Even harder to measure is the number of Americans who go bankrupt because of medical bills. The most commonly cited study, conducted by researchers from Harvard University and Ohio University, estimates that medical problems contributed to at least 46 percent of all bankruptcies in 2001 and to 62 percent of bankruptcies in 2007—a nearly 50 percent increase over six years. But conservatives have criticized its methodology and sample size. Liberal health care economist Uwe Reinhardt of Princeton University says the data on medical bankruptcies is vague. The solution, he says, is to conduct a major survey now measuring the stress of medical bills on American families and compare that data to new numbers after 2014, when the individual mandate kicks in. If the number of bankruptcies goes down, Obama can claim a victory.
And good luck measuring health care reform’s effect on the economy. The Congressional Budget Office projects that reform will reduce the deficit by $143 billion over the first 10 years and $1.3 trillion in the second decade. But the CBO emphasizes its uncertainty. Moreover, we may know 20 years from now how much we spend on health care. But it will be difficult to say for sure whether we would have spent more or less had reform never passed.
The problem with these numbers, as with any real-world economic measurement, is that there’s no control. Medical bankruptcies may eventually go down, but they might have gone down anyway, thanks to a rebounding economy. Americans might get healthier, but education and anti-obesity efforts might have made them healthier anyway. Despite the Obama administration’s penchant for citing “jobs created or saved,” no such measurement exists.
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