Stay calm and update priors as warranted

I want to flag something meta about my Upshot post today, in which I describe a study that suggests hospital productivity has increased in recent years (through 2011). The study findings surprised me. Based on prior work and history, I am highly skeptical hospitals can maintain the high productivity growth it suggests.

Put another way, writing about the study by John Romley, Dana Goldman and Neeraj Sood the way I did was counter to confirmation bias. I’ve posted about the hospitalor health care—productivity problem many times on TIE, as I linked to in the piece. It would have been easy to cling fast to the view that hospitals can never become substantially more productive (the cost disease) and to discount the Romley et al. study for any number of reasons. (I mention caveats at the end of the piece; more have been suggested to me on Twitter.) I find it more interesting and rewarding to take the study at face value—to challenge and update my own priors, if even provisionally.

I suspect some will read the piece as Obamacare boosterism. That’s a mistake. I don’t do that. The ACA really did make a big and risky bet that hospitals could increase productivity. I’ve worried about it for years. I hope it’ll pay off, as the study suggests. We should be prepared for the possibility it won’t. While we wait, we should be brave enough to assimilate new evidence independent of what it implies about the ACA.

Stay calm and update priors as warranted.


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