Seven Falsehoods about the Health Care Plan

Truth(lies) hr3200jpg (500 x 212)

Big myths about the current debate

By Brooks Jackson, Viveca Novak, Lori Robertson and Jess Henig

We offer a run-down of seven falsehoods we’ve taken on recently, with some additional updating and research thrown in.

Summary

So much for a slow news month. August feels like campaign season, with claims on health care coming at us daily. Does the House bill call for mandatory counseling on how to end seniors’ lives sooner? Absolutely not. Will the government be dictating to doctors how to treat their patients? No. Do the bills propose cutting Medicare benefit levels? No on that one, too.

But on the other hand, has Congress figured out how to pay for this overhaul? Not yet. Or will it really save families $2,500 a year as the president keeps claiming? Good luck on that one, too.

In this article we offer a run-down of seven falsehoods we’ve taken on recently, with some additional updating and research thrown in.

Analysis

False: Government Will Decide What Care I Get (a.k.a. they won’t give grandma a hip replacement)

This untrue claim has its roots in the American Recovery and Reinvestment Act of 2009 (the stimulus bill), which called for the creation of a Federal Coordinating Council for Comparative Effectiveness Research. The council is charged with supporting and coordinating research that the government has been funding for years into which treatments work best, and in some cases, are most cost-effective. Supporters of this type of research say it can provide valuable information to doctors, improving care and also lowering cost.

Betsy McCaughey, a former Republican lieutenant governor of New York (and now a professing Democrat), wrote in an opinion piece that the government would actually tell doctors what procedures they could and couldn’t perform. The claim took off from there, popping up in chain e-mails and Republican press conferences. It’s not true. The legislation specifically says that the council can’t issue requirements or guidelines on treatment or insurance benefits:

American Recovery and Reinvestment Act of 2009: Nothing in this section shall be construed to permit the Council to mandate coverage, reimbursement, or other policies for any public or private payer. … None of the reports submitted under this section or recommendations made by the Council shall be construed as mandates or clinical guidelines for payment, coverage, or treatment.

As for the health care bills themselves, the House’s H.R. 3200 sets up a center to conduct and gather such research within the Agency for Healthcare Research and Quality, an entity the CBO called “the most prominent federal agency supporting various types of research on the comparative effectiveness of medical treatments.” Like the stimulus legislation, the bill states that: “Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer.’’

The Senate Health, Education, Labor and Pensions Committee bill (not yet released in its entirety) calls for a similar center that “will promote health outcomes research and evaluation that enables patients and providers to identify which therapies work best for most people and to effectively identify where more personalized approaches to care are necessary for others,” according to the summary of the bill.

This claim also stems from a fear that the U.S. will institute a system like that of the U.K., where the government provides and pays for health care. But none of the bills now being debated in Congress call for such a system, and the president has said he doesn’t want nationalized or single-payer health care, as we’ve said several times.

For more, see: “Doctor’s Orders?” Feb. 20

“Government-Run Health Care?” April 30 

 

False: The Bill Is Paid For

At least, it isn’t paid for yet.

President Obama has repeatedly said that a health care overhaul “will be paid for” and that he won’t sign a bill that isn’t deficit-neutral. But neither the House bill nor the Senate HELP Committee bill meets that criteria. According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the HELP Committee bill racks up more, $597 billion over 10 years.

Obama has also said he has “identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now.” But “identified” is the operative word. These savings are estimates and whether around $650 billion (about two-thirds of the cost of health care over 10 years) can be saved remains to be seen. Most of the money would come from Medicare, but cuts in payments to insurers and practitioners aren’t popular measures that move easily through Congress.

So the big questions remain. Will the president break his promise and sign a bill that piles up hundreds of billions of additional debt? Will the legislation have to be scaled back to cost less, and perhaps cover fewer of the uninsured? Who will pay additional taxes? Can pain-free reductions in other government programs be found?

Obama’s Health Care News Conference,” July 23

 

False: Private Insurance Will Be Illegal

In July, Investor’s Business Daily published an editorial in which it claimed that H.R. 3200 would make private insurance illegal. But IBD was mistaken. It was citing the part of the bill that ensures people with individually purchased coverage don’t have to give up that coverage unless they want to.

Under the House bill, people who want to buy new individual, nongroup coverage will have to purchase it through a new health insurance exchange. They can still buy private insurance – the exchange, in fact, would offer a range of private plans, in addition to a new federal health insurance option. However, those who were already buying their own insurance before the bill went into effect – about 14 million Americans – will have their plans grandfathered in. The part of the bill IBD cites doesn’t forbid insurers from issuing new plans. It says that new individual plans will not be considered grandfathered, and will have to be purchased through the exchange.

“Private Insurance Not Outlawed” Aug. 13

 

False: The House Bill Requires Suicide Counseling

This claim is nonsense. In an appearance on former Sen. Fred Thompson’s radio show, McCaughey also enthusiastically pushed the bogus claim that the House bill will require seniors to have regular counseling sessions on how to end their lives:

McCaughey, July 16: The Congress would make it mandatory … that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go into hospice care … all to do what’s in society’s best interest … and cut your life short.

This is a misrepresentation. What the bill actually provides for is voluntary Medicare-funded end-of-life counseling. In other words, if seniors choose to make advance decisions about the type of care and treatments they wish to receive at the end of their lives, Medicare will pay for them to sit down with their doctor and discuss their preferences. There is no requirement to attend regular sessions, and there is absolutely no provision encouraging euthanasia.

Of course, seniors who talk to their doctors about end-of-life care might well choose to discuss what types of life-saving treatment they wish to refuse. That choice has been federally guaranteed for almost 20 years. Euthanasia, on the other hand, is legal in only three states, making it even more unlikely to be a major part of the federal health plan.

False Euthanasia Claims,” July 29

 

False: Families Will Save $2,500

Proponents speak constantly of holding down rising medical costs. As recently as May 13, the president said legislation plus some voluntary measures by the private sector “could save families $2,500 in the coming years – $2,500 per family,” echoing a claim he made countless times on the campaign trail last year.

Don’t start spending that $2,500 just yet.

For one thing, Obama isn’t actually promising to reduce health care spending below current levels, only to cut the rate of growth in spending. And even that is proving to be far tougher to accomplish than Obama led voters to believe. We’ve already mentioned that the Congressional Budget Office says “savings” in Medicare spending resulting from the House bill would fall short of what is needed to pay for two-thirds of its cost, which is Obama’s goal. And those savings come only in what the government pays, not in what families pay.

Squeezing more savings, even from Medicare, is proving difficult. On July 17, Obama’s lead man on the subject, Office of Management and Budget Director Peter Orszag, wrote to congressional leaders seeking legislation setting up an independent agency, the Independent Medicare Advisory Council (IMAC). It would be made up of health care experts with the power to make a package of annual changes in the amounts Medicare would pay to doctors. The president must either approve or diapprove the entire package as offered; if he approves, it goes into effect unless Congess passes a joint resolution stopping it. But when CBO took a look, it estimated that the new agency would save a total of only $2 billion over the next decade.

As for saving $2,500 for families, as opposed to saving money for the government, the CBO’s letter, signed by Director Douglas W. Elmendorf, said:

CBO: [E]xperts generally agree that changes in government policy have the potential to significantly reduce health care spending—for the nation as a whole and for the federal government in particular—without harming people’s health. However, achieving large reductions in projected spending would require fundamental changes in the financing and delivery of health care.

As an example of the “fundamental” changes that might do the trick: CBO suggested moving away from the current system of paying doctors and hospitals for performing medical procedures and paying them instead a fixed fee per patient or some other payment based on “value.” Another CBO suggestion: “higher cost-sharing requirements.” So far we don’t see those ideas in the bills being considered.

 

False: Medicare Benefits Will Be Slashed

The claim that Obama and Congress are cutting seniors’ Medicare benefits to pay for the health care overhaul is outright false, though that doesn’t keep it from being repeated ad infinitum.

The truth is that the pending House bill extracts $500 billion from projected Medicare spending over 10 years, as scored by the Congressional Budget Office, by doing such things as trimming projected increases in the program’s payments for medical services, not including physicians. Increases in other areas, such as payments to doctors, bring the net savings down to less than half that amount. But none of the predicted savings – or cuts, depending on one’s perspective – come from reducing current or future benefits for seniors.

The president has promised repeatedly that benefit levels won’t be reduced, reiterating the point recently in Portsmouth, N.H.:

Obama, Aug. 11: Another myth that we’ve been hearing about is this notion that somehow we’re going to be cutting your Medicare benefits. We are not.

Is he wrong? Not according to AARP, by far the nation’s largest organization representing the over-50 population. In a “Myths vs. Facts” rundown, AARP says:

AARP: Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.

To be sure, Obama hasn’t always thought that Medicare “savings” could be accomplished without actual cuts in benefits. Last fall, his campaign ran two television ads accusing Sen. John McCain of wanting “a 22 percent cut in [Medicare] benefits.” The basis for the ads was a newspaper article in which a McCain aide said the Arizona Republican would cut Medicare costs. But the aide said nothing about cutting benefits, in fact quite the contrary. We called the claim “false” when Obama made it against McCain, and it’s still false now when Obama’s critics are making the same accusation against him.

 

False: Illegal Immigrants Will Be Covered

One Republican congressman issued a press release claiming that “5,600,000 Illegal Aliens May Be Covered Under Obamacare,” and we’ve been peppered with queries about similar claims. They’re not true. In fact, the House bill (the only bill to be formally introduced in its entirety) specifically says that no federal money would be spent on giving illegal immigrants health coverage:

H.R. 3200: Sec 246 — NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS

Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

Also, under current law, those in the country illegally don’t qualify for federal health programs. Of interest: About half of illegal immigrants have health insurance now, according to the nonpartisan Pew Hispanic Center, which says those who lack insurance do so principally because their employers don’t offer it.

“Misleading GOP Health Care Claims” July 23

 


Sources

Congressional Budget Office. Letter to Rep. Charles B. Rangel. 17 Jul 2009.

Congressional Budget Office. Letter to Sen. Edward M. Kennedy. 2 Jul 2009.

U.S. House. “H.R. 3200.” (as introduced 14 Jul 2009.)

Agency for Healthcare Research and Quality. “Advance Care Planning: Preferences for Care at the End of Life.” Mar 2003.

AARP Responds to Health Reform Scare Tactics.” Press release. AARP 24 Jul 2009.

Keyserling, Jon. Interview with FactCheck.org 29 Jul 2009.

Patient Self-Determination Act. 42 USC 1395cc.

Collins, Sara. Interview with FactCheck.org. 21 Jul 2009.

It’s Not an Option.” Editorial. Investor’s Business Daily. 15 Jul 2009.

Orszag, Peter. Letter to House Speaker Nancy Pelosi. Office of Management and Budget. 17 Jul 2009.

Congressional Budget Office. Letter to Rep. Steny Hoyer. 25 Jul 2009.

Posted at FactCheck.org.

Also see 5 Myths Debunked by OpenCongress.org.

3 responses to “Seven Falsehoods about the Health Care Plan

  1. Pingback: Debunking Health Care Lies (by Reading the Bill) « COTO Report

  2. First: Why are we saddling employers with the cost of healthcare? This kills off more small businesses than any other one thing.

    Second: As forthe claim that illigal aliens will not be covered…thats a mis leading summary. Of course they will be covered. Just as they are now.

    Money (funding) will be authorized for states to implement these programs. Accepting the funding will be made conditional on the states continuing to provide healthcare on demand at emergency rooms etc…..but now fudning will be afforded to increase medicaid state by state. Most states now are in deficit due to the large number of illegals being granted access to medicaid.

    In 2007, I believe, I could be wrong about the exact year, the PEW hispanic center estimated between 12-20 million illegals were present in the country Of those, about 7 million were thought to be employed on and off the books. How were those additional 5-9 million living? Ask California.

    The devil is in the details……and not one of those pious jackasses in District of Criminals has bothered to read the netire bill and most have not read any of it. For cripe’s sake…..if they didn’t bother to read the 159 page food fascism bill you know damn well none of them have read this. besides…it might have big words in it with more than two syllables.

    This whole thing about what is or is not in the bill is a bogus stage show. It does not deal with the actual CAUSE of the problems with healthcare.

    A real plan would have regulated and penalized those same corrupt insurance corps we just bailed out. These are the same companies who got kabillions of our money for selling insurance (contracts) for which they had no real intentin of honoring. Isn’t that breach of contract? Then they took that money and used it for anything other than servicing their clients. Isn;t that fraud?

    I was ambivelant about this whole mess until i heard Obama at one of his town halls proudly announcing that they were “working with” insurance companies to fine tune this deal.

    Ok! So here it is! I told you so! I told you so! I told you so!

    The same insurance companies we had to bail out for corruption, malfeasance, deceptive practices, unethical practices, diversion of funds, accounting schemes, etc…..are going to be handed the keys to the kingdom.

    There is no way Obama or anyone in the District of Criminals is going to allow this golden egg to slip away from their big time donors. This bill does only two things:

    It makes the Obama adminsitraion look as if it is delvering oncampaign promises and is actually going to do something to make sure legal Americans can all get healthcare, and,

    It makes sure that the same companies who have been willing cash cows for politicians remain in place to keep the cash flowing.

    And those are my thoughts for the day. So there.

    • What’s actually in the 1,013 page bill may be a sideshow, since they often change things while we the public are still digesting the former versions. But, how can we have a debate about the bill without talking about what’s in it?

      I posted these two pieces on its contents to refute an earlier post here by a lawyer who mischaracterized what was in the bill.

      You probably do have a point about illegal aliens being covered. I’m not really opposed to that. If the chit hits the fan in the US and a bunch of us jump borders to escape mass arrest and roundups, and while in another country get injured or sick, I know that YOU and I both will be grateful for free medical care in that nation.

      I also posted here an excellent critique of Obama’s plan by a Leftist – Bruce Dixon, who calls the plan a health insurance reform bill, not a health reform bill. (so there 😉

      But, now Obama’s true colors are showing. Yesterday’s news wire reported that the ‘public option’ will be removed from this massive bill that will – as you state – benefit the health insurance industry.

      Too many people objected to Medicare for All, so now the bill will help corporations. I sincerely hope and pray the grassroots right will stop getting fooled by corporatists.

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