From the August 7 edition of Fox & Friends:

PETER JOHNSON JR. (guest co-host): And yesterday we told you about five procedures that could disappear under the president's health care proposal. Today we have five more to discuss with you.

GRETCHEN CARLSON (co-host): And joining us now, Fox News medical contributor Dr. Marc Siegel.

Fearmongering on rationing is a GOP strategy

Luntz memo urged Republicans to emphasize the “consequences of rationing.” In a memo to Republicans outlining rhetorical strategies for opposing Obama's health care reform initiative, Frank Luntz wrote: “Put simply, while Americans would oppose the concept (and reality) of healthcare rationing, it is the impact of rationing -- the long waits for tests, the denial of care, the thousands of people fleeing to America to get the care they can't get in their own countries -- this is what truly frightens the public more than the word rationing itself. ... The word ”rationing" does induce the negative response you want, but what you really want audiences to focus on is the "consequences of rationing."

Scare tactics deny reality: Insurance companies already ration care

Sebelius saw rationing by “private insurers” on “a regular basis” while serving as Kansas insurance commissioner. During her confirmation hearings, Health and Human Services Secretary Kathleen Sebelius stated, “I, frankly, as insurance commissioner, where I served for eight years, saw [rationing] on a regular basis by private insurers, who often made decisions overruling suggestions that doctors would make for their patients, that they weren't going to be covered. And a lot of what we did in the office of the Kansas Insurance Department was go to bat on behalf of those patients to make sure that the benefits that they had actually paid for were, in fact, ones that were delivered.” [Senate confirmation hearing, 3/31/09]

Sebelius: “Health care providers,” not “private insurers” should make coverage decisions. In Sebelius' words:

It's private insurers who often are telling their clients that, “No, you can't get this recommended treatment that the doctor has made”; “No, you can't get this drug”; “No, you're not going to be able to stay in the hospital an extra day”; “No, you're not going to get this because we're concerned about costs.” So, people who say that, “Oh, this is a terrible idea; this could happen someday in the future,” it's happening every day. But it's really private insurance plans that are making those decisions. What we're hoping to do is change that situation. Private insurance companies should no longer be able to decide who gets health coverage and who doesn't, what kinds of benefits are available. And we want to make sure that it's really health care providers that make those choices in the future. [Hardball, 6/15/09]

Health care reform designed to “end barriers to coverage for people with pre-existing medical conditions.” Discussing the administration's health-care reform goals, Sebelius stated that “we must end barriers to coverage for people with pre-existing medical conditions.” She continued: “In Kansas and across the country, I have heard painful stories from families who have been denied basic care or offered insurance at astronomical rates because of a pre-existing condition. Insurance companies should no longer have the right to pick and choose. We will not allow these companies to insure only the healthy and leave the sick to suffer.” [House Ways & Means testimony, 5/6/09]

Insurance companies acknowledge that they already ration care. WellPoint chief medical officer Dr. Sam Nussbaum has stated that “where the private sector has been far more effective than government programs is in limiting clinical services to those that are best meeting the needs of patients.” Nussbaum continued, “When we look at advanced imaging, and these -- this is MRI, CAT scan, PET scans -- we know that as much as 30 percent of those procedures are not necessary. And we've been able, over the last several years, to have growth in imaging procedures of between zero and 5 percent. The government, under CMS, has seen imaging grow 15 to 20 percent a year during the same time interval.” [NPR Morning Edition, 7/15/09]

Insured individuals are currently subject to rescission of their coverage if they become ill. Insurance companies restrict or deny coverage by rescinding health insurance policies on the grounds that customers had undisclosed pre-existing conditions. On June 16, a House Energy and Commerce subcommittee held a hearing exploring this practice, with the goal of examining “the practice of 'post-claims underwriting,' which occurs when insurance companies cancel individual health insurance policies after providers submit claims for medical services rendered.” The committee also released a memorandum finding that three major American insurance companies rescinded 19,776 policies for over $300 million in savings over five years, and that even that number “significantly undercounts the total number of rescissions” by the companies.

Fox & Friends has engaged in repeated fearmongering on rationing and care of elderly

Fox News' Johnson and Siegel suggest health care reform will deny kidney dialysis to the elderly.

From the August 7 edition of Fox & Friends:

JOHNSON: Kidney disease -- what if I have kidney disease and I need dialysis? We just have about 30 seconds, doctor.

SIEGEL: You know, Peter, I was studying dialysis last night, and 350,000 people are on dialysis every year. You know what? Most of them are elderly. Dialysis can help you get five or 10 years of quality life.

JOHNSON: So the concern is if you're too old, maybe you get it, maybe you don't, right?

SIEGEL: I don't want it taken away. I don't want it taken away from our elderly.

JOHNSON: Thanks, Dr. Siegel.

Siegel on “rationed care” under health reform: "[I]n a way it's a form of eugenics." Discussing “rationed care” that he said would occur under health care reform, Siegel asserted, “There's going to be more people trying to get in. I'm going to have less and less time to take care of them. Reimbursements to doctors and hospitals are being cut. If I'm being paid less, I got to work faster. That means I send more and more people for expensive tests. He's going to try to cost cut, which means he's going to ration care. So he's going to tell me what I can order, what I can't.” After co-host Steve Doocy suggested that “unfairly, the elderly are the ones who are going to get shortchanged,” Siegel asserted, “That's so true. In a way it's a form of eugenics: 'Oh, you're not good enough to live.' ” [Fox & Friends, 7/22/09]

Johnson: Health care reform is “a subtle form of euthanasia.” Johnson said: “Some people are saying, well, this is a health care reform, other people say -- maybe me -- that this is a subtle form of euthanasia. And when you start looking at the proposals, you say, God, what's happening? One of the proposals, Section 1233, talks about advanced care planning consultations. And that's a fancy term where a doctor goes to you every five years once you're 65, or more if you're chronically ill, and explains to you the benefits of so-called palliative care, of not giving active treatment.” Co-host Brian Kilmeade subsequently claimed, “Wow. Somebody you don't even know will decide if you're going to live.” [Fox & Friends, 7/27/09]

Johnson: An “Aldous Huxley kind of world.” Discussing health-care reform, Johnson asserted, “Advanced care planning consultation is kind of our 2009 Brave New World, Soylent Green, 1984, Aldous Huxley kind of world where you come in and see your doctor at age 65, and if you're chronically ill you come in every year, and your doctor -- who will be trained, and they will spend billions of dollars in training doctors to be counselors -- that, 'You have options. You don't have to go into a hospital.' ” Doocy then asked, “Are you saying these are the people that are going to determine whether you live or die?” and Brian Kilmeade subsequently characterized the provision as the “ultimate exit strategy.” [Fox & Friends, 7/28/09]

Doocy suggests that under health care reform, you'll be asked, “Isn't it just time?” During a segment on “rumors” about end-of-life care, Gretchen Carlson stated that “if you were looking for a way to cut costs, some people argue who don't agree with this health-care reform bill, they argue that, yeah, maybe they will decide to not give elderly people the care that many people believe they deserve to continue their life.” Steve Doocy subsequently claimed, “Besides, you look at other countries that have nationalized health-care situations, frequently there's a board that sits there and they go, 'OK. You're 85. You know, this $75,000 surgery just doesn't make sense. So rather than you winding up with this new lifesaving thing that could extend your life, you know, isn't it just time?' ” [Fox & Friends, 7/29/09]

Malkin on Fox & Friends: Health care reform “puts a discount on the lives of elderly people.” Discussing AARP's support for health care reform, conservative columnist Michelle Malkin stated, “The AARP just held a tele-town hall supporting Obama on his health care takeover plans, and this is at odds, it seems to me, with the best interests of millions of AARP members, given that that health care plan puts a discount on the lives of elderly people and would result in the redistribution of health away from the elderly and the infirm to other special favored interests and patients.” [Fox & Friends, 7/30/09]

Johnson tells viewers to ask Congress member if government will “decide whether I live or die.” Urging viewers to protest health-care reform during Congress' August recess, Johnson said, “People have to be contacting their congresspeople” in order to ask, “If I need to get a hip replacement, am I going to get it? If I've got private insurance now and I'm happy with it, am I going to lose it? Is the government going to decide whether I live or die at some point in the future?” [Fox & Friends, 8/3/09]

Fearmongering about euthanasia echoes discredited right-wing smear

Claims of mandatory counseling for seniors to end their lives are false. Fox & Friends' suggestions that health care reform will lead to the elderly being encouraged to die echo the discredited right-wing myth that a provision in the House health care reform bill would require that seniors receive “mandatory” end-of-life counseling sessions that would, in Betsy McCaughey's words, “tell them how to end their life sooner.” Contrary to these assertions, the bill does not make end-of-life counseling mandatory. The relevant section of the bill amends the Social Security Act to ensure that advance care planning will be covered if a patient requests it from a qualified care provider [America's Affordable Health Choices Act, Sec. 1233]. According to an analysis of the bill produced by the three relevant House committees, the section "[p]rovides coverage for consultation between enrollees and practitioners to discuss orders for life-sustaining treatment. Instructs CMS to modify 'Medicare & You' handbook to incorporate information on end-of-life planning resources and to incorporate measures on advance care planning into the physician's quality reporting initiative." [waysandmeans.house.gov, accessed 7/29/09]

PolitiFact: Claim that seniors would be told how to end lives sooner “is an outright distortion.” Criticizing McCaughey's false claims, PolitiFact.com wrote that the “claim that the sessions would 'tell [seniors] how to end their life sooner' is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn't just wrong, she's spreading a ridiculous falsehood.” [PolitiFact.com, 7/23/09]

Transcript

From the August 7 edition of Fox News' Fox & Friends:

JOHNSON: And yesterday we told you about five procedures that could disappear under the president's health care proposal. Today we have five more to discuss with you.

CARLSON: And joining us now, Fox News medical contributor Dr. Marc Siegel. Good to see you, Dr. Siegel.

SIEGEL: Good morning, Gretchen.

CARLSON: All right, so the first you want to talk about is targeted treatments, specifically things like chemotherapy, right?

SIEGEL: I don't think people realize out there how well we're doing with cancer right now. We used to just poison the cancer, and then we would end up poisoning the body. Now we have targeted antibiotics that go right to the cancer, but they don't work in everyone.

So how is insurance, one size fit all, going to cover this when it only works for certain people and it's very expensive? We have that with Herceptin, which has an 80 percent response rate for extensive breast cancer. It's a miracle drug. Only works in about 20, 30 percent -- same with some other targeted therapies.

I think that these could become extinct, even though they are the latest and greatest treatments. I'm very worried about that possibility.

JOHNSON: Now there's certain cosmetic or reconstructive procedures that are, in fact, covered by insurance when they are medically necessary. What's your concern about that under a prospective Obama plan?

SIEGEL: Well, you know, Peter, it's the same problem. I mean, how are going to justify it? You say, well, I can't breathe, I need a rhinoplasty. That's a very important consideration.

JOHNSON: Which is a nose job.

SIEGEL: Right, which is a nose job. Who's going to decide if you can't breathe or not? Here's another one: burns. One to 2 million people a year are burned. Thirty percent burns -- you have to go into burn unit. Guess what? You need hospital re-admission for more and more plastics procedures. They're already talking about cutting down on re-admissions.

JOHNSON: Transplants -- tell us about transplants.

SIEGEL: Well, liver transplants, I think, are really in danger, because already we have 16,000 people waiting for them. Only 6,500 people get them. Well, what if you're a drinker? What if you have a problem with cirrhosis? Are they going to get approved? We may end up with a point where only Steve Jobs gets a liver transplant and nobody else.

CARLSON: The leader of Apple. OK, bariatric surgery -- this is a huge thing; so many people get this done to fight their obesity problem. That could go away?

SIEGEL: I'm very worried about that, too. Look, 200,000 cases were done in 2008. It's up from 140,000 cases. Let me explain about gastric bypass surgery. It actually -- I'm convinced now; I used to be against it. I now think it really works. It cuts down on diabetes. It cuts down on high blood pressure. It cuts down on heart disease. If you're three or 400 pounds, you need these procedures.

JOHNSON: Kidney disease -- what if I have kidney disease and I need dialysis? We just have about 30 seconds, doctor.

SIEGEL: You know, Peter, I was studying dialysis last night, and 350,000 people are on dialysis every year. You know what? Most of them are elderly. Dialysis can help you get five or 10 years of quality life.

JOHNSON: So the concern is if you're too old, maybe you get it, maybe you don't, right?

SIEGEL: I don't want it taken away. I don't want it taken away from our elderly.

JOHNSON: Thanks, Dr. Siegel.

SIEGEL: You bet.

CARLSON: Wow. You've been doing a lot of reading.

SIEGEL: You bet I have.

CARLSON: Thank you very much for parsing that down for us.