MIT health economist Jon Gruber has made a number of appearances on this blog, and on blogs like this one. Alongside Harvard's David Cutler, he's probably been the most aggressive academic economist supporting the reform effort. On some level, that's no surprise: He was one of the architects of the Massachusetts reform, and arguably the leading health economist in the country, and so he's the guy best versed in the implications of scaling the Massachusetts approach to the whole nation.
What is a surprise is that he's also got a $300,000 contract with the Department of Health and Human Services to use his microsimulation model to produce "a technical memorandum on the estimated changes in health insurance coverage and associated costs and impacts to the government under alternative specifications of health system reform."
I wasn't aware of that, and if I had been, I would've made sure it was disclosed when I quoted Gruber. On the other hand, the implication that Gruber is somehow a paid shill for this bill belies a fairly long and consistent record in support of health reform, and in particular, this type of health reform. In a statement to Ben Smith, Gruber defends his work:
I do indeed have a contract with HHS. Throughout this year I have provided technical assistance to the administration and to Congress with my micro-simulation model, as well as based on my experience as a member of the Massachusetts health connector board. But NONE of the work I have done in public, or any public declarations I have made, has been in any way funded by the Administration. That funding was strictly for internal work that I did for the administration and, via the administration, for congress. All externally visible work and comments, such as my editorials or public reports, have been done on my own time.
Moreover, at no time have I publicly advocated a position that I did not firmly believe - indeed, I have been completely consistent with my academic track record. On the two issues this article raises:
1) I am known in economics as one of the leading experts on the impact of health insurance costs on wages - indeed, I wrote my thesis on that topic and have written extensively since on the fact that health insurance costs are fully translated into wages. I was asked by the editors of the Handbook of Health Economics, a review of literature in this area, to write the review article on this topic.
2) In my role as a member of the MA Health Connector board, I had to help decide what were affordable subsidies for our citizens. I was surprised to find how little work there was on this topic so I undertook a study to help lay out what might be considered affordable. I have since replicated that analysis at the federal level. Every position I have advocated on this topic is completely consistent with these reports.
I've spoken occasionally with Gruber for years now, and never noticed a shade of difference in his positions. Even so, his government contract should have been disclosed to me, and in the future, when I quote Gruber, it will be disclosed to you. In the meantime, if the administration is indeed listening to Gruber, I hope they heed him on this.
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