Dispelling Healthcare Falsehoods

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10 August 2009 :: J.E. Robertson

It has been suggested that the healthcare reform legislation currently before the House and Senate would set up a government committee to ration care and decide what care patients would receive. Some Republican opponents have even suggested individual senior citizens would be judged to be deserving of euthanasia if they are determined not to be productive members of society. The latter is absolutely false and has no basis whatsoever in the proposed reforms. The question of “rationing” care is also a false claim, and it’s important to understand why.

The smear that Obama and the Democratic Congress want to “ration care” is false, because it is based on two separate issues, neither of which involves rationing care. One is the nakedly abstract assumption that anything involving government (i.e. legislation) automatically leads to “socialized medicine” and by extension rationed care. This philosophical obsession may be a matter of principle for some people, but there is nothing in current legislation that would “socialize” or “nationalize” the medical system, nor that would ration care.

The other reference cited by the “ration care” crowd is an independent board of medical professionals that would be tasked with studying effectiveness of treatments. The proposal to study “effectiveness” of treatments is designed to 1) prevent patients from being denied needed care —for instance, an insurer could not claim a cheaper treatment is “more effective” if there is proof otherwise— and 2) make sure that treatment is consistently provided in the most effective manner, putting patient care before questions of cost.

In 2004, Gov. Howard Dean was attacked by the insurance industry and by some doctors organizations —Gov. Dean is an MD himself— for proposing that an incremental “fix” to the broken American healthcare system might be to start moving toward “evidence-based medicine”… the reason was because the interests opposing such a shift have financial interests and were concerned that evidence-based medicine could lead to a scaling back of their profits.

Insurers have a vested interest in not revealing that some of the most effective and necessary medical treatments might be more costly, requiring them to fund those treatments. Doctors groups worry that a study of effectiveness could find healthier ways to provide ongoing treatment which might rule out the need for expensive tests or other procedures that help increase their revenue stream, and that fear is in some ways legitimate, due to the meager payments they receive from insurers.

We are now seeing what appears to be an ad-hoc “astroturf” —fake grass-roots— effort to derail healthcare reform, with angry seniors shouting down members of Congress, accusing them of trying to consign their friends and families to untimely death by “rationing care”. People with legitimate concerns about their family’s long-term well-being are being whipped into a frenzy by the deliberate spreading of absolute fabrications and falsehoods by opponents of comprehensive healthcare reform.

On the wildly fictional claim that there are plans under consideration that would encourage or require senior citizens to commit suicide, the LA Times reports:

No. This has become one of the most misleading, inflammatory claims made in the healthcare debate, advanced repeatedly by conservative commentators such as Rush Limbaugh and Sean Hannity and Republican lawmakers working to stoke fears among seniors.

Rep. Virginia Foxx (R-NC) became one of the leading propagators of this false claim when she said current reform proposals would ”put seniors in a position of being put to death by their government.” The LA Times retorts concisely: “There is no such provision.” And there are aggressively concerted and well-funded efforts to mislead the public into fearing the onset of a totalitarian system that would put a price on human life.

Politifact, which studies the truthfulness of claims made by political figures or about political issues, examined the $1.2 million ad campaign launched by the Club for Growth, which alleges that currently proposed reforms would deny any treatment beyond $22,000 for six months of care. This claim is totally fabricated and has no foundation in any of the reforms currently under consideration.

Politifact specifically determines in response to the ad campaign that the “ad’s main point about cost limits is incorrect. There is no such practice in the comparative effectiveness program, nor is it part of the current health reform proposals pending in Congress.” In fact, the reforms being proposed would significantly enhance the likelihood that patients and doctors would determine which treatments are administered, not bureaucrats and not insurance companies.

Politifact also lays out a list of the most significant claims, judging which are false and which true. Investors Business Daily, for instance, makes the wild allegation that on page 16 of one of the proposed reform bills, private insurance is made “illegal”. This is false. As Politifact notes:

Under the House bill, companies that offer insurance to individuals will do it through an exchange, where the government sets minimum standards for coverage. The new regulations require insurance companies to accept people even if they have previously existing conditions and to provide a minimum level of benefits, among other things.

Legislation that changes the way private insurers sell insurance is designed to do three things: 1) make sure insurance policies actually cover treatment; 2) make sure consumers are not ripped off; 3) make sure private insurance does not lead to people being denied treatment, whether due to cost considerations, “pre-existing conditions” or outright manipulation and fraud by insurance companies.

In fact, one of the most widespread and direct misrepresentations of the proposed reforms was explored in detail by Politifact as early as last October. In answer to the claim that Obama’s reform plan would require people to leave their doctor or their healthcare plan, Politifact examined Obama’s claim that “if you’ve got a health care plan that you like, you can keep it” under the proposals he was laying out.

Politifact found that Obama’s claim about his own reform was true:

Obama’s plan essentially takes today’s system and seeks to expand it to the uninsured. It creates national pools for individuals to buy their own cheaper insurance. It increases eligibility for the poor and children to enroll in initiatives like Medicaid and the State Children’s Health Insurance Program. And it has several strategies to rein in costs for everyone, such as streamlining medical record-keeping and emphasizing preventive care.

In fact, Obama has repeated that pledge hundreds of times since then, in speeches, town hall meetings, White House briefings and interviews. And the framework he sent to Congress operated on the same premise. Congress has responded by producing reform proposals that would allow people to keep the insurance they have and which uses market dynamics to achieve the specific policy goals, so that the market system is not done away with or replaced by a government health system, but made more resilient and cost-effective.