Junk Social Science in the Medical Bankruptcy Debate

Cite this Article
Joshua D. Wright, Junk Social Science in the Medical Bankruptcy Debate, Truth on the Market (July 26, 2007), https://truthonthemarket.com/2007/07/26/junk-social-science-in-the-medical-bankruptcy-debate/

My GMU colleague Todd Zywicki and Gail Heriot (USD) have an op-ed in the Washington Times exposing Harvard Professors David Himmelstein and Elizabeth Warren’s study on medical debt and bankruptcy, presented to Congress earlier this week, as “one of the most misleading pieces of research ever placed before Congress — no small dishonor.” 

The punchline of the study is that over 50% of bankruptcies have a medical cause, a conclusion that Zywicki and Heriot say is reached only because the researchers have a fairly odd definition of “medical cause” which includes uncontrolled gambling, drug or alcohol addiction, the birth or adoption of a child, or $1,000 or more in out-of-pocket medical expenses over the two years prior to bankruptcy.  The study has been criticized extensively elsewhere (see, e.g. here). 

Maybe Congress isn’t interested in discovering the “true” causal relationship between medical debt and bankruptcy and is simply looking for a study that is consistent with its priors.  I don’t know.  But I don’t expect much more from a Congress that is apparently willing to pass price gouging legislation in the face of all theory and empirical evidence suggesting that this is a horrible idea.  One potential solution to preventing junk social science from influencing policy decisions is to allow for an adversial process in presenting the data so that spurious correlations can be brought to the surface.  Apparently, this solution was undone by some political manuevering.  From Gail Heriot’s post at the Right Coast:

The agenda as originally prepared called for Donna Smith, who was featured in Michael Moore’s Sicko, to testify first, followed by the experts witnesses on both sides, so that the witnesses invited by the minority would have a chance to respond to the study co-authors.  Minutes before the hearing began, the order of witnesses was re-arranged, so that Zywicki & and Clifford J. White III, Director of the Executive Office of United States Trustees, the other witness invited by the minority, would directly follow Ms. Smith’s emotional testimony.  The co-authors of the study, who were invited by the majority would both go later and thus be unrebutted. 

For TOTM readers interesting in seeing the primary sources themselves: Professor Warren’s testimony is available here, the study is available here, and Professor Zywicki’s testimony is available here.