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	<title>The Fact of My Ignorance &#187; myths</title>
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		<title>The Top 7 Craziest Myths About Healthcare Reform</title>
		<link>http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/</link>
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		<pubDate>Fri, 14 Aug 2009 18:02:47 +0000</pubDate>
		<dc:creator>Ryan</dc:creator>
				<category><![CDATA[Health]]></category>
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		<category><![CDATA[crazy]]></category>
		<category><![CDATA[death panels]]></category>
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		<description><![CDATA[A very thorough debunking of the 7 most insane and most commonly held myths regarding healthcare reform


No related posts.]]></description>
			<content:encoded><![CDATA[<!-- sphereit start --><p style="text-align: center;"><a rel="attachment wp-att-433" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/slide_2294_29659_large-jpg/"><img class="aligncenter size-large wp-image-433 -frame" title="craziest myths about healthcare reform" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/slide_2294_29659_large.jpg-500x363.jpg" alt="craziest myths about healthcare reform " width="500" height="363" /></a></p>
<p>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&#8217;ll admit, I&#8217;m still young, and I&#8217;ve only been following politics with intensity for the last 5 years or so, but I&#8217;ve done a fair amount of research on controversies of the past and I feel I&#8217;m fairly informed about the history of American politics over the course of the last century.  But the healthcare debate that&#8217;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&#8217;s perplexing to me how these smears can spread so quickly, and maintain such staying power.</p>
<p>And the pervasiveness of these myths is likewise surprising.  I&#8217;ve been watching videos of town hall protesters lately and it is extremely rare to see a protester carrying a sign that isn&#8217;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 &#8220;keep your government hands off of my medicare&#8221; comes to mind).  And in casual conversations I&#8217;ve had with others about the bill I have yet to talk to an opponent who has actually cited something that&#8217;s really in the bill as justification for their opposition.  Once again, to be clear, every single person I&#8217;ve talked to who opposes the bill, when asked about their reasons, has cited nothing but provisions that are not actually in this bill.</p>
<p>So for the last few days I&#8217;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&#8217;ve tried to cite original sources wherever possible.  And for those who aren&#8217;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.</p>
<p>In the interest of full disclosure I should also point out that I&#8217;m currently a voting delegate to the California Medical Association (CMA) and American Medical Association (AMA), and I hold positions on the CMA&#8217;s Council on Legislation and the AMA&#8217;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.</p>
<p><span id="more-419"></span></p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #7 &#8211; This Healthcare Reform Plan = Socialized Medicine</strong></span></p>
<p>I&#8217;ll talk about this one first because it&#8217;s probably the most pervasive of all the myths I&#8217;ve heard so far.  And it isn&#8217;t all that crazy when you get down to it.  In the public mind the terms &#8220;universal healthcare&#8221;, &#8220;socialized medicine&#8221;, &#8220;public plan&#8221;, and &#8220;single-payer healthcare&#8221; are all kind of viewed as the same communistic policy but they are, in reality, very distinct and different ideas.  Let&#8217;s do a little bit of defining.</p>
<p><strong>Socialized Medicine &#8211; </strong>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 &#8220;socialized medicine&#8221; 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. <a href="http://www.medterms.com/script/main/art.asp?articlekey=25521">(Definition at MedTerms)</a></p>
<p><strong>Single-Payer Healthcare -</strong> 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 &#8220;socialized health insurance system&#8221;.  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&#8217;t taken seriously by mainstream liberal politicians. <a href="http://www.medterms.com/script/main/art.asp?articlekey=25520">(Definition at MedTerms)</a></p>
<p><strong>Universal Healthcare -</strong> 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 &#8220;universal healthcare&#8221;.  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.  <a href="http://www.iom.edu/?id=17848">The US is the only industrialized country in the world that doesn&#8217;t have some form of universal healthcare.</a></p>
<p><strong>Public Plan &#8211; </strong>The public plan, as described in the House&#8217;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. <a href="http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-PUBLICOPTION-071409.pdf">(Fact Sheet on Public Plan)</a></p>
<p>Now that we have some basic definitions lets see which one&#8217;s apply to the reform plans currently in congress. <a href="http://www.cbo.gov/ftpdocs/104xx/doc10430/House_Tri-Committee-Rangel.pdf"> Well, according to CBO predictions (pg. 13),</a> 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&#8217;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.</p>
<p>I suppose the argument remains that it&#8217;s a &#8220;socialized&#8221; plan because it moves us closer to the &#8220;socialism&#8221; side of the spectrum.  I would say that&#8217;s barely true, but then we&#8217;re just playing games with words.  By the same token I could label any deregulation proposal &#8220;anarchic medicine&#8221; because it&#8217;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.</p>
<p>These ideas are reinforced by partisan news organizations who use headlines like &#8220;Would Americans accept socialized care?&#8221; or who put polls on their site asking &#8220;do you think American taxpayers should pay for universal healthcare?&#8221;, both of which are irrelevant questions when considering the healthcare legislation currently in congress.  I saw an example of this recently <a rel="attachment wp-att-434" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/headline-crop/"><img class="size-medium wp-image-434 alignleft" style="margin: 10px; border: 2px solid black;" title="FoxNews Misleading headline" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/headline-crop-300x155.png" alt="FoxNews Misleading headline" width="300" height="155" /></a>when a news organization featured an article discussing the merits and pitfalls of Canada&#8217;s system, implying that it had pertinence to the US healthcare debate, when in reality Canada&#8217;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.</p>
<p>In fact it&#8217;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 &#8220;source amnesia&#8221; <a href="http://thefactofmyignorance.com/politics/source-amnesia-and-its-political-pertinence/">(discussed here)</a> and a lesson in the importance of choosing information sources without an agenda, and who don&#8217;t attempt to manipulate your psyche.</p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #6 &#8211; A Public Plan Would Crowd Out Private Insurers</strong></span></p>
<p>This was one of the first criticisms of Obama&#8217;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 &#8220;public plan&#8221;, 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&#8217;s employer mandates, some fear regarding how big the public plan might become was warrented.</p>
<p>But thankfully we now live in more enlightened times and we&#8217;ve got enough information to falsify this claim several times over.  First of all, as addressed above, <a href="http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-PUBLICOPTION-071409.pdf">the public plan will compete as a non-profit entity with private insurance and will do so without help from taxpayers.</a> They will have to stay in the black through setting and regularly adjusting their premiums like everyone else.  They will NOT be allowed to<a rel="attachment wp-att-481" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/hmo-jpg/"><img class="alignright size-medium wp-image-481" style="margin: 10px; border: 2px solid black;" title="Public Plan would Crowd Out Private Insurance" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/HMO.jpg-300x216.jpg" alt="Public Plan would Crowd Out Private Insurance" width="300" height="216" /></a> dip into the general fund.  Thus there&#8217;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&#8217;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.</p>
<p>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, <a href="http://www.cbo.gov/ftpdocs/104xx/doc10430/House_Tri-Committee-Rangel.pdf">the vast majority of new public plan purchasers would be currently uninsured individuals.</a> And ten years from implementation they show private industry with a slightly smaller market share, but still going strong and holding steady.</p>
<p>Finally, most of the people who make this claim now act as if that&#8217;s somehow the government&#8217;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&#8217;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&#8217;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&#8217;d scale it down to give private insurance room to make new gains.</p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #5 &#8211; The Healthcare Reform Bill Would Force You Onto the Public Plan and Ban Private Insurance</strong></span></p>
<p><a rel="attachment wp-att-482" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/30574_logo-jpg/"><img class="alignleft size-full wp-image-482" style="margin: 10px; border: 2px solid black;" title="30574_logo.jpg" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/30574_logo.jpg.jpeg" alt="30574_logo.jpg" width="180" height="180" /></a>Ok, now we&#8217;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 <a href="http://www.ibdeditorials.com/IBDArticles.aspx?id=332548165656854">(link here)</a>:</p>
<blockquote>
<p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; font-size: 13px; line-height: 1.5em; padding: 0px;">&#8220;It didn&#8217;t take long to run into an &#8220;uh-oh&#8221; moment when reading the House&#8217;s &#8220;health care for all Americans&#8221; bill. Right there on Page 16 is a provision making individual private medical insurance illegal.</p>
<p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; font-size: 13px; line-height: 1.5em; padding: 0px;">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.</p>
<p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; font-size: 13px; line-height: 1.5em; padding: 0px;">It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of &#8220;Protecting The Choice To Keep Current Coverage,&#8221; the &#8220;Limitation On New Enrollment&#8221; section of the bill clearly states:</p>
<p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; font-size: 13px; line-height: 1.5em; padding: 0px;">&#8220;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&#8221; of the year the legislation becomes law.</p>
<p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; font-size: 13px; line-height: 1.5em; padding: 0px;">So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won&#8217;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.&#8221;</p>
</p>
</blockquote>
<p>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&#8217;s hard for me to understand how they could have come to this conclusion unless they were purposefully trying to distort its meaning <a href="http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf">(see the text of the bill here)</a>.  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. &#8220;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.&#8221;  But what they neglect to address is that &#8220;this paragraph&#8221; 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.  <a href="http://www.politifact.com/truth-o-meter/statements/2009/jul/22/ibdeditorialscom/private-health-insurance-page-16-house-bill/">Politifact,</a> <a href="http://www.kff.org/healthreform/sidebyside.cfm">The Kaiser Family Foundation</a>, <a href="http://www.ibdeditorials.com/IBDArticles.aspx?id=333069697522201">Rep Waxman</a>, and even the conservative <a href="http://blog.heritage.org/2009/07/16/does-the-house-plan-outlaw-private-insurance/">Heritage foundation</a> all called them out on their misrepresentation.</p>
<p>A variant of this claim is sometimes made in which the offender says, &#8220;You will not be able to keep your current plan for more than a year after the legislation is enacted&#8221; or &#8220;if your employer drops your insurance you won&#8217;t be able to get your private plan back&#8221;.  These claims are even more deceptive because they&#8217;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&#8217;ll keep your plan, but technically, when your contract is renewed in the year following the enactment of the bill it would be a &#8220;different plan&#8221; because its provisions would have changed.  So it&#8217;s technically true that your &#8220;current plan&#8221; will be gone and unavailable, but what they don&#8217;t tell you is that it will be replaced by one that&#8217;s exactly the same but better.</p>
<p>As an aside, IBD had another embarrasing moment in their healthcare coverage when they claimed in <a href="http://voices.washingtonpost.com/ezra-klein/2009/08/how_stehpen_hawking_proves_tha.html">a July 31st article</a>, &#8220;People such as scientist Stephen Hawking wouldn&#8217;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.&#8221;   Of course what they apparently aren&#8217;t aware of is that Stephen hawking was born, raised, and currently lives in the UK.  <a href="http://www.guardian.co.uk/politics/2009/aug/12/birthers-stephen-hawking-paul-rowen">His response to the editorial was</a>, &#8220;&#8221;I wouldn&#8217;t be here today if it were not for the NHS,&#8221; he told the Guardian. &#8221;I have received a large amount of high-quality treatment without which I would not have survived.&#8221;  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&#8217;t mean they know anything about what they&#8217;re talking about.</p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #4 &#8211; A Public Plan Would Lead to Rationing and Long Lines</strong></span></p>
<p>This is another one of those myths that&#8217;s just out there in the ether.  There&#8217;s no part of the bill cited when someone makes this claim, and there&#8217;s no particular line of reasoning used to justify it that I&#8217;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.</p>
<p><strong>Long Lines</strong></p>
<p>The truth, if you want to call it that, behind this myth is that <a href="http://en.wikipedia.org/wiki/Health_care_in_Canada">Canada does indeed have a single-payer, government-financed healthcare system.</a> And they do indeed have longer wait times than we do on elective surgeries (though you rarely hear anyone comment on the<a rel="attachment wp-att-483" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/healthcare-waiting-in-canada/"><img class="alignright size-medium wp-image-483" style="margin: 10px; border: 2px solid black;" title="Healthcare waiting in Canada" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/Healthcare-waiting-in-Canada-300x223.png" alt="Healthcare waiting in Canada" width="300" height="223" /></a> 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 <a href="http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2004/Jun/First%20Report%20and%20Recommendations%20of%20the%20Commonwealth%20Funds%20International%20Working%20Group%20on%20Quality%20In/ministers_complete2004report_752%20pdf.pdf">many countries with universal healthcare beat us in nearly every important statistic relating to healthcare quality and healthcare outcomes</a>.  The World Health Organization didn&#8217;t rank our system<a href="http://www.photius.com/rankings/healthranks.html"> 37th in the world for nothing</a>.  But I&#8217;m digressing here.</p>
<p>I suppose the reasoning goes, &#8220;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.&#8221;  It&#8217;s a simple line of reasoning and would make sense if not for the detail that every assumption along the way is factually flawed.</p>
<p><strong>Rationing</strong></p>
<p>As for rationing, I have heard some people cite the &#8220;comparative effectiveness research&#8221; 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. <a href="http://medical-dictionary.thefreedictionary.com/comparative+effectiveness">(definition from free dictionary)</a> 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&#8217;t always directly comparable.  So research designed specifically to compare treatment methods is important.</p>
<p>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&#8217;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&#8217;s this kind of CER that some people say could lead to rationing since, now that they&#8217;d have info on which treatments are expensive, they&#8217;d refuse to allow the elderly, or otherwise infirm access to those treatments because they&#8217;re expected to die soon anyway and they wouldn&#8217;t be deemed important enough to waste all that money on.  Apparently this assumes that the American value system has also been drastically altered.</p>
<p><a rel="attachment wp-att-484" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/stantis-on-obama-health-care-q20-jpg/"><img class="alignleft size-medium wp-image-484" style="margin: 10px; border: 2px solid black;" title="Stantis-on-Obama-health-care-q20.jpg" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/Stantis-on-Obama-health-care-q20.jpg-300x224.jpg" alt="Stantis-on-Obama-health-care-q20.jpg" width="300" height="224" /></a>So obviously there&#8217;s a large logical leap between funding CER and that kind of heartless rationing.  And I don&#8217;t know anybody in the healthcare policy arena who is seriously concerned that CER could lead to something like this.  Both the <a href="http://www.cbo.gov/ftpdocs/88xx/doc8891/12-18-ComparativeEffectiveness.pdf">non-partisan CBO</a> and the<a href="http://www.iom.edu/Object.File/Master/71/107/CER%20report%20brief%206%2030%2009.pdf"> Institute of medicine</a> have released reports wholeheartedly endorsing CER and I would suggest that anyone interested in this topic read those two documents as a starting point.</p>
<p>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&#8217;t fit for care, then couldn&#8217;t you just change to a private insurance company instead?  Or couldn&#8217;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&#8217; hands.  But even if they wanted to, there&#8217;s just really no avenue in our current system for enforcing CER findings on physicians since they operate autonomously.</p>
<p>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.</p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #3 &#8211; This Bill Would Encourage the Elderly to Kill Themselves!</strong></span></p>
<p>As far as I know, this claim started with <a style="color: #664433;" href="http://politifact.com/truth-o-meter/personalities/betsy-mccaughey/">Betsy McCaughey</a> on the July 16th epidode of the Fred Thompson radio show.  This was her claim: &#8220;Congress would make it mandatory — absolutely require — that every five years people in Medicare have a required counseling session <a rel="attachment wp-att-485" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/jlo0113l-jpg/"><img class="alignright size-medium wp-image-485" style="margin: 10px; border: 2px solid black;" title="euthanasia in healthcare bill" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/jlo0113l.jpg-300x281.jpg" alt="euthanasia in healthcare bill" width="300" height="281" /></a>that will tell them how to end their life sooner.&#8221;  She says the language can be found on page 425 of the health care bill, Sec. 1233, labeled &#8220;Advance Care Planning Consultation&#8221;.  Once again, <a href="http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf">click here</a> 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&#8217;t think I&#8217;ve heard any actual politicians repeat this one.</p>
<p>First some context, everyone should have in place a document describing their preferences for end-of-life care, a &#8220;living will&#8221; or &#8220;Advanced care directive&#8221;.  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&#8217;t you want all possible treatments?).  Many people are concerned about the burden on their families if they&#8217;re left in a vegetative state or in an untreatable coma for years, they&#8217;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 &#8220;full of tubes&#8221; with doctors pounding on their chest while their family watches from another room.  While an advanced directive detailing one&#8217;s preferred care is important for everyone to have, it&#8217;s especially important for seniors. These are critical issues that come up regularly in care of the elderly and it&#8217;s obviously difficult to ascertain the patient&#8217;s wishes on this subject once they are in a coma or otherwise incapacitated.</p>
<p>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&#8217;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.</p>
<p>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 &#8220;end their life&#8221; sooner or &#8220;do what&#8217;s in the best interests of society&#8221;.  They are for the patients&#8217; 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 &#8220;government agent&#8221; but with one&#8217;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&#8217;s expense, all across the country.  It&#8217;s just that now medicare will pay for them.</p>
<p><span style="font-weight: normal;"> </span><span style="font-weight: normal;">It&#8217;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, &#8220;In no way would these sessions be designed to encourage patients to end their lives.&#8221;  And he said that McCaughey&#8217;s comments are &#8220;not just wrong, they are cruel.&#8221;  I agree.  While I&#8217;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 &#8220;protecting seniors&#8221;, as Betsy McCaughey does here, is pretty despicable.</span></p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #2 &#8211; The Healthcare Reform Bill Would Force Taxpayers to Pay for Abortions!</strong></span></p>
<p><span style="font-weight: normal;">Ok, this is a really sneaky one.  And it&#8217;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 </span><a href="http://stoptheabortionmandate.com/"><span style="font-weight: normal;">Family Research Council and Focus on the Family</span></a><span style="font-weight: normal;"> (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 </span><a href="http://www.politifact.com/truth-o-meter/statements/2009/aug/07/john-boehner/boehner-says-democrats-health-care-plan-would-lead/"><span style="font-weight: normal;">repeated by John Boehner</span></a><span style="font-weight: normal;"> and echoed in town halls across the country.  The argument goes like this, &#8220;sure, the House bill doesn&#8217;t contain any mention of abortion, but that&#8217;s just the trick.  Because it&#8217;s not expressly forbidden, those wily democrats are going to ensure that the public plan covers abortion on demand and then we&#8217;ll all be paying for these immoral procedures.&#8221;</span></p>
<p><a rel="attachment wp-att-486" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/abortion-mandate-jpg/"><img class="alignleft size-medium wp-image-486" style="margin: 10px; border: 2px solid black;" title="abortion mandate healthcare bill" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/abortion-mandate.jpg-300x225.jpg" alt="abortion mandate healthcare bill" width="300" height="225" /></a><span style="font-weight: normal;">Now that should come off as a bit of a stretch in and of itself.  But it&#8217;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, </span><a href="http://www.prochoiceamerica.org/elections/2008-congressional-results.html"><span style="font-weight: normal;">anti-abortion legislators still outnumber pro-abortion legislators in each</span></a><span style="font-weight: normal;">.  So the assumption that Democrats are out to promote abortion at every opportunity is questionable to say the least.</span></p>
<p><span style="font-weight: normal;">But there are more problems with the assumption that the bill&#8217;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&#8217;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 </span><a href="http://www.cbsnews.com/stories/2009/07/21/eveningnews/main5178682_page2.shtml"><span style="font-weight: normal;">CBS interview said</span></a><span style="font-weight: normal;">, &#8220;As you know, I&#8217;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&#8217;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.&#8221;  Indicating pretty clearly that subversively introducing something as contentious as tax-payer funded abortions was not the goal at all.  It&#8217;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.</span></p>
<p><span style="font-weight: normal;">So we&#8217;ve established that the assumption that the bill&#8217;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&#8217;t make any sense.  Because as I indicated earlier, </span><a href="http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-PUBLICOPTION-071409.pdf"><span style="font-weight: normal;">the Public Plan, despite its name, is not funded with taxpayer money</span></a><span style="font-weight: normal;">.  It&#8217;s self sustaining.  So whether or not the public plan covers abortion is irrelevant.</span></p>
<p><span style="font-weight: normal;">A &#8220;smarter&#8221; 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, &#8220;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?&#8221;  One democratic senator asked, with no small amount of sarcasm, &#8220;should we ban women from driving to abortion clinics lest our taxpayer-funded roads facilitate an abortion?&#8221;  The point being that there has to be a limit to how many levels out we can go while still labeling something &#8220;tax-payer funded abortion&#8221;.  I tend to agree that trying to ensure that nobody uses tax credits to purchase a private insurance plan that might pay for somebody&#8217;s abortion is going a little far.</span></p>
<p><span style="font-weight: normal;">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 &#8220;to cover any part of the costs of any health plan that includes coverage of abortion.&#8221; The amendment was narrowly defeated.  But soon after, Rep. Lois Capps, D-Calif. introduced an amendment that did pass </span><a href="http://energycommerce.house.gov/Press_111/20090730/hr3200_capps_1.pdf"><span style="font-weight: normal;">(found here)</span></a><span style="font-weight: normal;">.</span></p>
<p><a href="http://www.politifact.com/truth-o-meter/statements/2009/aug/07/john-boehner/boehner-says-democrats-health-care-plan-would-lead/"><span style="font-weight: normal;">From Politifact.com:</span></a></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">Under the Capps amendment:</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* 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.</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* 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.</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* Public funding would only be permitted for abortions allowed under the Hyde Amendment — in cases of rape, incest or when the mother&#8217;s life is in danger.</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* At least one plan in every region must offer full abortion coverage; and one must not.</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* 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.</span></p>
<p style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 9pt; line-height: 1.3em; margin-top: 0px; margin-right: 0px; margin-bottom: 9px; margin-left: 10px; padding: 0px;"><span style="font-weight: normal;">* The plan will not pre-empt any state laws regarding abortion, such as parental notification laws.</span></p>
<p><span style="font-weight: normal;">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&#8217;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&#8217;s hard to imagine it will not be included, or even made more restrictive in the final bill.</span></p>
<p><span style="font-weight: normal;">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&#8217;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.</span></p>
<p style="line-height:24pt;"><span style="font-size:20pt;"><strong>Myth #1 &#8211; Death Panels</strong></span></p>
<p><span style="font-weight: normal;">When I began planning this article I was going to make this whole &#8220;Death panels&#8221; 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 </span><a href="http://tpmdc.talkingpointsmemo.com/2009/08/palin-obamas-death-panel-could-kill-my-down-syndrome-baby.php?ref=fpblg"><span style="font-weight: normal;">none other than Sarah Palin, in a rant on her Facebook page of all places</span></a><span style="font-weight: normal;">.  She said:</span></p>
<p><span style="font-weight: normal;">&#8220;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&#8217;s</span><a rel="attachment wp-att-487" href="http://thefactofmyignorance.com/politics/the-top-7-craziest-myths-about-healthcare-reform/attachment/slide_2396_31502_large-jpg/"><img class="alignright size-medium wp-image-487" style="margin: 10px; border: 2px solid black;" title="obama death panels healthcare bill" src="http://thefactofmyignorance.com/wp-content/uploads/2009/08/slide_2396_31502_large.jpg-300x218.jpg" alt="obama death panels healthcare bill" width="300" height="218" /></a><span style="font-weight: normal;">&#8216;death panel&#8217; so his bureaucrats can decide, based on a subjective judgment of their &#8216;level of productivity in society,&#8217; whether they are worthy of health care. Such a system is downright evil,..Rep. Michele Bachmann highlighted the Orwellian thinking of the president&#8217;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.&#8221;</span></p>
<p><span style="font-weight: normal;">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&#8217;m aware, she has the </span><a href="http://www.politifact.com/truth-o-meter/personalities/michele-bachmann/statements/"><span style="font-weight: normal;">Politifact record for highest number of &#8220;False&#8221; or &#8220;Pants on fire&#8221; ratings at 6/6.</span></a><span style="font-weight: normal;"> And they haven&#8217;t even gone after some of her craziest ones like her claim that &#8220;The stimulus carries a provision that would force kids into reeducation camps&#8221;. </span><a href="http://thefactofmyignorance.com/politics/study-shows-more-popular-pundits-are-less-accurate/"><span style="font-weight: normal;">I mean we talk about extremists making poor predictions</span></a><span style="font-weight: normal;">, well she&#8217;s as extreme as they come and I have yet to see one of her predictions pan out in any form.</span></p>
<p><span style="font-weight: normal;">The second thing that should set off alarm bells is that it&#8217;s all obviously made-up.  Understandably, everybody seemed initially baffled when Palin put this out, and even conservatives didn&#8217;t react kindly.  David Brooks dismissed her comments as </span><a href="http://mediamatters.org/mmtv/200908090006"><span style="font-weight: normal;">&#8220;crazy&#8221;</span></a><span style="font-weight: normal;"> adding that &#8220;the crazies are attacking the plan because it will cut off granny. That is simply not true, that simply is not going to happen.&#8221;  And GOP Rep Jack Kingston (GA) said </span><a href="http://thinkprogress.org/2009/08/09/kingston-palin/"><span style="font-weight: normal;">“It’s a scare tactic, no question about it,”</span></a><span style="font-weight: normal;"> adding that there are clearly no death panels.  And Republican Senator Johnny Isakson </span><a href="http://voices.washingtonpost.com/ezra-klein/2009/08/is_the_government_going_to_eut.html"><span style="font-weight: normal;"> called her assertion &#8220;nuts&#8221; in a washington post interview</span></a><span style="font-weight: normal;">.  But a few short days later </span><a href="http://www.huffingtonpost.com/2009/08/09/gingrich-defends-palins-o_n_254926.html"><span style="font-weight: normal;">Newt Gingrich endorsed this idea</span></a><span style="font-weight: normal;">.  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 </span><a href="http://iowaindependent.com/18456/grassley-government-shouldnt-decide-when-to-pull-the-plug-on-grandma"><span style="font-weight: normal;">endorsing the idea as well</span></a><span style="font-weight: normal;">.  Once again, he didn&#8217;t want to go on record using the terms &#8220;Death panel&#8221; or anything like that but he defended Sarah Palin&#8217;s claim and told an audience, &#8220;you have every right to fear&#8221; in reference to end-of-life counseling.  That&#8217;s all it took to turn &#8220;Death Panels&#8221; 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&#8217; signboards across the country.</span></p>
<p><span style="font-weight: normal;">After numerous fact checking organizations demonstrated that Palin&#8217;s statement was pure fiction </span><a href="http://politifact.com/truth-o-meter/personalities/sarah-palin/"><span style="font-weight: normal;">(with the trusty politifact.org calling it &#8220;a Sci-Fi Scenario not based on reality&#8221;)</span></a><span style="font-weight: normal;">, Palin slammed her critics (as is her wont)</span><a href="http://www.huffingtonpost.com/2009/08/13/sarah-palin-doubles-down-_n_258432.html"><span style="font-weight: normal;"> in a new statement</span></a><span style="font-weight: normal;">.  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&#8217;s staff validates everything she said.  Unfortuantely for her this claim is </span><a href="http://politifact.com/truth-o-meter/statements/2009/aug/12/michele-bachmann/bachmann-says-obama-health-advisor-thinks-health-c/"><span style="font-weight: normal;">also demonstrably false</span></a><span style="font-weight: normal;">.  And unfortunately for America, nobody in the mainstream media is bothering to correct her.</span></p>
<p><span style="font-weight: normal;">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:</span></p>
<p></strong></p>
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<td style="padding:2px 1px 0px 5px;"><a style="color:#333; text-decoration:none; font-weight:bold;" href="http://www.thedailyshow.com" target="_blank">The Daily Show With Jon Stewart</a></td>
<td style="padding:2px 5px 0px 5px; text-align:right; font-weight:bold;">Mon &#8211; Thurs 11p / 10c</td>
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<td style="padding:2px 1px 0px 5px;" colspan="2"><a style="color:#333; text-decoration:none; font-weight:bold;" href="http://www.thedailyshow.com/watch/mon-august-10-2009/healther-skelter---obama-death-panel-debate" target="_blank">Healther Skelter &#8211; Obama Death Panel Debate</a><a></a></td>
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<td style="padding: 2px 5px 0px 5px; width: 360px; overflow: hidden; text-align: right;" colspan="2"><a style="color:#96deff; text-decoration:none; font-weight:bold;" href="http://www.thedailyshow.com/" target="_blank">www.thedailyshow.com</a></td>
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<td style="padding: 3px; width: 33%;"><a style="font:10px arial; color:#333; text-decoration:none;" href="http://www.thedailyshow.com/full-episodes" target="_blank">Daily Show</p>
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