The Top 7 Craziest Myths About Healthcare Reform
Ok, those who have been following the healthcare reform battle have surely noticed that things have gotten nasty in the last couple of weeks. And I mean seriously nasty. I’ll admit, I’m still young, and I’ve only been following politics with intensity for the last 5 years or so, but I’ve done a fair amount of research on controversies of the past and I feel I’m fairly informed about the history of American politics over the course of the last century. But the healthcare debate that’s going on now seems to be shaping up to be among the most vitriolic policy battles of recent history. And along with that vitriol has come a slew of misinformation and purposeful misrepresentations that have far exceeded anything I would have expected to see in modern America. With the advent of the internet and increased access to original sources, it’s perplexing to me how these smears can spread so quickly, and maintain such staying power.
And the pervasiveness of these myths is likewise surprising. I’ve been watching videos of town hall protesters lately and it is extremely rare to see a protester carrying a sign that isn’t littered with false claims about the healthcare bills. And some of them are so shockingly confused as to deal a serious blow to my faith in humanity (A sign I saw recently reading “keep your government hands off of my medicare” comes to mind). And in casual conversations I’ve had with others about the bill I have yet to talk to an opponent who has actually cited something that’s really in the bill as justification for their opposition. Once again, to be clear, every single person I’ve talked to who opposes the bill, when asked about their reasons, has cited nothing but provisions that are not actually in this bill.
So for the last few days I’ve been working on this article: a feeble attempt on my part to correct 7 outlandish myths that are out there about healthcare reform. In reality there are several claims being thrown about that are probably more shocking than these, but I tried to pick 7 that were both blatantly false, and commonly held. Even many of the moderates in the audience may be unaware that the things mentioned below are, in fact, untrue. I’ve tried to cite original sources wherever possible. And for those who aren’t familiar with the methods of internet bloggers, the underlined text indicates a hyperlink to a source for the underlined statement. This article is quite long, but I believe its topic is vitally important.
In the interest of full disclosure I should also point out that I’m currently a voting delegate to the California Medical Association (CMA) and American Medical Association (AMA), and I hold positions on the CMA’s Council on Legislation and the AMA’s House Coordinating Committee. While these positions have certainly helped increase my understanding surrounding this bill and healthcare policy in general, I am speaking purely for myself in this article and nothing I say should be construed as reflecting the positions of those organizations or committees.
Myth #7 – This Healthcare Reform Plan = Socialized Medicine
I’ll talk about this one first because it’s probably the most pervasive of all the myths I’ve heard so far. And it isn’t all that crazy when you get down to it. In the public mind the terms “universal healthcare”, “socialized medicine”, “public plan”, and “single-payer healthcare” are all kind of viewed as the same communistic policy but they are, in reality, very distinct and different ideas. Let’s do a little bit of defining.
Socialized Medicine – a medical system in which the healthcare providers work for the government, healthcare facilities are owned by the government, and the government is the sole payer of healthcare costs. There are actually few modern examples of true “socialized medicine” with the UK and Spain being two of the only industialized countries to employ such a system. There are currently no groups in the US that are advocating for a system of this nature in the US. Literally even the furthest left-wing healthcare reform advocates are shooting for Single-Payer, described below. (Definition at MedTerms)
Single-Payer Healthcare - a system in which healthcare facilities are privately owned, healthcare providers work for themselves or for hospitals, and the government is the sole insurance company. This could alternatively be called a “socialized health insurance system”. This type of healthcare system is more common and can be found in Canada, Australia, and Taiwan. There are groups in the US, most prominently the PNHP, that advocate for single-payer healthcare, and Dennis Kucinich proposed such a system, but honestly these groups aren’t taken seriously by mainstream liberal politicians. (Definition at MedTerms)
Universal Healthcare - is just a general term for any system in which all or very nearly all of the populace in a given country has either private health insurance or government provided healthcare. There are as many ways to achieve this as one can think of. There are both market-based and regulation-centered reforms that could potentially lead the US to “universal healthcare”. Most countries that ensure universal healthcare do so through a mixture of public programs and private industry. Many of the best healthcare systems in the world are organized in this manner such as those in France or Greece. The US is the only industrialized country in the world that doesn’t have some form of universal healthcare.
Public Plan – The public plan, as described in the House’s initial draft of their healthcare reform bill would not provide free healthcare to anyone and nobody would be required to use it under any circumstances. It would compete with private industry in much the same way that the USPS competes with UPS, FedEx, and others in the package delivery business. But unlike the Postal system it would not be funded with taxpayer dollars but would be required to be financially self sustaining. Many countries with mixed public/private systems have a similar plan. (Fact Sheet on Public Plan)
Now that we have some basic definitions lets see which one’s apply to the reform plans currently in congress. Well, according to CBO predictions (pg. 13), the healthcare bill would reduce the number of Americans without health insurance by 37 million, leaving about 17 million uninsured and would have only a minor impact on the number of people currently using private insurance companies. So it wouldn’t even provide universal coverage and since our healthcare insurance system would still stay predominantly private, it brings us no closer to single-payer healthcare and keeps us multiple levels away from anything resembling socialized medicine.
I suppose the argument remains that it’s a “socialized” plan because it moves us closer to the “socialism” side of the spectrum. I would say that’s barely true, but then we’re just playing games with words. By the same token I could label any deregulation proposal “anarchic medicine” because it’s inching us ever closer to anarchy and it would be equally valid. One of the most basic ways that politicians and pundits try to influence the debate on an issue is through controlling the language used and opponents have done a very efficient job associating healthcare reform with socialism.
These ideas are reinforced by partisan news organizations who use headlines like “Would Americans accept socialized care?” or who put polls on their site asking “do you think American taxpayers should pay for universal healthcare?”, both of which are irrelevant questions when considering the healthcare legislation currently in congress. I saw an example of this recently 
when a news organization featured an article discussing the merits and pitfalls of Canada’s system, implying that it had pertinence to the US healthcare debate, when in reality Canada’s system is nothing like the reform being proposed. But they know that the more they make the association, the more ingrained that perception becomes.
In fact it’s probably already so ingrained that many of you probably have difficulty coming to terms with the idea that the impending healthcare reform bills do not represent anything close to socialized medicine, despite the clear and simple facts. Which is a testimony to the power of “source amnesia” (discussed here) and a lesson in the importance of choosing information sources without an agenda, and who don’t attempt to manipulate your psyche.
Myth #6 – A Public Plan Would Crowd Out Private Insurers
This was one of the first criticisms of Obama’s initial healthcare plan, and it was first made way back before any bill-writing even began. And at the time it was actually pretty valid. In those days no one knew exactly what was meant by a “public plan”, only that it was to be designed to compete with private insurance. If the public plan had been designed such that it was subsidized by tax funds, then it would be perfectly reasonable to worry that it would bankrupt private industry, since its competative advantage would be enormous. Similarly, before projections were released regarding the impact the public plan might have, or the effects of the bill’s employer mandates, some fear regarding how big the public plan might become was warrented.
But thankfully we now live in more enlightened times and we’ve got enough information to falsify this claim several times over. First of all, as addressed above, the public plan will compete as a non-profit entity with private insurance and will do so without help from taxpayers. They will have to stay in the black through setting and regularly adjusting their premiums like everyone else. They will NOT be allowed to
dip into the general fund. Thus there’s no reason to think that the public plan would be able to draw a substantial number of currently insured people away from their private plans unless it were somehow able to provide far better services at a far lower price. While part of its goal is to operate efficiently and thus create some semblance of a ceiling on premium prices, it’s not really reasonable to think they would have the ability to draw enough customers away from the large private insurance companies to put them in financial jeopardy.
Secondly, the CBO has already analyzed the situation and determined that while there would be some small amount of migration from private plans to the public plan, the vast majority of new public plan purchasers would be currently uninsured individuals. And ten years from implementation they show private industry with a slightly smaller market share, but still going strong and holding steady.
Finally, most of the people who make this claim now act as if that’s somehow the government’s secret plan all along; that this is some underhanded way to move us to a single-payer healthcare system. As someone who used to be a supporter of single-payer healthcare, I can tell you that it’s really not very popular amongst democrats in congress and a large majority of them are actively opposed to such a system. So that kind of shoots a hole in that conspiracy theory. It is to nobody’s benefit to undermine private insurance. The best healthcare systems in the world are those where public and private healthcare coexist in equilibrium. If the make-up of the congress was as it is now and the public plan ever did threaten the integrity of private firms, I can nearly guarantee that they’d scale it down to give private insurance room to make new gains.
Myth #5 – The Healthcare Reform Bill Would Force You Onto the Public Plan and Ban Private Insurance
Ok, now we’re getting to the crazy stuff. This claim first arose just a few days after the full text of the bill was released. It started with an article on the site Investors Business Daily that made this claim (link here):
“It didn’t take long to run into an “uh-oh” moment when reading the House’s “health care for all Americans” bill. Right there on Page 16 is a provision making individual private medical insurance illegal.
When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.
It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:
“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law.
So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.”
Now those of you who have attempted to read congressional bills on your own can probably testify that they can be confusing, but pages 16 and 17 of this bill are actually rather clear (relatively speaking) so it’s hard for me to understand how they could have come to this conclusion unless they were purposefully trying to distort its meaning (see the text of the bill here). These pages talk about how all plans offered after the bill is enacted need to conform to the regulations laid out in the bill. It does indeed say. “Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of the year the legislation becomes law.” But what they neglect to address is that “this paragraph” then goes on to describe the new regulations the bill applies to health insurance companies (no denying people for preexisting conditions or dropping them when they get a chronic disease etc) starting from page 19 onward. So what the bill is saying is that any contract entered into before the date the legislation is enacted will continue in its agreed-upon form until its expiration, but any new contract signed after the bill becomes active must conform to the new regulations laid out in the bill. Pretty standard boilerplate. Politifact, The Kaiser Family Foundation, Rep Waxman, and even the conservative Heritage foundation all called them out on their misrepresentation.
A variant of this claim is sometimes made in which the offender says, “You will not be able to keep your current plan for more than a year after the legislation is enacted” or “if your employer drops your insurance you won’t be able to get your private plan back”. These claims are even more deceptive because they’re just playing off of the fact that all private health insurance plans will change once the legislation is enacted so technically no plan that existed previous to the bill will continue to exist after the bill in the same form. So yes, you’ll keep your plan, but technically, when your contract is renewed in the year following the enactment of the bill it would be a “different plan” because its provisions would have changed. So it’s technically true that your “current plan” will be gone and unavailable, but what they don’t tell you is that it will be replaced by one that’s exactly the same but better.
As an aside, IBD had another embarrasing moment in their healthcare coverage when they claimed in a July 31st article, “People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Of course what they apparently aren’t aware of is that Stephen hawking was born, raised, and currently lives in the UK. His response to the editorial was, “”I wouldn’t be here today if it were not for the NHS,” he told the Guardian. ”I have received a large amount of high-quality treatment without which I would not have survived.” Indeed, the fact that Stephen Hawkings has survived longer than almost anyone else in history with ALS, all the while under NHS care, seems to demonstrate that IBD is just making things up, both when it comes to basic facts, and their health policy analysis. It just goes to show that just because someone has a website, and an official sounding name, and an audience, it doesn’t mean they know anything about what they’re talking about.
Myth #4 – A Public Plan Would Lead to Rationing and Long Lines
This is another one of those myths that’s just out there in the ether. There’s no part of the bill cited when someone makes this claim, and there’s no particular line of reasoning used to justify it that I’ve found. The myth seems to be driven by a general association between healthcare reform, universal healthcare, socialized medicine, and rationing and long lines ala Canada.
Long Lines
The truth, if you want to call it that, behind this myth is that Canada does indeed have a single-payer, government-financed healthcare system. And they do indeed have longer wait times than we do on elective surgeries (though you rarely hear anyone comment on the
associated implication that their wait times are shorter on essential ones). And for some reason Canada has become the posterboy (girl?) for universal healthcare despite that fact that, once again, every other industrialized country in the world has some kind of universal healthcare. And many of them have shorter wait times than we do in the US. As an aside, all this complaining about Canada in connection with universal healthcare is really an impressive accomplishment in selective statistics considering many countries with universal healthcare beat us in nearly every important statistic relating to healthcare quality and healthcare outcomes. The World Health Organization didn’t rank our system 37th in the world for nothing. But I’m digressing here.
I suppose the reasoning goes, “Canada has socialized healthcare (single-payer actually but close), Obama wants to institute socialized medicine (not even close), Canada has long wait times (on non-essential surgeries), therefore this healthcare reform plan will lead us to longer wait times.” It’s a simple line of reasoning and would make sense if not for the detail that every assumption along the way is factually flawed.
Rationing
As for rationing, I have heard some people cite the “comparative effectiveness research” provisions in the bill to support this idea. Comparative effectiveness research (CER) describes studies that are done for the purpose of determining which procedures are most effective for a given condition. (definition from free dictionary) I think everyone should be able to agree that this is vitally important and it comes as a surprise to a lot of people to know that very little of this kind of research is done. Obviously for a given treatment there is extensive research available that includes its effectiveness for a condition, but for treatments that address a problem in different ways, or when dealing with combination treatments, those studies aren’t always directly comparable. So research designed specifically to compare treatment methods is important.
A subset of comparative effectiveness research involves determining which treatments or tests provide more effectiveness for the money. In other words, in a given diagnostic situation an MRI might cost 20x more than a Chest X-Ray, and CER would be commissioned to determine whether that MRI gives you something like 5 times the accuracy, or a paltry 2% accuracy boost. If it’s the latter then it would probably be a good idea to reserve that expensive MRI for only those situations in which that extra accuracy is of vital importance. But it’s this kind of CER that some people say could lead to rationing since, now that they’d have info on which treatments are expensive, they’d refuse to allow the elderly, or otherwise infirm access to those treatments because they’re expected to die soon anyway and they wouldn’t be deemed important enough to waste all that money on. Apparently this assumes that the American value system has also been drastically altered.
So obviously there’s a large logical leap between funding CER and that kind of heartless rationing. And I don’t know anybody in the healthcare policy arena who is seriously concerned that CER could lead to something like this. Both the non-partisan CBO and the Institute of medicine have released reports wholeheartedly endorsing CER and I would suggest that anyone interested in this topic read those two documents as a starting point.
But even if the unthinkable happened, and the public plan started only paying for certain procedures based on some formula that determined who was or wasn’t fit for care, then couldn’t you just change to a private insurance company instead? Or couldn’t you just pay for the procedure yourself? The answer is, of course, yes. Yes you could. So unless you assume that private insurance is also nonexistant (see myths #5 and #6) this could never really catch on. And the bill is very clear that the CER findings will be available publicly, but that the information would not be used to force physicians’ hands. But even if they wanted to, there’s just really no avenue in our current system for enforcing CER findings on physicians since they operate autonomously.
The only situation in which this apocalyptic prediction would be remotely plausible would be if we were in a system in which we had true socialized healthcare (see the definitions in myth 1) and as has already been discussed, there is zero chance of that happening anytime in the foreseeable future.
Myth #3 – This Bill Would Encourage the Elderly to Kill Themselves!
As far as I know, this claim started with Betsy McCaughey on the July 16th epidode of the Fred Thompson radio show. This was her claim: “Congress would make it mandatory — absolutely require — that every five years people in Medicare have a required counseling session 
that will tell them how to end their life sooner.” She says the language can be found on page 425 of the health care bill, Sec. 1233, labeled “Advance Care Planning Consultation”. Once again, click here to read the bill yourself. The claim was then parroted by Rush Limbaugh, and has since made its way around through conservative circles. Notably, I don’t think I’ve heard any actual politicians repeat this one.
First some context, everyone should have in place a document describing their preferences for end-of-life care, a “living will” or “Advanced care directive”. It should specify whether or not they want to be kept on ventilation, whether they want to be given artificial nutrition, whether they want to be intubated or resuscitated, etc. And it should be reviewed regularly. Of course most people do not have such a document. These decisions are not as easy as they might seem on the surface (why wouldn’t you want all possible treatments?). Many people are concerned about the burden on their families if they’re left in a vegetative state or in an untreatable coma for years, they’re not willing to undergo the trauma of intubation or artificial ventilation, or some simply want to die in a bed surrounded by their families and not “full of tubes” with doctors pounding on their chest while their family watches from another room. While an advanced directive detailing one’s preferred care is important for everyone to have, it’s especially important for seniors. These are critical issues that come up regularly in care of the elderly and it’s obviously difficult to ascertain the patient’s wishes on this subject once they are in a coma or otherwise incapacitated.
Of course these are difficult subjects to discuss (no one wants to sit down and dwell on their mortality or the possible method of their death) but it is generally agreed upon that it’s best for patients to sit down with their family doctor, who they are comfortable with, to discuss these things while still healthy. Unfortunately, because medicare and most private insurance plans do not compensate doctors for time spent counseling patients on these issues, and because these kinds of visits tend to be long and FP doctors have crowded schedules, they are not done as often as they need to be. This means that elderly patients are forced to make these complex decisions in the Emergency room, without time to thoroughly consider their options, or in the prep room immediately before facing surgery. This adds a huge unnecessary burden to patients at a time when they need it the least and creates tension and uncertainty for families. In fact many in medicine, especially those who work with the elderly, consider it a tragedy that so many of our seniors have to spend those moments running through a list of unseemly and complex questions about their possible death instead of spending that time with loved ones.
So for years the AMA has been lobbying for medicare to cover these counseling sessions so they can be done properly. This bill finally gives medicare the power to compensate doctors for these counseling sessions once every five years per patient, or more often if the patient becomes very ill. These sessions are absolutely NOT mandatory as this radio show suggests (the relevant portion of the bill is a modification of medicare, all of which is voluntary). They are absolutely NOT designed to advocate for patients to “end their life” sooner or “do what’s in the best interests of society”. They are for the patients’ benefit, so they can have the opportunity to make their wishes known about how they want to be treated. They would NOT be performed with a “government agent” but with one’s family doctor. The counseling sessions discussed in this bill are exactly the same as the counseling sessions that are occurring now, at your doctor’s expense, all across the country. It’s just that now medicare will pay for them.
It’s worth noting that it was the AARP, amongst others, that lobbied for the inclusion of this provision and after this radio segment was released, this was the response of their national spokesman, “In no way would these sessions be designed to encourage patients to end their lives.” And he said that McCaughey’s comments are “not just wrong, they are cruel.” I agree. While I’m often frustrated by the massive volumes of misinformation being propagated about the current healthcare bill this particular claim infuriates me more than most. This is something that seniors, and those who advocate for them, have been fighting for for years and to use deceit to encourage fear surrounding this provision in the name of “protecting seniors”, as Betsy McCaughey does here, is pretty despicable.
Myth #2 – The Healthcare Reform Bill Would Force Taxpayers to Pay for Abortions!
Ok, this is a really sneaky one. And it’s become quite popular amongst the furious town hall crowd (Regarding Healthcare Town Hall Protesters). As far as I can tell, this rumor was started by the Family Research Council and Focus on the Family (this used to be their website but it seems to be partially taken down now) shortly after the first iteration of the house bill was released. And it was quickly repeated by John Boehner and echoed in town halls across the country. The argument goes like this, “sure, the House bill doesn’t contain any mention of abortion, but that’s just the trick. Because it’s not expressly forbidden, those wily democrats are going to ensure that the public plan covers abortion on demand and then we’ll all be paying for these immoral procedures.”
Now that should come off as a bit of a stretch in and of itself. But it’s shown to be an outright distortion when we consider the facts. First off, I think Republicans often make the mistake of assuming all democrats are pro-choice, which is clearly not the case. Democrats are not nearly as united on abortion issues as republicans are and even NARAL points out that despite the healthy democratic majorities in both houses, anti-abortion legislators still outnumber pro-abortion legislators in each. So the assumption that Democrats are out to promote abortion at every opportunity is questionable to say the least.
But there are more problems with the assumption that the bill’s silence on the subject indicated a pro-abortion agenda. In the finals days leading up to the production of the initial version of this bill, talk about what to include about abortion started to bubble up. At the time Nancy Pelosi was quoted saying that they didn’t want to try to tackle abortion through healthcare reform and that their goal with that bill was to simply leave things the way they are now. And Obama himself, in a CBS interview said, “As you know, I’m prochoice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of government-funded health care. Rather than wade into that issue at this point, I think that it’s appropriate for us to figure out how to just deliver on the cost savings, and not get distracted by the abortion debate at this station.” Indicating pretty clearly that subversively introducing something as contentious as tax-payer funded abortions was not the goal at all. It’s also worth noting that the federal employees health insurance program, which this reform is based on, does not allow tax dollars to be spent on abortion.
So we’ve established that the assumption that the bill’s silence on abortion was a signal of a coming abortapocalypse is a shaky one, but even if by some chance the public plan ends up covering abortion this myth still wouldn’t make any sense. Because as I indicated earlier, the Public Plan, despite its name, is not funded with taxpayer money. It’s self sustaining. So whether or not the public plan covers abortion is irrelevant.
A “smarter” version of this myth was popular amongst republican members of the house and senate who were basically arguing that since tax credits would be given to millions of Americans to purchase healthcare, and some of those people will choose to purchase private insurance plans that cover abortion, taxpayers will end up funding abortion through that convoluted means. The democratic response to this was to ask, “what about the grant money we give to students? The tax credits for new home buyers? The salaries of government employees? Should we be monitoring these things to make sure none of that money is used to fund abortions?” One democratic senator asked, with no small amount of sarcasm, “should we ban women from driving to abortion clinics lest our taxpayer-funded roads facilitate an abortion?” The point being that there has to be a limit to how many levels out we can go while still labeling something “tax-payer funded abortion”. I tend to agree that trying to ensure that nobody uses tax credits to purchase a private insurance plan that might pay for somebody’s abortion is going a little far.
But, as evidence of their moderation on abortion issues, the democrats in the House disagreed with me, and Rep. Bart Stupak, D-Mich. offered an amendment to the House health care proposal shortly after it was completed that would have prohibited the use of public money “to cover any part of the costs of any health plan that includes coverage of abortion.” The amendment was narrowly defeated. But soon after, Rep. Lois Capps, D-Calif. introduced an amendment that did pass (found here).
Under the Capps amendment:
* Abortion coverage would not be part of the required minimum benefits package. In other words, insurers would not be required to offer, or be prohibited from offering, abortion services in order to participate in the exchange.
* The public plan could include abortion coverage, but the cost of the additional coverage could not be paid through public subsidies (tax dollars), only through the premiums paid by the insured. And with private plans in the exchange, again, federal subsidies could not be used for abortion coverage.
* Public funding would only be permitted for abortions allowed under the Hyde Amendment — in cases of rape, incest or when the mother’s life is in danger.
* At least one plan in every region must offer full abortion coverage; and one must not.
* Any insurance plan participating in the exchange cannot discriminate against hospitals or other health care facilities (such as Catholic hospitals) that are unwilling to provide abortions.
* The plan will not pre-empt any state laws regarding abortion, such as parental notification laws.
It should be noted that the Hyde Amendment referenced there has been in place since 1976, and forbids federal funds from being used for abortions through Medicaid except in cases of rape, incest or when the mother’s life is in danger. So the Capps amendment essentially ensures that nothing will change in regards to abortion and tax-payer funds. Of course the House bill is still in flux, and will eventually be combined with the Senate bill. But considering the fact that this amendment easily passed in the more liberal House, it’s hard to imagine it will not be included, or even made more restrictive in the final bill.
Of course the eventual passage of this kind of amendment surprised nobody, since this was the stated goal of DC leaders from the beginning. But these organizations took advantage of the few days between when the bill was completed and the amendment was passed to present their forced and contradictory conspiracy theory, knowing that the general public would be immediately enraged. It’s apparent that their goal is defeat of the healthcare reform bill for political reasons and they knew that by shifting the debate to something as contentious as abortion, they could rally their troops. It worked wonderfully and now here we are, weeks after abortion foes have won the amendment they wanted, and posters claiming that healthcare reform will lead to federally funded abortion are still a mainstay of town hall protests.
Myth #1 – Death Panels
When I began planning this article I was going to make this whole “Death panels” thing a humerous bonus at the end. You know, something so far out there that nobody would take it seriously. But then it actually caught on! It is thrown around now by elected officials! This one was started by none other than Sarah Palin, in a rant on her Facebook page of all places. She said:
“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s
‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil,..Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.”
The first thing that should set off alarm bells here is her endorsement of Michele Bachmann. Whether republican or democrat we should all be able to agree that Michele Bachmann is crazypants. As far as I’m aware, she has the Politifact record for highest number of “False” or “Pants on fire” ratings at 6/6. And they haven’t even gone after some of her craziest ones like her claim that “The stimulus carries a provision that would force kids into reeducation camps”. I mean we talk about extremists making poor predictions, well she’s as extreme as they come and I have yet to see one of her predictions pan out in any form.
The second thing that should set off alarm bells is that it’s all obviously made-up. Understandably, everybody seemed initially baffled when Palin put this out, and even conservatives didn’t react kindly. David Brooks dismissed her comments as “crazy” adding that “the crazies are attacking the plan because it will cut off granny. That is simply not true, that simply is not going to happen.” And GOP Rep Jack Kingston (GA) said “It’s a scare tactic, no question about it,” adding that there are clearly no death panels. And Republican Senator Johnny Isakson called her assertion “nuts” in a washington post interview. But a few short days later Newt Gingrich endorsed this idea. While he carefully avoided saying that he thought her statement was accurate, he expressed sympathy for the idea and encouraged a kind of generalized fear around anything government related. Then Senator Chuck Grassley stepped forward endorsing the idea as well. Once again, he didn’t want to go on record using the terms “Death panel” or anything like that but he defended Sarah Palin’s claim and told an audience, “you have every right to fear” in reference to end-of-life counseling. That’s all it took to turn “Death Panels” into the new headline on certain news stations, to inspire several frothing-at-the-mouth death panel rants from Glenn Beck, and to turn the phrase into the new claim de jour on protestors’ signboards across the country.
After numerous fact checking organizations demonstrated that Palin’s statement was pure fiction (with the trusty politifact.org calling it “a Sci-Fi Scenario not based on reality”), Palin slammed her critics (as is her wont) in a new statement. But this time made a different claim, stating that while it might not be in the bill, one obscure, misunderstood quote from someone on Obama’s staff validates everything she said. Unfortuantely for her this claim is also demonstrably false. And unfortunately for America, nobody in the mainstream media is bothering to correct her.
But her claim did get her a daily show clip based off of her comments, which ended up being pretty hilarious. So I leave you with this clip as a conclusion, and as a reward for making it through this enormous mass of text. Feel free to skip to 1:30 in the video if you want to skip right to the death panel discussion, and bypass some censured cursing:
| The Daily Show With Jon Stewart | Mon – Thurs 11p / 10c | |||
| Healther Skelter – Obama Death Panel Debate | ||||
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August 14th, 2009 at 11:04 am
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August 14th, 2009 at 1:10 pm
[...] thought this person did a good job with this blog post and I thought I’d pass it along. Sure I could post it on Facebook or something, but I [...]
August 14th, 2009 at 3:30 pm
Excellent article! I am going to pass your blog address along to some people I know. Thanks for taking the time to putting it all in perspective.
August 15th, 2009 at 11:53 am
I do really like your takes on these myths, but these aren’t the complaints I’ve been hearing from people I know. I’m nowhere near the public protests, so I can’t speak for those, but I hadn’t even heard about any of these but the first and last ones.
August 15th, 2009 at 1:28 pm
Well I suppose everyone travels in different circles. It’s true I tried to focus on the “Craziest” myths as per the title, but these are also the myths I’ve heard cited most often in private conversations and in the numerous emails I’ve been sent by various people over the last several months. Especially the euthanasia claim, the abortion fears, and the idea that the bill would bankrupt private industry. If there are other complaints you’ve heard, do feel free to let me know. In fact please do. I’ll be doing several more articles on the various healthcare reform plans over the next couple weeks.
August 15th, 2009 at 11:59 am
I had heard that the abortion amendment had been removed, so now tax dollars will be used to pay for general abortions.
August 15th, 2009 at 1:24 pm
The amendment was in the House bill on August 8th when congress left DC for their districts. They have been out of session since then, so I’m pretty sure there can be no official activity on the bill until they reconvene on Sept 8th. Perhaps you heard that some of the representatives who voted for it have changed their minds? I spent some time investigating the subject just now and I couldn’t find anything indicating it had been removed or that anyone’s support had changed, so if you have a source I’d be interested to see it.
August 17th, 2009 at 9:15 am
Thanks for taking the time to write this. I’m an American who has lived in England for the last 10 years and who has come to fully support the National Health Service here. Trying to talk to family and friends back home who just don’t get the idea behind the health bill is frustrating and saddening. I’ll try to use some of your post to help explain things.
August 17th, 2009 at 5:36 pm
How you can say that Obama’s plan does not require tax dollars is breathtaking. The CBO estimates that ObamaCare will add $1 trillion dollars to the deficit over the next decade. (think, btw, about what the interest on that would look like). It is just undeniable that Obama’s plan runs on taxes. It incorporates Medicare and Medicaid, which also run on taxes. It is simply wrong, and clearly wrong, to state that it wouldn’t.
Yet you use this theory as the basis for arguing that it is therefore a myth that Obama’s plan would inevitably drive private insurers out of the market. Because the government will offer insurance at a subsidized rate, how can it do anything but? You even concede that it would, if only the govt subsidized the program. Which it does.
How you can write 10 pages of this without understanding the source of the funds or mentioning the CBO estimate of the cost to our nation just underscores how very limited your understanding of this issue is.
August 17th, 2009 at 7:21 pm
Alexandra,
I would humbly suggest that you read the sources I cited regarding the funding of the public plan. We need to be careful in our wording here because this is a complex topic and there is a lot of confusion about this. I don’t believe I said that healthcare reform would not require taxes. Indeed it is likely that a focused tax increase will be part of the plan. And the plans being floated are expensive, no doubt, but the expense comes from the subsidies to the poor and middle class for purchase of their own healthcare coverage, and from the expansion of medicaid, not from the public plan. It is laid out in the bill and its stated very clearly in the summary sheets I listed. The House’s Bill provides for a public plan that is not funded by taxpayer money and cannot take money from the general fund. You are correct in stating that my conclusion for Myth 6 rests on the accuracy of this premise. I’ve checked again just to be sure and I feel confident in my original interpretation. I think if you read any other reputable analysis you’ll find that their understanding of the public plan funding is the same. And again, I think if you read the sources I cited it will be pretty clear.
August 17th, 2009 at 7:32 pm
Also alexandra, though I appreciate your participation in the blog, I would hope that in future conversations you would wait for my response before making assumptions about my level of ignorance (which is high, but not quite so high as you suppose on this particular issue).
I didn’t mention the 1 trillion in deficit additions because that is referencing a very early CBO analysis of a bill that ended up dying in the House. The CBO analysis you’re talking about can be found here: http://www.cbo.gov/ftpdocs/103xx/doc10310/06-15-HealthChoicesAct.pdf and was submitted June 15th in reference to the Kennedy-Dodd healthcare bill. And even that was just a preliminary analysis of the spending portions of the bill and did not include an analysis of the cost savings measures.
But either way its irrelevant because the bill that was eventually completed and presented to the house was the tri-commission bill and the CBO analysis for that one was presented July 17th and can be found here: http://cbo.gov/ftpdocs/104xx/doc10464/hr3200.pdf. As you will find it predicts that the bill in its current form would add 239 billion to the deficit. Still not small, but the bill hasn’t even been voted on yet, and Obama has stated clearly that he would not sign a bill that was not deficit neutral.
So the bill in its current form would not add anything close to 1 trillion to the deficit, and the eventual bill that will be produced is very unlikely to add anything at all.
August 17th, 2009 at 5:42 pm
As far as the abortion issue goes, right now the president want to remain silent on it. The wording in the statute is that all medically necessary or medically appropriate procedures will be covered. Unless you specifically prohibit abortion, the “medically appropriate” language ushers it right in. What could be more medically appropriate to terminating a pregnancy than an abortion?
August 17th, 2009 at 7:41 pm
I don’t know if you finished reading the Myth #2 section but the amended bill doesn’t stay silent on abortion. The Capps amendment can be found here: http://energycommerce.house.gov/Press_111/20090730/hr3200_capps_1.pdf
And it does specifically prohibit taxpayer dollars from funding abortions.
August 19th, 2009 at 11:53 am
I think that the biggest myth you have provided is found in the form of your response to my comment. You say: “The eventual bill that will be produced is very unlikely to add anything [ie cost] at all [to the deficit].”
There are several iterations (5? 6 now?) all on the same theme of health care reform in the House right now. They are each over 1,000 pages and are really complicated. So, at best, a day after the CBO released the $1.3 trillion dollar deficit projection, Obama called the man into his office for a private chat. Now we have another projection for another bill (how different in detail I could not say, and I doubt many members of Congress could, either, as that would require some pretty heavy reading by any standard) that comes out to adding (only!) $239 Billion dollars to our deficit.
Now, I understand that this is the new Obama age of racking up our deficit to the point that numbers begin to be meaningless, and that compared to $1.3 trillion, 239 billion would seem like no big deal. But it is. And it is important to bear in mind three things when considering this number:
1) this is only a ten year projection. Health care costs are only going to increase over time.
2) CBO works for Pelosi. To think that that man is not under intense pressure from his boss and the President to get his numbers on board is unrealistic.
3) Every financial estimation that the CBO has ever done on things like Medicare, Medicade (and other non-healts programs) have been under-estimation to the tune of millions and often billions of dollars.
Reforming health care under Obama’s philisophy, whatever form it eventually takes, which no one can know right now, is going to be very expensive. And it is going to be paid by the taxpayers, as every government program is. There is just no way around that fact.
Most of the people who support Obama’s reform believe that it will lead eventually to single payer. Obama has publicly stated that he is in favor of single payer. And logic and math indicates that single payer is the eventual outcome.
To rest your theory that “the eventual bill . . . is very unlikely to add anything at all” to the deficit (startling in itself!) on the belief that Obama would not sign a bill that would increase the deficit is the most breathtaking leap of all.
Obama has already quadrupled our deficit, in just the short time he has been president. Cap and trade is intended to put our utility bills “through the roof” (that is his quote). The stimulus package was a barrel of pork . . . His actions have provided no evidence that he is fiscally concerned, let alone fiscally responsible.
August 19th, 2009 at 1:36 pm
Alexandra, please. Nothing I’m writing should be taking your breath away. I am just expressing the consensus opinion on both this and the abortion issue. Literally, I’m not sure there are any conservative politicians that would agree with you that the bill is going to add 1 trillion to the deficit or that the CBO is corrupt. I don’t think I’ve even heard FoxNews try to make either of those claims.
The Kennedy-Dodd bill and the tri comission bill are very different. The whole 1 trillion thing was a red herring because nobody, and I mean nobody, was taking the kennedy-dodd bill seriously. That bill is irrelevant to the current debate. It didn’t even come from the same house of congress! So to suggest that the new bill is just a reworking of the old bill is certainly walking on shaky ground to say the least.
And once again, I discuss politics with a lot of conservatives and I’m not sure I’ve ever heard someone try to insinuate that the CBO is a liberal organization or that they are swayed by the president. If you want to rest your argument on that assumption then once again, that seems like shaky ground to me. If you know of any non-partisan organizations or even republican politicians that are claiming that the CBO predictions for this are a sham then let me know because I’d be interested to see it.
Has the president added to the deficit? Of course. But he didn’t claim the stimulus would be budget neutral. He made a very public promise on this one, and he made it repeatedly. And the legislature has committed to work on their bills until they are budget neutral. Signing anything else into law would be a very public and stupid blunder. I think what we’ve gotten down to here is that you just don’t trust Obama to do what he says so you are freeing yourself to assume he’ll do whatever is convenient to support your position. Look you can guess that he’ll break his promise and the bills won’t be budget neutral if you want. I don’t know many republicans even that would support you on that but you can do it. But don’t go around acting like I’m nuts for not accepting your guess as fact.
August 19th, 2009 at 12:01 pm
As for the abortion issue, the link you provided does not support your contention. Here is a quote:
the plan is not required (or prohibited) under
2 this Act from providing coverage of services de-
3 scribed in paragraph (4) (A) or (4)(B) and the
4 ,QHBP offering entity shall determine whether such
5 coverage is provided.
6 (3) COVERAGE UNDER PUBI.JIC HEAIJTH INSUR-
7 ANCE OPTION.-The public health insurance option
8 shall provide coverage for services described in para-
9 graph (4)(B). Nothing in this Act shall be construed
10 as preventing the public health insurance option
11 from providing for or prohibiting coverage of serv-
12 ices described in paragraph (4) (A).
Abortion services are neither specifically included nor prohibited. It is my contention that it need not be specifically included to one day be construed as included (after all, all things “medically appropriate,” right?). This is the Politician’s Way for getting things done without appearing to be getting that thing done. And I don’t think it is a very hidden or subtle thing at all. As long as abortion services are not strictly prohibited from the bill, they will be covered.
August 19th, 2009 at 1:10 pm
Alexandra, “the link I provided doesn’t support my contention”? With all due respect I don’t think you are understanding what my contention is. The question is not whether or not the public plan covers abortion, its whether or not tax dollars will be used to fund abortion.
The coverage of the public plan is absolutely irrelevant. The real issue was whether or not the healthcare exchange was going to require private plans to cover abortion (and because of the capps amendment they cannot) and whether or not subsidies given to low income individuals could be used to pay for abortion (and because of the capps amendment they cannot). The public plan can choose to cover abortion or choose not to, because once again, it is not funded with taxpayer dollars.
I think you may be misunderstanding what I’m referring to when I say “public plan”. I’m not referring to the healthcare plan overall, I’m referring to the specific provision of the bills that call for a public health insurance plan with the special ability to compete nationally. Whether or not this plan is publicly funded is not up for debate. It will not be funded by tax dollars and will not draw from the general fund, that is an accepted fact by democrats and republicans alike.
August 19th, 2009 at 2:05 pm
I am not trying to insinuate that the CBO is corrupt. The fact that it scored the bill at 1.3 trillion demonstrates that, to my view. All I am saying is that the head of CBO has a tremendous amount of pressure upon him from his boss, Pelosi, a liberal democrat, to work the numbers to agree with Obama’s team. This is politics, after all. But you are right: we have got to acceptthe CBO scoring as it is because that is basically all we have got. And I do accept it. But I don’t count on it infallible in its final accuracy. When I say that they have traditionally underestimated the costs of certain govt programs, it is not to insinuate that it is corrupted. It is just to say that we have in the past often not taken account of all the things that end up being factors in the cost of a program. It is just simply true that CBO has (in perfectly good faith) underestimated costs of certain programs, and I don’t see any reason why we should not think that the same might happen here–that the costs end up being much higher than expected. After all, calculating future costs of an unimplemented plan is not a perfect science.
You are right that I do not trust Obama to create a plan that is deficit neutral. How one would add 50 million people to a plan and not reduce any services and do it at no additional cost to anyone defies my imagination. But not yours.
August 19th, 2009 at 3:20 pm
“You are right that I do not trust Obama to create a plan that is deficit neutral. How one would add 50 million people to a plan and not reduce any services and do it at no additional cost to anyone defies my imagination. But not yours.”
Alexandrea, it is apparent from this statement that you still don’t understand my position. I never said that the plans won’t cost money. In fact, quite the opposite. I’ve said several times that they are going to be expensive. Deficit free does not mean cost free.
First off, the public plan portion of the healthcare reform bill will be cost-free to the government. It will not provide free care to anyone. Those who participate in it will pay premiums and co-pays like any other plan. This will cover the cost of the public plan. The real cost to the taxpayer comes in the form of subsidies to the poor and to an expansion of medicaid. Those will be expensive, no doubt. In fact its likely to cost a bit over 1 trillion dollars, but that doesn’t mean 1 trillion will be added to the deficit. The bill also calls for a certain number of cost saving measures, that the CBO estimates will make up for a large portion of that cost. Then to cover the remaining costs, there are several ideas being floated, most prominently a focused tax increase on those making over 250,000 per year, but there are other ideas out there too.
In no way, at no time, have I claimed that somehow 50 million people are going to get health insurance without anybody paying for it. That would be ridiculous. But creating a bill that pays for itself through cost saving measures and tax increases should in no way strain anybody’s imagination. It is very common historically for a president to issue an edict that a particular reform effort must be “deficit neutral” in that congress must balance the cost of the program by finding new ways to pay for it. And President Obama indicated at the beginning of his term that he was going to make this a more common practice. And once again, I’m pretty sure even republicans in congress believe that the eventual bill will be deficit neutral.
I think questioning the CBO’s predictions is reasonable. They’re not always right, but I think historically they overestimate cost as often as they underestimate. In two recent examples, the recession ended earlier than they predicted and the bank bailout has cost less than they expected.
So are they perfect? Of course not. Are they non-partisan? I think most people would say so. Certainly their estimations are just about the best we have. And when they line up with predictions from third-party organizations we can have some confidence in the likely result.
August 19th, 2009 at 2:10 pm
As for abortion, the impact of the Capps amendment is that the public plan cannot pay for abortions that some other existing law prevents it from paying for. The Hyde Amendment, then, would prevent Medicaid from paying for abortions, and under the Capps amendment, Hyde would still be in force to keep Medicaid from paying for abortions. (But if they Hyde Amendment were to be overturned, Capps would be not prevent Medicaid dollars from funding abortions).
But what it also means is that the private plans that receive federal funds may also cover abortion services. The idea is that the federal funds are segregated from the other funds. But money is fungible.
August 19th, 2009 at 3:33 pm
Ok well this is a different, and a much more reasonable, argument than your last one. But I feel I need to point out that you seem to be using the term “public plan” to refer to the healthcare reform plans being talked about in congress. I think this is where much of our miscommunication lies. The “public plan” is just one small part of the healthcare reform plan. When I talk about the “public plan” I’m only talking about the special insurance plan being offered nationally as part of the house bill. There is much more to the bill than this. This is why I’m saying things like “the public plan is not taxpayer funded” but you’re saying things like “how can the bill not require a tax increase?” Of course the entire bill will be costly and will require a tax increase, but the “public plan” part of the bill is not tax-payer funded. If you need clarification on that then I suggest going back and reading the summary sheets put out by the house.
So with that said, the capps amendment would not prohibit the public plan from paying for abortions that are forbidden under the hyde amendment. Meaning that under both the capps and hyde amendment, the public plan could choose to cover elective abortions. This is because, unlike medicare and medicaid which are limited by the hyde amendment, the public plan is not a tax-payer funded insurance plan. Its called a “public plan” because it would be available to the public and immune from certain regulations, not because its funded by the public.
Now this, “But what it also means is that the private plans that receive federal funds may also cover abortion services. The idea is that the federal funds are segregated from the other funds. But money is fungible. ” is a valid argument. I would argue that segregated funds are not meaningless and in fact money is segregated in real ways commonly in accounting and for tax purposes.
But before getting too deeply into that I’ll first point out that the private plans aren’t really receiving “federal funds”, its individuals who will be receiving tax credits who will use that money to purchase a private healthcare plan. If this is concerning to you then I ask this question, “what about the grant money we give to students? The tax credits for new home buyers? The salaries of government employees? Should we be monitoring these things to make sure none of that money is used to purchase private health insurance plans (most of which currently cover abortion)?”
August 19th, 2009 at 3:34 pm
Also, I sincerely appreciate the more civil tone of these posts.
August 19th, 2009 at 4:03 pm
I think that this issue is basically just another face of the old question: can the government run things more efficiently and effectively than a private organization? Conservatives tend to think not, and liberals tend to think so.
Raising taxes to cover the costs such that nothing will be added to the deficit does not seem to me to be realistic. I am, of course, no expert, and I have not drudged through the thousands of pages of legislation that is currently floating through the House. But given the CBO estimates that it will add at least in the hundreds of millions to the deficit seem so suggest that I am right. I take it that Obama never said that he would only pass a deficit neutral health reform package, but that you are assuming this from a statement that he made that he wanted to pass more deficit sensitive legislation? Well, I hope that is what he does.
On this issue, like most, really, I think that everyone is on the same side. We all want the best care for the most people delivered in the most efficient and cost-effective way possible. Some people believe that the government can provide that; others, like me, have more faith in the private sector than in politicians and beaurocrats.
This is all to say that I continue to disagree with your assertions. I think that this will be prohibitively expensive, I think that services will be rationed, as they are in other countries with single-payer or socialized care. While I agree that terms like “death panels” is totally inflammatory, there is still a reality to be dealt with that 80% of costs come in the last year? six months? of life and that curbing those is an easy way to cut down costs, and that Obama himself has said this, and that there was something unsettling about government-paid doctors initiating conversations with the elderly about their end of life care, and that enough rational people felt uncomfortable such that they agreed to change the language. I agree with most proponents of Obama’s plan that this plan will lead to single-payer because the private sector will be unable to compete. Already, some of the provisions in some bill out there makes it cheaper for small businesses to dump private health care coverage in favor of the public option.
This article was written by a very liberal woman who still loves Obama but harbors the same issues as I regarding his plan. Sometimes it is easier to understand a different perspective when it comes from someone who share’s one’s own philosophy. So here it is “obama’s healthcare horror” http://www.salon.com/opinion/paglia/2009/08/12/town_halls/
ps i detected no difference in the civility of my early comments v the later ones, and i understand that people don’t like others to disagree with them, but there is something off-putting and self-righteous about congratulating the person on the other side of the debate for improving their tone. just saying.
August 19th, 2009 at 8:13 pm
Alexandra, well I’m sorry if it came off as patronizing. I didn’t mean it that way. In my defense you did say that my understanding of healthcare policy was “very limited” in your first comment, despite the fact that healthcare policy is and will continue to be my life’s work. Then you repeatedly referred to my points as breathtaking, implying they were “breathtakingly ignorant”. Then I asked you to please refrain from doing so and I thought that you did. I honestly didn’t mean to offend you by pointing that out. I have absolutely no problem with people disagreeing with me. Anyone who knows me will tell you I pretty much crave it. It disappoints me greatly when nobody challenges me.
Anyway, I don’t know where to start here so this may be a little scattered. Obama did actually say “I won’t sign a health bill unless its deficit neutral”. See here for one example: http://durhamcounty.mync.com/site/durhamcounty/news/story/39103/president-talks-health-care-in-the-triangle/. He has said it repeatedly. So I wasn’t just assuming that was the case.
And, no, I don’t think the CBO analysis supports your assumption that the bill will add to the deficit. The House hasn’t even voted on the legislation yet. When the CBO said the bill in its current form would still run 239 billion over, many in the house said they were “Devestated” and were back to the drawing board. My point is that everything is still in flux. The CBO reports that come periodically are like check-ins to see how things are developing. We won’t know if the bill is deficit neutral until the house finishes amending their version and passes it, the senate finishes their three versions, passes one of them, and then the senate and house versions are melded together and the CBO analyzes the result. I hope, as you do that the final bill is deficit neutral and I think its likely that if they are not Obama will maintain his promise, especially since, in this case, it was so specific and publicly known.
And I don’t know why you seem to think I’m pro-government or super liberal because that is not the case. I got one of my degrees in business management and am a big fan of private industry and free markets. I’m an independent who only recently converted to centrism from a life of libertarianism. I absolutely do not support a government run healthcare system. In fact, I don’t support government participation in the healthcare delivery system at all. I would be adamantly, furiously, opposed to it. Fortunately, that’s not what this bill contains. This bill is about fixing malfunctioning market forces. Its about providing competition where currently there is none. Its about providing comparable information so consumers can make informed choices about their care. Its about reducing costs with market principles so the uninsured can afford to purchase their own care. And its about reforming the system such that American taxpayers don’t have to continue to fund the care of the uninsured through the emergency room.
This is the same healthcare plan that Nixon presented when he ran for president, it is almost the exact same plan that Mitt Romney proposed for America. Its a very, very moderate plan.
I’ll be writing another post soon where I detail why I choose to support the plan, despite its flaws and imperfections, but the quick version is that it delivers on nearly all of the important things that the healthcare policy community has been wanting for years. That’s why organizations like the American Medical Association, the American Hospital Association, and others who have traditionally been opposed to democratic healthcare reform have enthusiastically supported and endorsed the current House bill, despite their reputation as very conservative organizations. This is not a left-wing bill in any way. If it was, I would not support it.
The Salon article was interesting, but unfortunately the author demonstrated misunderstandings of basic elements of the bill. For example she says, “what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor” when you and I both know by now that the “public plan” is not tax-payer funded, not government bankrolled, and therefore has no advantage over private insurance. I don’t know how many times I have to say it. Here it is from the official bill summary,” Public option must be financially self-sustaining, as private plans are.” Here it is from ITUP analysis,”Public Plan: Self-sustaining with out public subsidies”. The Kaiser Family Foundation’s analysis says the House Bill will, “Finance the costs of the public plan through revenues from premiums.” Here it is from the CBO, “…but as long as the public plan charged premiums that covered its costs (as it is supposed to do under the proposal), those amounts would be offsetting…”. And you can read it in the bill yourself on pages 119 and 120 http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf You can also read a pretty thorough description of how many people would leave private insurance for the public plan on pages 3-8 of the CBO analysis I linked earlier.
Look, the idea that the public plan is a government run entity that will lead us down the path to single payer is just plain not true, which is why it was Myth #6 above.
And I’m not sure where you got this statistic. ”I agree with most proponents of Obama’s plan that this plan will lead to single-payer because the private sector will be unable to compete. ” But I would like to see your source if you have it because I would be very surprised if most proponents of Obama’s plan believe it will lead to single-payer. As I stated in this original article I know very many single-payer advocates and even they don’t believe this plan will lead to single-payer. Most of them are against it. Single-payer is not popular among democrats. It really, truly isn’t. I’ve spoken personally with democratic legislators about single-payer healthcare and even most of the very liberal ones do not think its right for America.
These problems are the reason I wrote this article. Its not that I don’t understand the conservative perspective. As a life long, hardcore conservative I understand very well the concept behind promoting free-enterprise over government solutions and individual responsibility over entitlement philosophy. Its that as someone passionate about healthcare, who will actually have to spend my life working in whatever healthcare system we create, and who has looked forward for years for a bill like this to be written (whether by a democrat or a republican), it tears me apart to see it being dragged down by myths and misinformation in a way that no bill has before it.
Disagree with the bill if you want to. I have absolutely no problem with that. But disagree with the actual bill. Read the non-partisan analysis and the reports of the bill’s actual content. Keep up with the fact-checking organizations to see what’s really true. And then make your judgement. That’s the whole point of this post.
I don’t know that anything I’ve written will change your opinion. If it doesn’t that’s OK. But it has been an enjoyable experience overall. This site was created to promote debate and as I said, I would much rather be having a back and forth like this than just a bunch of favorable responses. But I probably won’t have time to respond again since this week is a busy one for me and I’m already behind. Thanks again for participating in the blog and I hope to hear your perspective on future articles.
August 21st, 2009 at 8:45 am
Hey Ryan,
I was just curious what you thought about Obama’s original idea to push the plan through before the August recess?
I’ll give you mine…I don’t know all the details to the plan and unfortunately I really don’t know who to believe has the complete truth…its tough because I know you have always been Pro Obama and so you obviously have bias towards him and his plan…the other folk on the opposite side I’m sure have some bias as well…so it is kind of frustrating. Again, not that I don’t trust you, I think I would need to read the entire bill myself to get the real story…and even then I probably wouldn’t understand the implications of the things written…I would think that the best people to believe would be those that were Pro Obama to begin with and disagree with the bill or those that were anti Obama to begin with and agree with the bill…and as far as I can tell there is a lot more of the former than the latter.
Anyway thanks for the effort, I really am trying to hear both sides of the story and form my own opinion, and I am VERY conservative but am always willing to hear someone out.
By the way please define “non-essential” surgeries. When I first read that, my first inclination was to think of things like plastic surgeries…cosmetic stuff…but don’t think that is the case at all. So give me a definition and a source for your non-essential surgeries. I heard the former president of the Canadian medical association on TV last night saying that there were indeed very long wait lines for many surgeries….so again is essential only emergency?…is it surgery if you have cancer?…or what…What about an elderly lady who falls and breaks her hip…is fixing her hip essential…or a high school athlete that blows out his knee…or a 40 year old lady who has 10/10 painful periods every month and wants her uterus out…are those essential surgeries?…I know we are not trying to copy Canada…but you did mention it above.
Thanks man, look forward to hearing your reply
Ryan Skinner
August 21st, 2009 at 11:18 am
Ryan,
Thanks for commenting on the blog! Yeah it can be difficult to figure out what’s true and what’s not, especially when we’re dealing with an issue like healthcare that tends to inflame passions and inspire fear. But I don’t know that you have to read the entire bill to figure it out. In fact that might not even be the best way even if you had the time since its pretty legalistic. Honestly I’ve probably only read a little over half of it at this point. I’ve just stuck to the more debated parts and I don’t feel like I’ve missed out on much.
But I’m not sure even that’s necessary. I think you can get a pretty good overview by reading the official bill summaries, the CBO analysis, and then maybe a few summaries and analysis from the major think tanks. If you want to get a balanced perspective I’d suggest checking out the Lewin Group for a somewhat conservative viewpoint and the Kaiser Family Foundation for a more liberal take (though when reading their analysis make sure they’re talking about the right bill, both those organizations are reviewing several minor bills as well. The only finished bill following Obama’s original plan is HB3200). Both these groups are mainstream and generally trustworthy, in my opinion, despite their leanings.
Then I’d suggest reading through the major fact-checking organizations to cut through the myths. Politifact.com and FactCheck.org are both fantastic and they do very thorough and non-partisan work. And you might want to check out what the AMA says about the House bill. I think their perspective is important since they’re coming from the viewpoint of the physician and they are an undeniably conservative organization. In fact there’s an example of an organization that was certainly “anti-obama” to begin with, but the bulk of its members now support this healthcare reform plan. Anyway, if you checked out all those sources, I think you’d be in a pretty good place. And it shouldn’t take more than 8 hours or so (which is not an insignificant amount of time but this is an important subject).
I certainly don’t expect you to simply trust my opinion, and I’m not at all offended that your still skeptical, but I tried to back up most of my points with original sources and links to analysis by people smarter than myself, so if you still have concerns about any of the myths listed above I’d suggest checking out those links, and I’d be happy to discuss any of them more if you want to.
For what its worth I was not a fan of Obama’s plan initially. Frankly, I thought it was a bit too conservative. It was definitely the most conservative of the plans presented by democrats during the primaries. I thought he was just pandering to republicans (a lot of good that did). But I’ve come around over time and while I would say I definitely support the plan, I have my concerns as well. Frankly the house bill as it stands isn’t much like what I would think ideal reform would look like, but as it always is in politics, its not a choice between this and some hypothetical perfect option, its a choice between what’s politically feasible right now or nothing.
Ok, with that said, on to your questions. On the issue of them trying to push reform through early. Honestly I was kind of ambivalent. I was following the news pretty heavily at the time and there was a CFPR conference call like a month before congressional recess in which Senator DeMint opined that if they could stall the bill until recess he thought they could kill it and it would be “Obama’s waterloo”. It was around that time that the new rallying cry of “slow down!” and “Democrats are trying to cram this through!” seemed to pop up. So in short I think that concern was kind of manufactured as a strategy. I mean they started working on this in Late February/Early March a week after Obama’s speech to the joint sessions of congress. We have to remember that just because congress only started drafting the bills a couple months ago, that doesn’t mean they just started thinking about it recently. Almost all of the wording was hammered out long ago. My understanding is that the congressional process is more about deciding what to include and not to include. So I don’t know that 6 months is a particularly short working time, even for something this massive. Especially when the country had at least 6 months previous to Obama’s election to analyze his healthcare proposals, which have turned out to match the current bills in pretty much all important ways.
As for the Canada thing I really wish I hadn’t included anything about that because in retrospect it just reinforces this false idea that Canada is relevant to the current debate. Also, I’ve since realized that my wording there was quite confusing. First-off, by “non-essential”, what I meant was simply “elective”, which is the term most used by the statisticians. What I was trying to communicate in that sentence was just that whenever you hear someone talking about long wait times for surgeries in countries with single-payer healthcare the only statistic anyone ever seems to brings up is Canada’s wait times for elective surgeries. I don’t have any particular statistics on non-elective surgeries but I was just commenting on how the implication of the fact that critics of Canada always cite that one statistic is that their non-elective surgery wait times don’t support their argument and are likely as good or better than ours. Once again, I don’t know that that’s the case (thus my use of the word “implication” and the lack of a citation), I was just trying to poke a little fun at Canada’s critics by highlighting their selective use of statistics. And I was trying to be a little more casual with that section since none of those arguments were crucial to my point (which when you get down to it was just that fears of long lines because of Canadas long lines are unfounded since we’re not looking at changing to anything like canada’s system).
In truth Canada does have a pretty crappy healthcare system, which is why critics of single-payer healthcare always use it as an example. And I have no doubt that in general one would wait longer in Canada for most things than one would here since their system is so underfunded. But in the relatively famous 6 countries study by the commonwealth fund, they’re the only country that’s consistently worse than us on issues of timely access to care.
So sorry if that was confusing. I didn’t mean to imply that I had more information than I presented there and I may have to consider editing that section if its coming off that way to a lot of people.
Anyway, thanks again for commenting. I’m going out of town this afternoon but I’ll definitely post up a couple more healthcare related things next week so I’d certainly like to hear your opinion on those as well if you have the time.
September 15th, 2009 at 5:07 pm
Ryan,
Saw a link on Gaylynn’s FB with your blog address, and I have been reading a few of your posts. The more I read about this bill the less I seem to know, so I am just trying to be patient and not get passionate about one side or another before I feel secure in my opinion.
That being said, I recently read more of a commentary on this bill from another friend where she spoke of women having a time period before they were allowed to get pregnant – meaning that those insured by this public plan would have their ‘family planning’ dictated to them by their insurance policy. In this same commentary, my friend quoted the common analysis of the bill which I saw was debunked by factcheck here: http://factcheck.org/2009/08/twenty-six-lies-about-hr-3200/. So I realize that she is very passionate about her opinions, and probably doesn’t know all the facts. But I cannot seem to find the truth or falsehood to her claim of the timeline regarding women becoming pregant and wanting to keep their pregnancy. Have you heard or seen this before?
I appreciate you taking the time to share your views. It’s refreshing to hear someone talk about it candidly and openly rather than blindly passionate. Thank you.
Heather Christensen
September 16th, 2009 at 12:49 am
Heather,
Thanks for commenting! I really liked what you said here:”The more I read about this bill the less I seem to know”. I think that’s true of many things. If you haven’t yet read my first post (found here) I’d encourage you to do so because what you expressed there is like, one of the foundational philosophies of my life. These kinds of issues are far, far more complex than they’re made to seem by media pundits and partisan commentators. And I’ve found in my life that the more I learn about a particular subject, the more I find I still have yet to learn. So I think its wise to be wary of the strongly opinionated or impassioned. Not that there’s anything wrong with passion as long as its carefully placed. But I think its rare in politics that something comes along that is absolutely bad or absolutely good. Honestly, I think most of us probably never acquire enough information to make a truly informed decision about most policy proposals. That doesn’t mean we don’t try to do the best we can, it just means its probably a good idea to always maintain a certain humility about our conclusions.
Anyway, on to the real question. That claim is actually a new one to me, and that’s surprising because I thought I’d heard all of them. I searched the internet for a bit and couldn’t find anything about it and in fact I couldn’t find much about family planning and health reform in general. And I think there’s a reason for that. By this time I’ve read the portions of the initial house bill pertaining to the public plan several times over. And from what I’ve seen, the bill doesn’t really describe any details about what the public plan will cover, outside of stating that it will be bound by the same regulations as other private insurance plans that participate in the healthcare exchange. That means it will be required to have drug coverage, maternity coverage, inpatient coverage, etc. The details about the plan are left up to the appointed administrators of the plan who will adjust coverage and rates on a regular basis, just like any other insurance plan. I checked again just to be sure and you can read about it in the original bill starting on page 116.
And I think that’s a very important thing to remember that most people seem to misunderstand. The public plan will just be a non-profit health insurance company with administrators appointed by the government. Once established it would operate just like any other health insurance company, without government subsidies or tax-payer money to help them out. It will be one choice out of many. I don’t know of any circumstances where one would be forced to choose the public plan. Even those receiving insurance subsidies from the government will be able to use them to buy a private healthcare plan. The CBO estimates that less than 5% of Americans will be on the public plan ten years out. My point being that even if the public plan ended up having some kind of bizarre pregnancy wait period, though there doesn’t seem to be evidence that would be the case, one could just switch to another plan.
And the fact that that choice will exist will pretty much ensure that the public plan’s coverage doesn’t deviate too much from what would be expected or what the people want. In fact, that’s one of the goals of the public plan is to increase competition so that private insurers, and the public plan, will both be more responsive to the needs of the market.
Anyway, I know it can be tough to find reliable sources of objective information these days. I think if you’re reading factcheck.org you’re starting out well. I’ve always liked them quite a bit, along with politifact.com. So those are two reader-friendly places to get information. If you want more I’d suggest checking out the official bill summaries (which I’ve posted here) along with the CBO analysis which can also be found on that page. Next I’d say the Lewin Group and the Kaiser Family Foundation would be good places to look. The first one leans a little conservative and the second one’s a bit liberal but they’re both relatively moderate and are considered powerhouses in the healthcare policy arena. Since you guys are also heading into medicine (assuming this is the heather I think it is) then you could also check out what the AMA has to say about it (found here). They are traditionally very conservative and this is the first time they’ve endorsed a healthcare reform plan since their inception. So that was pretty big news.
Of course to complicate all this the House bill that everyone’s been talking about this whole time is now actually pretty dead in the water. It looks like the bill being produced by the Senate Finance Committee (which was half republicans and half democrats) is the new bill to look to and its likely it will be released tomorrow. After that there will be probably about two weeks of modifications made before we’ll really know what the contents of the final senate bill will really be. Then it still needs to be combined with the House’s bills and then voted on by everyone again. So we still have a ways to go in all this. One thing that’s frustrated me a bit about this whole discussion is how so many people had hardened opinions way back before a single bill was even written! Even now it still seems early to me for anyone to know their opinion on the bill. The most controversial elements are still very much in flux.
Anyway, like usual, that was way long. Sorry about that. If you have any more questions feel free to send them my way, and I hope you can check back in and comment on the blog in the future.
April 10th, 2010 at 6:40 pm
Thanks for writing such an appealing post. Cheers