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	<title>Comments on: Junk Social Science in the Medical Bankruptcy Debate</title>
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	<description>Academic commentary on law, business, economics and more</description>
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		<title>By: market failure, right here</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-114962</link>
		<dc:creator>market failure, right here</dc:creator>
		<pubDate>Thu, 30 Aug 2007 13:54:43 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-114962</guid>
		<description>I give you points for consistency, but serious demerits for a complete lack of a soul.  Are you really saying that you place a higher value on a supposedly &quot;truly free market,&quot; than in protecting childrens&#039; lives?  That&#039;s cold.</description>
		<content:encoded><![CDATA[<p>I give you points for consistency, but serious demerits for a complete lack of a soul.  Are you really saying that you place a higher value on a supposedly &#8220;truly free market,&#8221; than in protecting childrens&#8217; lives?  That&#8217;s cold.</p>
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		<title>By: Market Sense</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-114901</link>
		<dc:creator>Market Sense</dc:creator>
		<pubDate>Thu, 30 Aug 2007 00:16:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-114901</guid>
		<description>Mr. Market Failure --

since no one else responded to your question I will:  the answer is clearly yes.  &quot;the amount of bankruptcy-due-to-debt might actually be a lot lower than it is today&quot; - and then again, it &quot;might actually&quot; be a lot higher.  and since the primary concern is for a &quot;truly free market,&quot; one is entitled to be agnostic as to the consequences for children of poverty.  That is their problem -- we are just concerned with getting ourselves to a truly free market.</description>
		<content:encoded><![CDATA[<p>Mr. Market Failure &#8211;</p>
<p>since no one else responded to your question I will:  the answer is clearly yes.  &#8220;the amount of bankruptcy-due-to-debt might actually be a lot lower than it is today&#8221; &#8211; and then again, it &#8220;might actually&#8221; be a lot higher.  and since the primary concern is for a &#8220;truly free market,&#8221; one is entitled to be agnostic as to the consequences for children of poverty.  That is their problem &#8212; we are just concerned with getting ourselves to a truly free market.</p>
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		<title>By: market failure, right here</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-112974</link>
		<dc:creator>market failure, right here</dc:creator>
		<pubDate>Mon, 06 Aug 2007 18:23:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-112974</guid>
		<description>Hodak--Are you saying that if a &quot;market economy&quot; reaches an equilibrium where children of poverty die of easily and cheaply preventable causes at a certain rate, then that rate is not only acceptable, but preferrable?  The &quot;invisible hand&quot; determines who lives and who dies?  The rich receive multiple organ transplants and sex meds, while the poor can&#039;t find innoculations for polio?  

It&#039;s time to stop thinking about healthcare as a consumption good like Josh&#039;s power sucking bigscreen TV.</description>
		<content:encoded><![CDATA[<p>Hodak&#8211;Are you saying that if a &#8220;market economy&#8221; reaches an equilibrium where children of poverty die of easily and cheaply preventable causes at a certain rate, then that rate is not only acceptable, but preferrable?  The &#8220;invisible hand&#8221; determines who lives and who dies?  The rich receive multiple organ transplants and sex meds, while the poor can&#8217;t find innoculations for polio?  </p>
<p>It&#8217;s time to stop thinking about healthcare as a consumption good like Josh&#8217;s power sucking bigscreen TV.</p>
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		<title>By: A Stitch in Haste</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-112208</link>
		<dc:creator>A Stitch in Haste</dc:creator>
		<pubDate>Mon, 30 Jul 2007 07:21:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-112208</guid>
		<description>&lt;strong&gt;Questions...&lt;/strong&gt;

--Is it a proper function of government to declare the Titanic &quot;an international maritime memorial&quot;?

--Finding true love in ...</description>
		<content:encoded><![CDATA[<p><strong>Questions&#8230;</strong></p>
<p>&#8211;Is it a proper function of government to declare the Titanic &#8220;an international maritime memorial&#8221;?</p>
<p>&#8211;Finding true love in &#8230;</p>
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		<title>By: M. Hodak</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-112154</link>
		<dc:creator>M. Hodak</dc:creator>
		<pubDate>Sun, 29 Jul 2007 17:18:05 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-112154</guid>
		<description>&quot;What is the optimal level of bankruptcy-due-to-medical-debt in a market economy?  Could it ever get to a level that would lead to concern among those who oppose universally guaranteed coverage?&quot;

Two questions:

The answer to the first is, obviously: whatever level of bankruptcy-due-to-debt level you would observe in a market economy.  Unfortunately, we don&#039;t have anything approaching a market economy in the highly regulated health insurance and health care markets, so we can&#039;t know what that level actually is.  One should allow the possibility that in a truly free market, the amount of bankruptcy-due-to-debt might actually be a lot lower than it is today.

The second question is flawed in its framing, as partly exposed by Ryan.  This question implicitly presupposes that universal guaranteed coverage would substantially eliminate the excess costs of care for all individuals such that bankruptcy would no longer pose a significant risk for a large number of people.  This premise, however, is highly doubtful, even aside from ignoring the implicit trade-off between universal coverage, actual access to health care, and innovation in treatments.</description>
		<content:encoded><![CDATA[<p>&#8220;What is the optimal level of bankruptcy-due-to-medical-debt in a market economy?  Could it ever get to a level that would lead to concern among those who oppose universally guaranteed coverage?&#8221;</p>
<p>Two questions:</p>
<p>The answer to the first is, obviously: whatever level of bankruptcy-due-to-debt level you would observe in a market economy.  Unfortunately, we don&#8217;t have anything approaching a market economy in the highly regulated health insurance and health care markets, so we can&#8217;t know what that level actually is.  One should allow the possibility that in a truly free market, the amount of bankruptcy-due-to-debt might actually be a lot lower than it is today.</p>
<p>The second question is flawed in its framing, as partly exposed by Ryan.  This question implicitly presupposes that universal guaranteed coverage would substantially eliminate the excess costs of care for all individuals such that bankruptcy would no longer pose a significant risk for a large number of people.  This premise, however, is highly doubtful, even aside from ignoring the implicit trade-off between universal coverage, actual access to health care, and innovation in treatments.</p>
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		<title>By: Ryan Waxx</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111990</link>
		<dc:creator>Ryan Waxx</dc:creator>
		<pubDate>Sat, 28 Jul 2007 04:15:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111990</guid>
		<description>&gt; what is the optimal level of 
&gt; bankruptcy-due-to-medical-debt in a market  
&gt; economy? Could it ever get to a level that would 
&gt; lead to concern among those who oppose universally
&gt; guaranteed coverage?

Well, you might have the answer to that question, if those who presented the study had resisted the temptation to obviously and shamelessly inflate the results.

A counterquestion: could taxation levels and expanding queues ever get to a level that would lead to concern among those who propose socializing the healthcare system?

Just askin&#039;, is all...</description>
		<content:encoded><![CDATA[<p>&gt; what is the optimal level of<br />
&gt; bankruptcy-due-to-medical-debt in a market<br />
&gt; economy? Could it ever get to a level that would<br />
&gt; lead to concern among those who oppose universally<br />
&gt; guaranteed coverage?</p>
<p>Well, you might have the answer to that question, if those who presented the study had resisted the temptation to obviously and shamelessly inflate the results.</p>
<p>A counterquestion: could taxation levels and expanding queues ever get to a level that would lead to concern among those who propose socializing the healthcare system?</p>
<p>Just askin&#8217;, is all&#8230;</p>
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		<title>By: Frank Pasquale</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111960</link>
		<dc:creator>Frank Pasquale</dc:creator>
		<pubDate>Fri, 27 Jul 2007 21:57:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111960</guid>
		<description>Regardless of the merits of particular studies, one interesting question this raises is: what is the optimal level of bankruptcy-due-to-medical-debt in a market economy?  Could it ever get to a level that would lead to concern among those who oppose universally guaranteed coverage?

&lt;a href=&quot;http://www.accessproject.org/medical.html&quot; rel=&quot;nofollow&quot;&gt;This page &lt;/a&gt;provides several reports on the problems that medical debt poses.

Also, check out&lt;a href=&quot;http://www.accessproject.org/adobe/living_in_the_red.pdf&quot; rel=&quot;nofollow&quot;&gt; this study &lt;/a&gt;on how even small levels of medical debt can cause a &quot;downward spiral&quot; for low-income individuals.</description>
		<content:encoded><![CDATA[<p>Regardless of the merits of particular studies, one interesting question this raises is: what is the optimal level of bankruptcy-due-to-medical-debt in a market economy?  Could it ever get to a level that would lead to concern among those who oppose universally guaranteed coverage?</p>
<p><a href="http://www.accessproject.org/medical.html" rel="nofollow">This page </a>provides several reports on the problems that medical debt poses.</p>
<p>Also, check out<a href="http://www.accessproject.org/adobe/living_in_the_red.pdf" rel="nofollow"> this study </a>on how even small levels of medical debt can cause a &#8220;downward spiral&#8221; for low-income individuals.</p>
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		<title>By: Peter Schwartz</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111951</link>
		<dc:creator>Peter Schwartz</dc:creator>
		<pubDate>Fri, 27 Jul 2007 20:29:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111951</guid>
		<description>My thoughts on this dust-up, extracted from my post on the Knowledge Mosaic Blogwatch today:

If one reads the Harvard study, it is clear that the claims of Zywicki and Heriot are malicious and unfair. The Harvard study&#039;s authors come clean about the significant limitations of the survey data they are using. They draw only the most general, tentative, and circumspect conclusions. Their policy prescriptions - paid disability and sick leave, stopgap insurance coverage between jobs, and catastrophic insurance coverage - are sufficiently bromidic to leave one wondering what all the fuss is about.

Regarding the idea that uncontrolled gambling is a major and legitimate cause of medical bankruptcy, the authors merely state that uncontrolled gambling is defined as a psychiatric disorder and that it contributes (not causes, mind you) to 1 percent of bankruptcies. They admit that out-of-pocket expenses for debtors were often below levels typically considered catastrophic, and attribute causal impact more to concomitant income loss or the ongoing need for costly medical care over a period years. Medical causes of bankruptcy related to childbirth-related conditions that led, among other things, to one parent leaving their job to stay home with a child. Hardly a &quot;lifestyle&quot; decision.</description>
		<content:encoded><![CDATA[<p>My thoughts on this dust-up, extracted from my post on the Knowledge Mosaic Blogwatch today:</p>
<p>If one reads the Harvard study, it is clear that the claims of Zywicki and Heriot are malicious and unfair. The Harvard study&#8217;s authors come clean about the significant limitations of the survey data they are using. They draw only the most general, tentative, and circumspect conclusions. Their policy prescriptions &#8211; paid disability and sick leave, stopgap insurance coverage between jobs, and catastrophic insurance coverage &#8211; are sufficiently bromidic to leave one wondering what all the fuss is about.</p>
<p>Regarding the idea that uncontrolled gambling is a major and legitimate cause of medical bankruptcy, the authors merely state that uncontrolled gambling is defined as a psychiatric disorder and that it contributes (not causes, mind you) to 1 percent of bankruptcies. They admit that out-of-pocket expenses for debtors were often below levels typically considered catastrophic, and attribute causal impact more to concomitant income loss or the ongoing need for costly medical care over a period years. Medical causes of bankruptcy related to childbirth-related conditions that led, among other things, to one parent leaving their job to stay home with a child. Hardly a &#8220;lifestyle&#8221; decision.</p>
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		<title>By: Josh</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111947</link>
		<dc:creator>Josh</dc:creator>
		<pubDate>Fri, 27 Jul 2007 19:58:02 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111947</guid>
		<description>Ted: Good question.  I&#039;ll defer to anybody else who has more experience with this than I.  Perhaps because the rebuttal is already in the written testimony, it is not worth it for the minority members to post additional questions now --- they can just read the record.</description>
		<content:encoded><![CDATA[<p>Ted: Good question.  I&#8217;ll defer to anybody else who has more experience with this than I.  Perhaps because the rebuttal is already in the written testimony, it is not worth it for the minority members to post additional questions now &#8212; they can just read the record.</p>
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		<title>By: Ted Frank</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111934</link>
		<dc:creator>Ted Frank</dc:creator>
		<pubDate>Fri, 27 Jul 2007 17:21:11 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111934</guid>
		<description>From my experience in testifying before a Congressional subcommittee, I don&#039;t understand why the speaking order matters.  Why couldn&#039;t a minority member use the questioning period to ask Zywicki and Heriot whether they had any problems with the Warren study, and thus permit rebuttal then?  Indeed, why can&#039;t a minority member *now* pose additional questions to Zywicki and Heriot in writing, and give them a chance to rebut the Warren claims in the record?</description>
		<content:encoded><![CDATA[<p>From my experience in testifying before a Congressional subcommittee, I don&#8217;t understand why the speaking order matters.  Why couldn&#8217;t a minority member use the questioning period to ask Zywicki and Heriot whether they had any problems with the Warren study, and thus permit rebuttal then?  Indeed, why can&#8217;t a minority member *now* pose additional questions to Zywicki and Heriot in writing, and give them a chance to rebut the Warren claims in the record?</p>
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		<title>By: BandarBush</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111933</link>
		<dc:creator>BandarBush</dc:creator>
		<pubDate>Fri, 27 Jul 2007 17:12:34 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111933</guid>
		<description>Why should we be surprised at this? In light of Gonzalez v. Carhart and the Court&#039;s overwhelming deference to Congressional fact finding, I think we can expect a lot more of this in the future.</description>
		<content:encoded><![CDATA[<p>Why should we be surprised at this? In light of Gonzalez v. Carhart and the Court&#8217;s overwhelming deference to Congressional fact finding, I think we can expect a lot more of this in the future.</p>
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		<title>By: The Volokh Conspiracy</title>
		<link>http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/comment-page-1/#comment-111932</link>
		<dc:creator>The Volokh Conspiracy</dc:creator>
		<pubDate>Fri, 27 Jul 2007 17:06:52 +0000</pubDate>
		<guid isPermaLink="false">http://www.truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/#comment-111932</guid>
		<description>&lt;strong&gt;More Junk Social Science:...&lt;/strong&gt;

In a Washington Times op-ed yesterday Gail Heriot and I noted that Congress &quot;has been on a binge diet of junk social science.&quot;

Josh W......</description>
		<content:encoded><![CDATA[<p><strong>More Junk Social Science:&#8230;</strong></p>
<p>In a Washington Times op-ed yesterday Gail Heriot and I noted that Congress &#8220;has been on a binge diet of junk social science.&#8221;</p>
<p>Josh W&#8230;&#8230;</p>
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