Over at HealthBlawg, David Harlow points to a recent study conducted by The Commonwealth Fund and the Employee Benefit Research Institute (EBRI) showing that enrollment in consumer-directed health care plans remains largely unchanged over last year. Harlow asks, “Why haven’t consumer-directed health plans taken off?” “Maybe they’re just not a good idea,” Harlow offers as one explanation.
Here’s a better one: The Commonwealth Fund-EBRI study is a piece of garbage. As Greg Scandlen of Consumers for Health Care Choices pointed out recently,
How do [the Commonwealth Fund and EBRI] reach these distortions? Well, they explain on page 5 that they conducted an on-line survey of 3,158 privately insured adults drawn from “Synovate’s online sample of 1.5 million Internet users who have agreed to participate in research surveys.” The self-selection problem here is huge, but it isn’t until you get to page 46 that you discover the original “base sample” included all of 21 (that’s twenty-one) people with CDHP coverage. They had to “oversample”ù to get more and that oversample was drawn from just “95,000 online panel members who met the criteria for our study (having private insurance and age 21-64).”
Wait a minute. Only 95,000 of the touted 1.5 million database have private insurance and are between the ages of 21 and 64??? What kind of “random sample”ù is that supposed to be? This is what we are supposed to trust over the actual numbers reported by insurance companies and employers?
Well said, Greg.