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Offline mystery-ak

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Census Survey Revisions Mask Health Law Effects
« on: April 15, 2014, 01:09:24 PM »
http://www.nytimes.com/2014/04/16/us/politics/census-survey-revisions-mask-health-law-effects.html?_r=0

Census Survey Revisions Mask Health Law Effects

By ROBERT PEARAPRIL 15, 2014

WASHINGTON — The Census Bureau, the authoritative source of health insurance data for more than three decades, is changing its annual survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said.

The changes are intended to improve the accuracy of the survey, being conducted this month in interviews with tens of thousands of households around the country. But the new questions are so different that the findings will not be comparable, the officials said.

An internal Census Bureau document said that the new questionnaire included a “total revision to health insurance questions” and, in a test last year, produced lower estimates of the uninsured. Thus, officials said, it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument.


“We are expecting much lower numbers just because of the questions and how they are asked,” said Brett J. O’Hara, chief of the health statistics branch at the Census Bureau.

With the new questions, “it is likely that the Census Bureau will decide that there is a break in series for the health insurance estimates,” says another agency document describing the changes. This “break in trend” will complicate efforts to trace the impact of the Affordable Care Act, it said.

A major goal of the law is to increase the number of people with health insurance. The White House reported that 7.5 million people signed up for private health plans on the new insurance exchanges and that enrollment in Medicaid increased by three million since October. But the administration has been unable to say how many of the people gaining coverage were previously uninsured or had policies canceled, so the net increase in coverage is unclear.

Health policy experts and politicians had been assuming that the Census Bureau would help answer those questions when it issued its report on income, poverty and health insurance, based on the Current Population Survey. The annual report shows the number of people with various kinds of health insurance and the number of uninsured for the nation and for each state.

Several recent private polls, including one by the Gallup organization, suggest that the number of uninsured is indeed declining, because of the Affordable Care Act and improvements in the economy.

Census officials and researchers have long expressed concerns about the old version of insurance questions in the Current Population Survey.

The questionnaire traditionally used by the Census Bureau provides an “inflated estimate of the uninsured” and is prone to “measurement errors,” said a working paper by statisticians and demographers at the agency.

In the test last year, the percentage of people without health insurance was 10.6 percent when interviewers used the new questionnaire, compared with 12.5 percent using the old version. Researchers said that they had found a similar pattern in the data for different age, race and ethnic groups.

In addition, “the percentage of people with private coverage was statistically higher” when the bureau tested the new questionnaire, the working paper said. For reasons that are not clear, people were less likely to respond when interviewers used the new questionnaire.

Another Census Bureau paper said “it is coincidental and unfortunate timing” that the survey was overhauled just before major provisions of the health care law took effect. “Ideally,” it said, “the redesign would have had at least a few years to gather base line and trend data.”

The old questionnaire asked consumers if they had various types of coverage at any time in the prior year. The new survey asks if they have insurance at the time of the interview — in February, March or April — then uses follow-up questions to find out when that coverage began and what months it was in effect. Using this technique, census officials believe they will be able to reconstruct the history of coverage month by month, over a period of about 15 months, for each person in a household.

However, Mr. O’Hara of the Census Bureau said the agency was not planning to release coverage data from early this year in its next report. Agency officials want to assess the reliability of the monthly data, being collected this year for the first time.

The White House is always looking for evidence to show the benefits of the health law, which is an issue in many of this year’s midterm elections. The Department of Health and Human Services and the White House Council of Economic Advisers requested several of the new questions, and the White House Office of Management and Budget approved the new questionnaire. But the decision to make fundamental changes in the survey was driven by technical experts at the Census Bureau, and members of Congress have not focused on it or suggested political motives. The new survey was conceived, in part, to reduce a kind of bias or confusion in the old survey. When asked about their insurance arrangements in the prior year, people tended to give answers about their coverage at the time of the interview — forgetting, for example, if they had Medicaid for a few months early in the prior year.

People are continually moving on and off Medicaid rolls. The number of people who say in surveys that they have Medicaid coverage is almost always lower than the enrollment figures reported by federal and state agencies that administer the program.

The new survey asks people if they have coverage through an exchange, if it has premiums and if the premiums are subsidized.

People generally know if they have health insurance, but not necessarily the type of coverage. A study by the Census Bureau said that the line between public and private coverage is blurry.

“The same exact coverage will be construed as private by some and public by others,” it said.

Census Bureau research in Massachusetts found that consumers “inevitably conflate Medicaid and the subsidized exchange.” And many people with subsidized private insurance, purchased on the exchange, said they were receiving coverage from the government or the state.

Such perceptions are understandable. “Exchange coverage is a hybrid, partly private and partly government,” said Joanne Pascale, a Census Bureau researcher who helped develop the new questionnaire.

The new survey also includes more detailed questions about whether people were offered insurance at work and whether they accepted it. If a worker is not in an employer’s plan, the government asks why.

Kathleen Thiede Call, a professor at the University of Minnesota School of Public Health, said, “The health insurance data reported in September of this year will not be directly comparable to what was reported last September.”

But Ms. Call, who was consulted by the Census Bureau, said: “I am excited about the redesign of the survey. For the first time, we will be able to look at monthly changes in coverage over a 14- or 15-month period, which was not possible with the old version of the survey.”

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #1 on: April 17, 2014, 12:49:57 PM »
Here's something else that's strange about the census bureau's activities in recent days: Last week while Mr. M and I were in Boston, he received a call from the agency that cares for his mentally handicapped older brother Tim. They said people from the census bureau were sitting in their office asking questions about his brother.

A little background:  Tim lived with his father until Dad's death in 2006. At that time, Mr. M scrambled to get his brother into a group home and to receive service under Title XIX of the Social Security act. After a few months, we got it worked out and Tim was able to live in a home with one or two other handicapped men and receive 24/7 supervision and care from the agency (REM) that has contracted with the gov't. Tim later moved from his first home to one closer to us. After a few years, the owner of the second house decided he didn't want to rent it to REM anymore. Mr. M, using money left by his father for this purpose, bought a house near us and now Tim and his roommate and the REM folks get along swimmingly in a nice little three-bedroom ranch.

From our hotel in Boston, Mr. M told REM that the census people were not permitted to set foot on the property on Tim's house, so they agreed the census people would come back and speak to Mr. M when we returned home. The other day, he received a call from them. The REM supervisor said she'd already provided info on Tim's roommate, and then handed the phone to the census person. That person proceeded to ask questions about the second house. Mr. M said Tim doesn't live at that address, without offering the address of the 3d residence. He asked why - four years after the census - his brother was being singled out for information (keep in mind the inept census bureau never bothered to send a survey to Mr. M and me, and we remain uncounted). The census person said it was just selected "at random" among people living in group homes, receiving TItle XIX benefits or some such thing.

Mr. M reiterated that Tim hadn't lived at the address (the second house) for three years. The census person was flummoxed and didn't know what to say, and the conversation ended.

The question is WHY THE HECK are they looking into this now?  What has this to do with counting the number of people living in the USA?
The only difference between the Democrats and the Republicans is that the Democrats allow the poor to be corrupt, too.
--- Oscar Levant

Online Bigun

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #2 on: April 17, 2014, 01:01:47 PM »
THIS may be the most completely lawless administration in history and certainly is in MY lifetime!

Online Bigun

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #3 on: April 17, 2014, 01:30:30 PM »
This particular issue isn't a matter of lawlessness.  It is more a matter of exploiting the law, legally, for political advantage.  That doesn't make it excusable, but it shouldn't be conflated with lawlessness.  Conflating the two simply weakens both arguments.

So just what IS the definition of "is"?

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #4 on: April 17, 2014, 01:42:15 PM »
So just what IS the definition of "lawless"?  Is changing the survey methodology this way contrary to law?  Is there a statute that prohibits it?

Frankly I don't know or care whether or not there is a law against it! It is still, let us say, HIGHLY unethical at the least in my view!!

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #5 on: April 17, 2014, 02:00:53 PM »
On that we most surely agree.  It is unethical.  It just isn't lawless.

And that Sir is just the sort of hair splitting that is destroying this once great Republic!

Offline Fishrrman

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #6 on: April 17, 2014, 10:36:19 PM »
Bigun wrote above:
[[ THIS may be the most completely lawless administration in history and certainly is in MY lifetime! ]]

Barack Obama is the equivalent of The Tar Baby in Disney's "Song of the South".

Everyone that touches him becomes entangled. Every government agency gets corrupted, gets subjugated.

Even those who despise and keep away from him, cannot escape the grasp of the government that has been degraded by him.

What will it take to break free again?

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #7 on: April 18, 2014, 07:39:06 AM »
What is the citation for the law that authorizes this sort of prying on the part of the Census Bureau?
The only difference between the Democrats and the Republicans is that the Democrats allow the poor to be corrupt, too.
--- Oscar Levant

Online Bigun

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #8 on: April 18, 2014, 09:37:26 AM »
What is the citation for the law that authorizes this sort of prying on the part of the Census Bureau?


In Article ! Section 2 of the Constitution we find the following language: "The actual Enumeration shall be made within three Years after the first Meeting of the Congress of the United States, and within every subsequent Term of ten Years, in such Manner as they shall by Law direct."

They have by law directed in U.S. Code Title 13 .

13 U.S. Code § 4 - Functions of Secretary; regulations; delegation

The Secretary shall perform the functions and duties imposed upon him by this title, may issue such rules and regulations as he deems necessary to carry out such functions and duties, and may delegate the performance of such functions and duties and the authority to issue such rules and regulations to such officers and employees of the Department of Commerce as he may designate.

13 U.S. Code § 5 - Questionnaires; number, form, and scope of inquiries

The Secretary shall prepare questionnaires, and shall determine the inquiries, and the number, form, and subdivisions thereof, for the statistics, surveys, and censuses provided for in this title.

And thus it appears that the Secretary of Commerce is yet another imperial potentate who can do whatever the hell he wishes to do with regard to the census!
« Last Edit: April 18, 2014, 09:51:16 AM by Bigun »

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Re: Census Survey Revisions Mask Health Law Effects
« Reply #9 on: April 18, 2014, 09:56:15 AM »
The bureau's job is to count people living in the United States, not ask about their personal lives, what type of toilets they have, how the ACA has improved their lives, etc.

Since my previous post, above, I've learned that the census rep asked what might be termed medical questions about my brother-in-law's roommate, e.g., the extent of his disability (he also is mentally handicapped), how it affects his ability to get around, etc. Thankfully, the REM people refused to answer many of the questions, citing privacy obligations.
The only difference between the Democrats and the Republicans is that the Democrats allow the poor to be corrupt, too.
--- Oscar Levant


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