz: http://tinyurl.com/NEWG-gar-discussion

>>> Saturday March 22 - All-Day Events: http://tinyurl.com/NEWG-Sat-Mar-22

A showcase of Pittsburghers’ efforts to create an economy where the benefits are equitably shared between business employees or employee-owners, stakeholders, and host communities; creates strong, nurturing social ties; and replenishes nature.

See http://www.NEWGPGH.WORDPRESS.COM/ for more information on the Pittsburgh New Economy Working Group.

A featured appearance from Gar Alperovitz, a leading voice in the nationwide new economy movement.
People who attended October 2013's "Unconference" are planning resources, projects, and event activities now.

THURSDAY MAR 20: NEWG sponsors "Green Drinks" 5-9 PM @ The Map Room
FRIDAY MAR 21: 2 PM @ Frick Fine Arts Building, PITT
FRIDAY MAR 21: 5 PM @ CMU Baker Hall Adamson Wing
SATURDAY MAR 22: 9 AM - 4 PM @ CMU Baker Hall Giant Eagle Auditorium

 

**Related Posts** 

 

Video from the Friedman Pittsburgh Talk is now Available 

 

State of Working PA: Slowing Job Growth, Falling Wages Impede Recovery (and The Drop in Uninsured)

New Time Magazine Article on Healthcare Costs with 

Stewart Discussion 

Real Reasons for High Medical Costs 

Bob Mason: Letter to the Pittsburgh Post Gazette

System in Waiting

March 2, 2014

In “Bigger Hospitals, Higher Prices” (Feb. 23 Forum) Shannon Brownlee and Vikas Saini present a strong indictment of the rapid consolidation of health care systems, essentially creating monopolies and concentrating power, as we’ve experienced in Pittsburgh. This has resulted in unsustainable cost increases without an accompanying improvement in care. Many researchers have noted that the United States’ health care system ranks poorly in lifespan, infant mortality and social inequality compared with most other developed nations.

Ms. Brownlee and Dr. Saini write that hospitals that dominate a market could be turned into “common carriers, regulated like utilities with transparent pricing and community oversight.” They add: “The most efficient way to achieve this goal would be through a single-payer system.”

Pennsylvania and the United States have single-payer systems in waiting, ready to transform our health care so that it is affordable, improves quality and is available to all. The state legislation is SB 400 and the federal is HR 676. More information about the solutions can be found at www.healthcare4allpa.org.

BOB MASON
Trafford

The writer is president of Health Care 4 All PA.