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Tuesday, February 2, 2016

Junk "Science": Obamacare

We have to rely on something but when numbers are used to make arguments rather than prove them, or to justify conclusions rather than influence them, then our mistrust is warranted. Beyond the subject matter covered here which is the Kaiser Health Tracking Poll of January 2016, ( http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-january-2016/, Bianca DiJulio, Jamie Firth, Ashley Kirzinger and Mollyann Brodie), in an environment where everything about our healthcare from diagnosis to treatment is based on some "study," the alarming quantity of junk science is meaningful.

Consider articles such as, "Lies, Damned Lies, and Medical Science," by David H. Freedman in, "THE ATLANTIC," in November of 2010, http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/, "…much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong."

In the February 2016 issue of REASON.COM, Ronald Bailey in his article reports on, "Broken Science," and about "The mounting evidence that most scientific findings are false," http://reason.com/archives/2016/01/19/broken-science.

In 2012, the US National Library of Medicine, National Institutes of Health, PubMed.gov have found the same thing-- Research by Grimes and Schulz states, "Most reported associations in observational clinical research are false, and the minority of associations that are true are often exaggerated," (http://www.ncbi.nlm.nih.gov/pubmed/22996110).

In September of 2014, researchers Hartsell, Dorais, Preston, Hamilton, Fuller, Mallin, Barton and Madsen researched, " False-positive rates of provocative cardiac testing in chest pain patients admitted to an emergency department observation unit," concluding, "False-positive rate for stress testing was 75% and 66.7% for perfusion and stress echo respectively. False-positive rate for CCTA was 42.9%. It must be acknowledged that while these findings do not directly impugn the utility of stress testing or CCTA, it may indicate the need for more appropriate patient selection to avoid unnecessary cardiac catheterization among EDOU chest pain patient cohorts."

These are examples of more serious implications of junk science than the Kaiser survey, but the Kaiser survey is not helping us trust information.

Back to the "Poll" and what it "means": In a graphic that announces: "Affordable Care Act ranks EIGHTH in Issues Important to Voters this Fall," (http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-january-2016/, Bianca DiJulio, Jamie Firth, Ashley Kirzinger and Mollyann Brodie), you'll find that yes, the reported results indicate that the "2010 health care law" described as that rather than the ACA or Obamacare does come in eighth, BUT that the Cost of your health care/health insurance ranks THIRD.

So why no headline that the cost of health care and health insurance ranks THIRD among concerns for voters? To me it's obvious--Kaiser doesn't want people to focus on Obamacare. In fact, if you go through the article, you'll see very little attention paid to the issue of cost though 82 percent of voters polled are concerned about such costs (see Figure 2 of the survey) and 64 percent of voters say that healthcare costs is the "single most or a very important factor" and 58 percent say that the future of the 2010 health care law (Obamacare, ACA) is the "single most or a very important factor," (see Table 1).

Suddenly, the pronouncement that the Affordable Care Act ranks EIGHTH becomes a junk science headline. We are concerned about the costs of our health care and we see the connection between Obamacare and those costs. That's what candidates need to know--Obamacare has not "reformed" anything to our satisfaction, which is obviously justified in the face of the direction healthcare has taken under Obamacare.

Until "scientists" of every ilk stop manipulating data at the outset or after-the-fact to prove their own point, our mistrust is justified and with all the reliance on science that the scientific community itself is finding to be false we face the risk of losing or underestimating the importance of good science.