I found the article in question. The fact-checking was about
Sanders not the Himmelstein article. The fact-checking was about the claim that 500,000 medical bankruptcies occur per year. When, in fact that's basically the number of people who had bankruptcies where health played any role at all. So you could get sick and lose your job and default on your bills, and now that's a medical bankruptcy because health played any part whatsoever. The point here is that Sanders is making the claim to emphasize medical costs, but it's not actually an accurate claim to say half a million people declare bankruptcy
because of medical bills. I give Sanders a free pass here because you guys need him, but that doesn't magically make everything he says accurate or that we have to bend reality over backwards to fit with what Sanders says.
The "500,000 per year" claim is actually that 2/3rds of all bankruptcies per year are "medical bankruptcies", regardless of how much medical bills added to the total, as long as there were any medical bills included in the debt, basically. It's a fairly empty nonsense election-year claim. A basic sanity check when the figure claims "X number of this thing are caused by <specific reason>" per year is to look at the total of that thing for any year and see if it makes sense. Googling the number of bankruptcies per year and see that it's 700,000-800,000 per year,
total, and to say almost all bankruptcies are because of the health system needs more evidence than some editorial. note that the WAPO article cites a more nuanced study that found that in 4% of bankruptcies medical bills were the primary cause, which would give a figure about 10 times smaller than the one Sanders cited.
That study, led by David U. Himmelstein, took a sample of bankruptcy court filings from 2013 to 2016, identified 3,200 bankrupt debtors and mailed them a survey. The response rate was 29.4 percent, with 910 responses and 108 surveys returned as undeliverable.
Debtors were asked whether medical expenses, or loss of work related to illness, contributed to their bankruptcies. Of those who responded, 66.5 percent said at least one of those factors contributed “somewhat” or “very much.”
Sixty-six percent of 750,000 is 500,000, so Sanders’s math adds up at first glance.
“The majority (58.5%) ‘very much’ or ‘somewhat’ agreed that medical expenses contributed, and 44.3% cited illness-related work loss; 66.5% cited at least one of these two medical contributors—equivalent to about 530,000 medical bankruptcies annually,” the AJPH editorial says.
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This study includes a range of people for whom medical expenses or illness contributed “somewhat” to bankruptcy. What does “somewhat” mean? It’s broad enough to mean “slightly,” “fairly” or “moderately.” Sanders’s claim works only by erasing this ambiguity and taking “somewhat” to mean “mostly.”
The AJPH editorial did not undergo the same peer-reviewed editing process as a research article.
“In AJPH, many editorials are commissioned by the editor-in-chief from experts in their field(s), as a forum to present their most recent or preliminary findings on specific topics, or to coincide with significant dates or events,” said Morgan Richardson, an AJPH editor. “Lack of peer review does not indicate inaccuracy, but editorials are less likely to be cited in the scientific literature as evidence because the standard of rigor is different due to context.”
However, Himmelstein used a methodology similar to what he, Warren and other researchers used in a 2005 peer-reviewed study that they updated in 2009. Warren was a co-author of those two studies, but not the AJPH editorial published in March.
Note that the study mixes in medical costs
and loss of work due to health reasons, and asks if either of these added to the bankruptcy "somewhat" or greater. Then Sanders takes the total, scales it up to the number of bankruptcies per year and then claims 500,000 people declared bankruptcy
because of medical bills. The original study doesn't support that claim even if you take the results as face value. It's mixing different things together. Also, as with any self-reporting thing, the data may be further skewed. Perhaps people who went bankrupt but have medical issues as well were more likely to respond to the survey because they're less likely to have found work after the bankruptcy, giving them more time to respond?
As for the Himmelstein issue, it wasn't lying, it was just insufficient fact-checking. The editor of the journal told WAPO that the editorials aren't peer-reviewed, which Himmelstein himself also agrees with, and they just assumed that also applied to the Himmelstein one, however Himmelstein wrote to them, as per your post, that
normally the editorials aren't peer-reviewed, but his one was from a peer-reviewed study. So it's an error, not lying. Lying needs to be deliberate. The editor of that journal outright said "the editorials aren't peer-reviewed" and they misconstrued the context of what that meant for the stuff cited in the editorial. Also, focusing on that mistake as if it's some "gotcha" moment is missing the point. Does it make a difference to the truth of
Sander's claim if the editorial was peer-reviewed or not? In fact, it doesn't. What Sanders said was just wrong, and isn't supported by the source study regardless of whether it was peer reviewed.
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