Dobbs, Beck allow McCaughey to advance health IT falsehood

During appearances on Lou Dobbs Tonight and Glenn Beck, Dobbs and Beck allowed Betsy McCaughey to advance the false claim that provisions in the economic recovery act would permit the government to control health care. In fact, the provisions she cited address establishing an electronic records system in part for the purpose of “reduc[ing] health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information.” It does not say that the federal government will determine what constitutes “unnecessary care.”

During February 10 appearances on CNN's Lou Dobbs Tonight and Fox News' Glenn Beck, hosts Lou Dobbs and Glenn Beck allowed former New York Lt. Gov. Betsy McCaughey to advance the false claim that provisions in the economic recovery act would permit the government to control health care. At one point, Dobbs stated to McCaughey that "[y]ou know the proponents of this -- of this legislation are saying that it is only about the technology, only about the data. How do you respond?" But neither Dobbs nor Beck challenged McCaughey's claims about the bill substantively. In fact, the provisions she cited would not allow the National Coordinator of Health Information Technology to eliminate, in McCaughey's words on Lou Dobbs Tonight, "[w]hatever the federal government deems unnecessary care." Rather, they address establishing an electronic health records (EHR) system in part for the purpose of “reduc[ing] health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information.” It does not say that the federal government will determine what constitutes “unnecessary care.” Indeed, CNN senior medical correspondent Elizabeth Cohen reported during the February 11 edition of CNN Newsroom, “I had a PDF of the bill up on my computer. I said, 'Show me where in the bill it says that this bill is going to have the government telling your doctor what to do.' And she directed me to language -- it didn't actually say that.” Cohen added, “Now when we asked the folks who wrote this bill, 'Hey, is this bill going to allow the government to tell doctors what to do?” they used words like, 'preposterous' and 'completely and wildly untrue.' "

As Media Matters for America has noted, talk show host Rush Limbaugh, Internet gossip Matt Drudge, Wall Street Journal senior economic writer Stephen Moore, and Fox News anchors Bill Hemmer and Megyn Kelly have previously forwarded McCaughey's falsehoods about the health care provisions in the recovery bill.

Discussing the health care information technology provisions on Lou Dobbs Tonight, McCaughey asserted, “It promises several things. It promises that whatever the system is, it's going to eliminate inefficient care, excessive care, duplicative care. It's going to eliminate disparities of care between one person and another.” Responding to Dobbs's claim, "[T]he issue is, in whose opinion is it duplication?" McCaughey asserted, “Whatever the federal government deems unnecessary care. Take a look at page 442. And worse yet -- and now I'm speaking really to the physicians -- this bill gives the secretary of Health and Human Services the power to determine which doctors are, quote, 'meaningful users of this new system' -- it's against the rules not to be -- and empowers the secretary to use quote, 'increasingly stringent measures to enforce compliance.' ”

Likewise, during the February 10 edition of Glenn Beck, McCaughey claimed without challenge from Beck that the provisions “explain[] why every doctor in the United States and every patient will be required to use these records. It says that it will achieve elimination of waste, more cost-effective medicine, that it will eliminate disparities between what one patient gets and another” and that "[t]he secretary of Health and Human Services is empowered to determine which medical providers, doctors, and hospitals are, quote, 'meaningful users of this system,' and therefore, in compliance. And, the HHS secretary is also authorized to use 'increasingly stringent measures' -- that's the language in the bill - 'to enforce compliance.' "

But McCaughey's evidence does not support the suggestion that the bill would establish federal control over health care delivery. In fact, "page 442" of the House version of the legislation does not permit the secretary of Health and Human Services to eliminate "[w]hatever the federal government deems unnecessary care." (Page 442 of the original Senate version, the amended Senate version, and the version passed by the Senate do not deal with health care information technology.) Further, language similar to the provision McCaughey referenced on “page 442” appeared in a 2004 executive order signed by former President Bush that originally established a National Coordinator of Health Information Technology.

From the 2004 executive order:

In fulfilling its responsibilities, the work of the National Coordinator shall be consistent with a vision of developing a nationwide interoperable health information technology infrastructure that:

[...]

(c) Reduces health care costs resulting from inefficiency, medical errors, inappropriate care, and incomplete information.

From the economic recovery bill:

The National Coordinator shall perform the duties under subsection (c) in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that --

[...]

(3) reduces health care costs resulting from inefficiency, medical errors, inappropriate care, duplicative care, and incomplete information.

Moreover, contrary to McCaughey's claim on Lou Dobbs Tonight that the bill “gives the secretary of Health and Human Services the power to determine which doctors are, quote, 'meaningful users of this new system' -- it's against the rules not to be -- and empowers the secretary to use quote, 'increasingly stringent measures to enforce compliance,' ” the provisions do not say it's “against the rules” for doctors not to be “meaningful user[s] of the system”; the section which mentions “more stringent measures,” Section 4312 of the bill, defines “meaningful EHR user” in order to determine whether hospitals are eligible for Medicare incentive payments (and penalties after 2016) and would require the secretary of Health and Human Services to implement “more stringent measures” to determine who is an eligible user for the purpose of awarding incentives.

From the February 10 edition of CNN's Lou Dobbs Tonight:

DOBBS: Well, hidden deep within the stimulus package are provisions that could greatly limit the health care that we all receive. My next guest says those provisions, in fact, could give the federal government unprecedented control over our medical treatment. Betsy McCaughey is former lieutenant governor of New York; she's the founder and the chair of the Committee to Reduce Infection Deaths. She's also senior fellow with the Hudson Institute. Betsy, great to have you with us.

McCAUGHEY: Thank you, and I really appreciate this opportunity to call to the public's attention and actually encourage them to look in this bill, which anybody can download now. It looks big, but if you have a computer, you can download it.

DOBBS: You and I look like we're having warring legislation.

McCAUGHEY: That's right. We've got -- I've got my pink slips on mine. And this bill will affect every individual in the United States. The bill is emphatic about that -- it says several times. Every person in the United States, every individual, check out page 445, 454, 479.

It says several things, Lou. First of all, it says that every single person in the U.S. must have their medical treatments entered into an electronic federal database. Now, electronic medical records can be a good thing. It means that if you have to go to the hospital, you can get your records instantly --

DOBBS: Right.

McCAUGHEY: -- that your doctor has more at his fingertips when he needs that information.

DOBBS: Now portability, I -- is, I think everyone would agree --

McCAUGHEY: A very good thing.

DOBBS: -- absolutely beneficial.

McCAUGHEY: Yes.

DOBBS: And is something that we would look forward to.

McCAUGHEY: Yes.

DOBBS: Your problem --

MCCAUGHEY: It's compulsory now, however. But in addition, it goes much farther than that. It promises several things. It promises that whatever the system is, it's going to eliminate inefficient care, excessive care, duplicative care. It's going to eliminate disparities of care between one person and another.

DOBBS: And the issue is, in whose opinion --

McCAUGHEY: That's right.

DOBBS: -- is it duplication?

McCAUGHEY: Whatever the federal government deems unnecessary care. Take a look at page 442.

DOBBS: Right.

McCAUGHEY: And worse yet -- and now I'm speaking really to the physicians -- this bill gives the secretary of Health and Human Services the power to determine which doctors are, quote, “meaningful users of this new system” -- it's against the rules not to be -- and empowers the secretary to use quote, “increasingly stringent measures to enforce compliance.”

DOBBS: You know the proponents of this -- of this legislation are saying that it is only about the technology, only about the data. How do you respond?

McCAUGHEY: Well, first of all, I'd like to know why it's slipped in here. This is a stimulus bill. It's about taxing and spending.

From the February 10 edition of Fox News' Glenn Beck:

BECK: Betsy, I get up this morning, and I start hearing about universal health care, and that -- that the doctors are now going to have to answer to some, you know, doctor czar in Washington.

What is this? How much of this is fact and how much is fiction?

McCAUGHEY: Well, what is particularly disturbing about the health provisions in this bill is that they don't belong in this bill. There are several provisions that affect every individual in the United States.

The bill makes it very clear there are no exceptions. It's on page 445, 454, 479 -- the phrases “every person in the United States.” Now, these provisions belong in a health care legislation where they can be discussed on the floor of the Senate --

BECK: Give me --

McCAUGHEY: -- and the House, not slipped into a stimulus bill.

BECK: Right.

McCAUGHEY: This isn't a spending provision, because all of these provisions constitute less than half a percent of government spending in this bill. And it is certainly not a tax cut. So it is not a spending provision. It is not a tax cut. And these provisions were slipped in with no discussion.

BECK: What are the provisions? What are they?

McCAUGHEY: Well, the first is that every person in the United States will have their medical treatments recorded in a federal electronic database.

BECK: Let me play devil's advocate. Well, that's good, because then mistakes will be reduce -- mistakes will be reduced.

McCAUGHEY: You don't have to play devil's advocate, because I also see the benefits of electronic medical records. I'm a patient advocate, and I'd like to know that if a patient gets sick, their medical records can make it to the next hospital or to a specialist in a matter of seconds, right?

BECK: OK. All right.

McCAUGHEY: That's a good thing, but the bill goes farther than that in explaining why every doctor in the United States and every patient will be required to use these records. It says that it will achieve elimination of waste, more cost-effective medicine, that it will eliminate disparities between what one patient gets and another.

BECK: Well, what is that?

McCAUGHEY: There must be more to this than just what is written down in the record. So then I went to the section of the bill that prescribes how this will be enforced. The secretary of Health and Human Services is empowered to determine which medical providers, doctors, and hospitals are, quote, “meaningful users” of this system, and therefore, in compliance.

And, the HHS secretary is also authorized to use “increasingly stringent measures” -- that's the language in the bill -- to enforce compliance.

BECK: OK.

McCAUGHEY: It's this toughness and vagueness --

BECK: OK, I mean, look, George Washington said that government is brute force, and that's what it seems to me we have coming. Is there anything that the average person sitting at home going, “Oh, dear God now” -- is there anything they can do right now?

From the February 11 edition of CNN Newsroom:

HEIDI COLLINS (anchor): The president's economic recovery package throws billions of dollars at health care reform. Critics say there are provisions in the fine print that will let doctors dictate the kind of medical care your doctor gives you. Actually, I think that should say the government dictate --

COHEN: Yes, that is what is should say.

COLLINS: -- what your doctor can do for you. Senior medical correspondent Elizabeth Cohen, of course, here with a fact-check now, because a lot of people, I would imagine, would have serious issue with the government -- who are not physicians usually --

COHEN: Right. Right.

COLLINS: -- except for Bill Frist -- not there anymore -- anyway, telling your doctors what to do and how to care for you. And there is money in the stimulus bill for this?

COHEN: Not exactly. Let me tell you what the concerns are first. The concerns are, as you said, the long arm of the government reaching into your doctor's examining room and telling him what to do. So let's read from two writers who have said that this is the case.

First of all, this is from Betsy McCaughey, a Republican former lieutenant governor for the state of New York. She writes, “The stimulus bill will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective.” Definitely sounds like something you don't want.

And this is -- was something that Scott Gottlieb wrote. He's from the American Enterprise Institute. “The bill will be used to create guidelines to direct doctors' treatment of difficult, high-cost medical problems.”

But, Heidi, it was interesting, when we asked Betsy McCaughey, “Show us the bill.” I had a PDF of the bill up on my computer. I said, “Show me where in the bill it says that this bill is going to have the government telling your doctor what to do.” And she directed me to language -- it didn't actually say that. But she said that it was vague enough that it would allow for that to happen in the future.

Now when we asked the folks who wrote this bill, “Hey, is this bill going to allow the government to tell doctors what to do?” they used words like, “preposterous” and “completely and wildly untrue.”

COLLINS: Completely and wildly untrue. All right.

COHEN: Yes.