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The Centers for Medicare & Medicaid Services will be removing statistics on potentially life-threatening” mistakes made in hospitals from its Hospital Compare website. See the “Readmissions, Complications, and Deaths” tab when you choose hospitals to compare.
- U.S. to Delete Data on Life-Threatening Mistakes From Website, By Charles R. Babcock, Bloomberg (May 2, 2013).
Two years ago, over objections from the hospital industry, the U.S. announced it would add data about “potentially life-threatening” mistakes made in hospitals to a website people can search to check on safety performance.
Now the Centers for Medicare and Medicaid Services is planning to strip the site of the eight hospital-acquired conditions, which include infections and mismatched blood transfusions, while it comes up with a different set.
…The statistics were first posted in October 2011. CMS officials have said they’ll be removed during the website’s annual update in July, according to Binder and the American Hospital Association. Binder estimated it could be two years before data from the new HACs appear on Hospital Compare.
Recently Bert Chapman, the Government Information & Political Science Librarian and Professor of Library Science at Purdue University, posted a comment (An Economic Case Against Homosexuality) on his blog (Conservative Librarian, October 27, 2009).
We disagree both with Bert’s premises (that homosexuality is “aberrant ” or a “lifestyle” or that it is a “threat” to “traditional sexual morality”) and with his conclusions (that “the extremely high financial costs” justify imposing one’s religious beliefs on others).
In fact, we do not believe that any economic argument could justify denying basic human rights to members of our society. Jonathan Swift made this point better than we ever could in his satiric piece, A Modest Proposal for Preventing the Children of Poor People in Ireland Being a Burden to Their Parents or Country, and for Making Them Beneficial to the Publick (1729).
We understand that, in a secular country whose citizens embrace many (often conflicting) religious beliefs, we make economic and legal choices democratically all the time. Those decisions come from what we as a society value collectively, democratically. We make those choices with the understanding that the process will yield good decisions for all (including minorities). We also believe that, in this country, we have an explicit, Constitutional responsibility to refrain from imposing one religious or philosophical belief on others who do not share that belief.
Although we reject Bert’s premise that economics can be used as an argument “against homosexuality,” we do recognize that some people might find Bert’s “economic case” convincing even if they do not share Bert’s religious beliefs. For that reason, we think it important, even necessary, to address the factual inaccuracies of Bert’s posting.
Our colleague and guest FGI blogger Amy West, Data Services Librarian at the University of Minnesota, has investigated Bert’s claims and reports, below, on her findings.
As the FGI folks say above, I’m not planning to discuss the premises underlying Bert’s article. Instead, I will take his arguments as is and respond. As I look at the comments he’s received on his site, on the article in Inside Higher Ed (http://www.insidehighered.com/news/2009/11/13/purdue) and on professional listservs, I notice no one has systematically addressed the figures he presents, or more commonly doesn’t present. So, paragraph by paragraph, here’s what I found…
Paragraph One: Introduction – no factual assertions
Paragraph Two: Federal Expenditures on HIV/AIDS
Bert says that federal expenditures on HIV/AIDS related activities in 2008 are $23.3 billion dollars, but provides no citation. So, I went to the Consolidated Federal Funds Report (CFFR) from the Bureau of the Census. The CFFR provides annual reports on funds expended by the federal government. According to the CFFR, in Fiscal Year 2008, the federal government expended $3,692,496,880 on activities related to HIV and AIDS.(1) However, the total amount of federal expenditures is $4,416,612,547,616 or $4.4 trillion dollars. Thus, HIV/AIDS expenditures would be 0.08% of all federal expenditures. Yes, $3.6 billion dollars is a lot of money, but in context of the overall federal budget, it’s a tiny, tiny portion of the pie. Does this really constitute an undue burden on the overall population? For some additional perspective, keep in mind that federal flood insurance expenditures for FY 2008 were $1.16 trillion dollars or 26% of total federal expenditures.(2)
Paragraph Three: Costs from pharmaceuticals and patient care as a result of sexually transmitted diseases.
Bert suggests that we should factor in costs from behaviors he’s opposed to, but doesn’t provide any such data himself – just implies that there must be a cost and it must be significant. However, if you look at the leading causes of death from the Centers for Disease Control, you’ll see that the number one cause of death in the U.S. is heart disease.(3) Further, as of 2005, Forbes.com reported that the best-selling drug in the U.S. was Lipitor ($8.4 billion in sales in the list attached to the article), which treats high cholesterol (a factor in heart disease).(4) Given the readily available data showing that other diseases and associated treatments are significant factors in health care costs, it’s going to take more than an assertion to make this point. It’s also worth noting that $8.4 billion dollars in sales for a single drug for a single health condition in 2005 is more than double all federal spending on HIV/AIDS programs for 2008 as reported in the CFFR.
Paragraph Four: HIV/AIDS in Prisons
The inclusion of this paragraph is a mystery. Rape is certainly bad in any circumstance, but the relationship of prison rape to HIV/AIDS and any economic costs is left unstated in Bert’s post. Of note is the series HIV in Prisons published by the Bureau of Justice Statistics which shows that for 2006, “1.6% of male inmates and 2.4% of female inmates in state and federal prisons were known to be HIV positive or to have confirmed AIDS.”(5) HIV in Prisons sheds no light on how or when the prisoners acquired HIV/AIDS because of the varied methods in which testing occurs in prisons.(6)
Paragraph Five: Domestic Partner Employee Benefits Reduce Benefits to Heterosexual Couples
Once again, there is no data here, just assertions. There is reference to an article called “Do Domestic Partner Benefits Make Good Economic Sense?” as a source of supporting data.(7) This article relies on a single study of small businesses to make arguments regarding all domestic partnership benefit packages from all employers of all sizes. Yet, even the authors of this article acknowledge that there exists no data to prove their claims when they say “To date there is very little publicly available data-and no publicly available actuarial studies-on the cost of health-care for live-in partners, for nearly 90 percent of the employers with such benefits adopted them within the past six years. Moreoever, most employers and insurers either do not track the cost of domestic partnership benefits separately, or do not disclose the information publicly. Accordingly, it is nearly impossible to accurately predict the cost of granting cohabitation benefits.”(8) In fact, the study on which they rely analyzed small businesses. It may well be that adding domestic partnership benefits is more expensive for small companies than large companies, but that could just be an effect of the overall structure of health care in the U.S. According to the fact sheet “The Economic Effects of Health Care Reform on Small Businesses and their Employees” from the Council of Economic Advisers, the current structure of health care means that small businesses usually pay 18% more the same sets of benefits as large employers, regardless of what those benefits might be.(9)
Paragraph Six: Legalizing Same-Sex Marriage nationwide will increase costs for insurance, estate planning, divorce
There is no data in this paragraph; just what a “what-if” scenario. Since only five states allow same-sex marriages and federal law actively bans them, there simply is no data on which to base speculations on the effect of expanding marriage to more people with respect to insurance, estate planning and divorce law.(10) It is worth noting though that for those people who do have the option to marry, not all is rosy: nearly half of all marriages end in divorce.(11) Any increase in costs associated with marriage and divorce (if there are any) must lie with heterosexual couples because they are only ones with a guaranteed right to do both nationwide.
Paragraph Seven: Conclusion – – no factual assertions
Bert describes his post as a description of “substantive realities which cannot be denied”. However, as I show above, he describes neither current reality nor provides indisputable data. If there is an economic case to be made against homosexuality, it’s not present here.
(1) West, Amy. “HIV/AIDS Expenditures.” Consolidated Federal Funds Report. https://spreadsheets.google.com/ccc?key=0AuLB6VoqlRSidE11YVZBMFRMZFB2UzhiQ2pLS0NzblE&hl=en. Accessed 11/16/09.
(2) Bureau of the Census. “Table 9. Federal Government Insurance Programs—Volume of Coverage Provided by State and Outlying Area: Fiscal Year 2008.” Consolidated Federal Funds Report for Fiscal Year 2008. http://www.census.gov/prod/2009pubs/cffr-08.pdf. Accessed 11/16/09.
(3) Centers for Disease Control. “Deaths and Mortality.” FASTSTATS. http://www.cdc.gov/nchs/fastats/deaths.htm. Accessed 11/16/09.
(4) Herper, Matthew. “The Best-Selling Drugs In America.” Forbes.com. http://www.forbes.com/2006/02/27/pfizer-merck-genentech-cx_mh_0224topsellingdrugs.html. Accessed 11/16/09.
(5) Maruschak, Laura M. “Highlights.” HIV in Prisons, 2006. http://www.ojp.usdoj.gov/bjs/pub/html/hivp/2006/hivp06.htm#highlights. Accessed 11/16/09.
(6) Maruschak, Laura M. “HIV Testing in Prisons.” HIV in Prisons, 2006. http://www.ojp.usdoj.gov/bjs/pub/html/hivp/2006/hivp06.htm#testing. Accessed 11/16/09.
(7) Corporate Resource Council. Do Domestic Partner Benefits Make Good Economic Sense? http://www.corporateresourcecouncil.org/white_papers/DP_Good_Business_Sense.pdf. Accessed 11/16/09.
(8)ibid, pg. 1.
(9)Council of Economic Advisors. The Economic Effects of Health Care Reform on Small Businesses and their Employees. http://www.whitehouse.gov/administration/eop/cea/Health-Care-Reform-and-Small-Businesses. Accessed 11/16/09.
(10) United States Congress. To define and protect the institution of marriage. P.L. 104-199. http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=104_cong_public_laws&docid=f:publ199.104. Accessed 11/16/09.
(11) Centers for Disease Control. “Marriage and Divorce.” FASTSTATS. http://www.cdc.gov/nchs/fastats/divorce.htm. Accessed 11/16/09.