The Wall Street Journal won a well-deserved Pulitzer Prize this week for publishing a series of articles on Medicare billing and health care provider practices. The win highlights an important issue that does not get much attention – limited public access to government data. Across many government-provided programs, provider and individual data (even if it has no personally identifying information) is restricted from public view. Not only is this bad from a transparency perspective, but it limits the ability of researchers to assess the effectiveness of government programs.
The WSJ Medicare series was only made possible after a lawsuit provided them with access to Medicare billing data on 880,000 providers from 2012, overturning a 1979 injunction on public access to the data. The article series identified suspicious practices that led to Medicare fraud investigations and directly resulted in at least one tentative settlement between a provider and the government for suspicious payments that amounted to kickbacks.
Access to these Medicare data is a positive development, but it is very much the exception and not the norm. Although the Centers for Medicare and Medicaid have expressed an intent to publish similar Medicare data each year, Medicaid-related data has not been published and it is not clear whether it will. Medicaid spending totaled almost $450 billion in 2013, making access to Medicaid provider billing data equally critical. In addition, the data that was released was limited to a small portion of the Medicare program and did not include patient outcomes.
Similarly, access to other federal program data has historically been restricted. Data on Supplemental Nutrition Assistance Program (SNAP) retailers is also not publicly available. This means that the public cannot see how many SNAP dollars go to particular retailers nor can they see the types of foods purchased with SNAP dollars. The USDA is considering the release of SNAP retailer data, but nothing has been made available to date.
In 2011, prominent economists David Card, Raj Chetty, Martin Feldstein, and Emanuel Saez co-wrote a paper imploring the US to provide access to administrative data on individuals in federal programs for research purposes. They wrote:
Access to existing administrative US data is required to evaluate the effects of various specific US government policies, such as stimulus spending, on job creation and overall personal income. We emphasize that direct access to micro-data is critical for success.
Privacy and confidentiality are important concerns related to the release of data on individuals and providers involved in government programs. But there are ways to provide greater transparency while still protecting privacy. The public needs access to more government data in order to take a critical look at government policies and programs.
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