UPDATED: Myths and falsehoods about health care reform
Research ››› ››› CHRISTINE SCHWEN & MORGAN WEILAND
Media Matters for America identifies and debunks four more myths and falsehoods surrounding the health care reform debate, bringing the total to 18.
CLAIM: VA end-of-life booklet encourages vets to "pull the plug."
- In an August 18 Wall Street Journal op-ed, headlined "The Death Book for Veterans," former Bush administration aide Jim Towey criticized a Veterans Health Administration (VHA)-promoted booklet on advanced care planning directives that he claimed will "steer vulnerable individuals to conclude for themselves that life is not worth living." [Wall Street Journal, 8/18/09]
- KARL ROVE: [T]he book is designed to encourage people towards a certain direction, which is to give up and accept pain. In fact, you know what? ... [W]hen it comes to advanced directives -- what to do at your end of your life to give guidance to your physician and your family -- it lists one group, Compassionate -- Compassionate Choices [sic]. And it gives their phone number and their log site. What they don't tell you, however, is that that really is the name of ... the Hemlock Society that is referenced there. This is a group that believes in assisted suicide. [Hannity, 8/24/09]
REALITY: End-of-life educational booklet "Your Life, Your Choices" is not a "death book." The booklet emphasizes that "your wishes will direct future health care decisions" and presents preserving one's life "using any means possible" as an option to consider. An August 23 post by VoteVets.org blogger Richard Smith criticized Towey's assertion that "Your Life, Your Choices" presents "end-of-life choices in a way aimed at steering users toward predetermined conclusions," writing: "Really, if the document was really trying to get veterans to pull the plug on themselves, then first suggesting to them that their life should be prolonged at all costs is a pretty stupid way to do it" [emphasis in original].
Booklet doesn't reference assisted suicide groups Compassion and Choices, Hemlock Society. Contrary to Rove's claim, the current version of the booklet as posted on the VA's website does not reference either group, nor does it provide "their phone number and their log site." Indeed, Towey himself admitted the Compassion and Choices reference was "pulled" from the 2007 edition of booklet during the Bush administration. During his Fox News Sunday interview, Towey alleged of "Your Life, Your Choices" that "[t]he 2007 edition said go to Compassion Choices [sic]. That's the Hemlock Society." After Wallace stated that "we need to point out that those references which were in ... the 2007 edition are not in the edition that is currently being circulated at the Veterans Administration," Towey acknowledged that "they pulled that page after we raised concerns about it." [Fox News Sunday, 8/23/09]
CLAIM: VHA document requires doctors to direct veterans to the end-of-life educational booklet.
- During his interview with Assistant Secretary of Veterans Affairs Tammy Duckworth on Fox News Sunday, host Chris Wallace claimed that "more than a month ago -- VA health practitioners were told to refer all veterans -- not just end-of-life veterans, but all 24 million veterans -- to this document, 'Your Life, Your Choices.' " [Fox News Sunday, 8/23/09]
- MEGYN KELLY: "[The VHA] requires physicians at VAs to at least refer their patients to this booklet." [Fox News' America's Newsroom, 8/24/09]
REALITY: VHA does not "require" physicians to refer patients to the booklet. In fact, as Media Matters documented, a July 2 VHA handbook actually directs patients to " 'Your Life, Your Choices' ... or other published resources," later specifically referencing the VA's own "What You Should Know About Advance Directives" document.
CLAIM: Bush administration stopped using the booklet.
- Fox News' Megyn Kelly said the booklet "was generated years ago under President Bush. It was in use. Then it was called to President Bush's attention what the thing said, and he put it out of use." [America's Newsroom, 8/24/09]
- Sean Hannity claimed the booklet "was eliminated in the Bush years and brought back under President Obama." [Hannity, 8/20/09]
REALITY: Bush's VA promoted the document throughout his presidency. Bush's VA promoted the document throughout his presidency, as Daily Kos blogger Jed Lewison documented. Indeed, an online document on the VA's website labeled "Reviewed/Updated Date: December 29, 2008" stated, "To learn about a Living Will, read 'Your Life, Your Choices." (PDF available here.) Under the Bush administration, the booklet was available through government document websites, according to an Obama White House fact sheet. From the fact sheet:
The print version of Your Life, Your Choices was made available to patients in the Seattle area, but was never distributed nationally to Veteran patients, except that it was publicly available to VHA facilities through government document websites. [White House "Fact Sheet" on "Your Life, Your Choices," 8/25/2009 (via Greg Sargent)]
CLAIM: Towey can credibly criticize "Your Life, Your Choices."
REALITY: Towey's organization sells a competing booklet. As Media Matters noted, the organization Towey founded, Aging with Dignity, sells "Five Wishes," a booklet that, like "Your Life, Your Choices," is designed to guide people in the creation of a living will. Towey received more than $90,000 from the organization in 2007. Huffington Post news editor Marcus Baram reported on August 22 that "Towey seems to have his own axe to grind" in criticizing "Your Life, Your Choices" in that Towey, according to "VA sources," has "repeatedly tried to get the government to spend millions to purchase his 'Five Wishes' book."
CLAIM: Reconciliation would "change," "circumvent" Senate rules and its use is unprecedented for major legislation.
- An article in The Hill reported that Sen. Judd Gregg "told The Hill in a recent interview that Republicans will wage a vicious fight if Democrats try to circumvent Senate rules and use a budget maneuver to pass a trillion-dollar healthcare plan with a simple majority." [The Hill, 9/1/09]
- Fox News anchor Jamie Colby cited "a lot of talk in the last week about potentially splitting the bill, potentially changing the rules with the nuclear option." [America's Newsroom, 8/22/09]
REALITY: Media have frequently quoted Republicans' criticism of reconciliation without noting their past support for the tactic, including for tax cuts. Media Matters has documented a pattern of journalists quoting Republican senators criticizing the idea of using reconciliation to pass health care reform, without noting that those same senators -- including Sens. Gregg, Lamar Alexander (R-TN), Charles Grassley (R-IA), Mitch McConnell (R-KY), Olympia Snowe (R-ME), and Orrin Hatch (R-UT) -- voted to allow the use of the budget reconciliation process to pass legislation during the Bush administration, including tax cuts.
Reconciliation process would not change Senate rules -- it is currently part of the congressional budget process. The budget reconciliation process is defined by the U.S. House Committee on Rules as "part of the congressional budget process ... utilized when Congress issues directives to legislate policy changes in mandatory spending (entitlements) or revenue programs (tax laws) to achieve the goals in spending and revenue contemplated by the budget resolution." A "Glossary of Budget Terms" posted on the website of the Senate Budget Committee's Republicans defines "Reconciliation Process" as a "process by which Congress includes in a budget resolution 'reconciliation instructions' to specific committees, directing them to report legislation which changes existing laws, usually for the purpose of decreasing spending or increasing revenues by a specified amount by a certain date. The legislation may also contain an increase in the debt limit. The reported legislation is then considered as a single 'reconciliation bill under expedited procedures' " [emphasis in original].
Congress -- including under GOP leadership -- has used reconciliation to pass health care measures. As Media Matters has noted, Congress has used reconciliation to pass health care measures several times. A Republican-led Congress used reconciliation to pass Medicare Advantage as part of the Balanced Budget Act of 1997. In 1986, Congress used reconciliation to pass COBRA, which gave "workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances." In the Omnibus Reconciliation Act of 1990, Congress used reconciliation to pass the Patient Self-Determination Act, which requires hospitals, nursing homes, HMOs, and other organizations that participate in Medicare or Medicaid to provide information about advance directives and patients' decision-making rights. Additionally, Republicans attempted to use reconciliation to pass an increase in the eligibility age for Medicare in 1995 and 1997.
CLAIM: Reconciliation for health care is the "nuclear option."
- BILL HEMMER: "Democrats may go it alone on their effort to change America's health care; Democratic congressional leaders now considering a nuclear option to pass the most controversial parts of the reform package." [Fox News' America's Newsroom, 8/20/09]
REALITY: GOP Sen. Trent Lott described proposal to change filibuster rules as "nuclear option." The term "nuclear option" was originally coined by Lott in 2003, and referred to a proposal Lott supported to change the Senate rule that requires a three-fifths supermajority to invoke cloture and end a filibuster. After Republican strategists deemed the term a political liability, Republican senators began to attribute it to Democrats. As Media Matters for America noted, at the time, many in the news media followed suit, repeating the Republicans' false attribution of the term to Democrats.
MYTH 3: Kennedy's absence -- rather than GOP obstructionism -- is to blame for partisan health care fight
CLAIM: Sen. Edward Kennedy's absence from the health care debate, rather than Republican obstructionism, has prevented Democrats from reaching a bipartisan compromise.
- Politico reported in its Kennedy obituary that "Republicans complained that without Kennedy, Democrats were less willing to make the concessions needed for true compromise." [Politico, 8/26/09]
- The Associated Press reported that "[s]ome lawmakers" blame stalemate on Kennedy's absence and quoted a GOP senator claiming "we probably would have an agreement by now." [AP, 8/27/09]
- The Washington Post wrote that "[t]hree GOP senators suggested in their remembrances of Kennedy that Democrats will need more than respectful conversation to gain bipartisan support for a health-care bill. Sens. John McCain (Ariz.), Orrin Hatch (Utah) and Judd Gregg (N.H.) lamented Kennedy's absence in the negotiations," and went on to quote them blaming the stalemate on Kennedy's absence. [The Washington Post, 8/27/09]
REALITY: Some journalists have identified this claim as GOP spin. For instance, discussing Hatch's suggestion on NBC's Meet the Press that had Kennedy been more involved in health care reform negotiations, "we would have worked it out," Salon.com's Joan Walsh wrote that "[d]espite Sen. Orrin Hatch's statement this weekend that Kennedy would have brokered a bipartisan healthcare bill, absolutely no evidence supports that point of view" [Salon.com, 8/26/09]. And in a post to his WashingtonPost.com blog, Ezra Klein wrote, in reference to Sen. John McCain's claim that, in Klein's words, "the real hindrance to health-care reform is the absence of Sen. Ted Kennedy," "[t]his stuff just isn't plausible ... Kennedy's committee, the HELP Committee, has passed health-care reform. Kennedy's staff, as you might expect, led their effort. But neither Kennedy nor his staff can make the deals for another committee" [emphasis in original] [WashingtonPost.com, 8/24/09].
CLAIM: Kennedy would not want current health legislation passed "if it wasn't good."
- On ABC's World News, senior congressional correspondent Jonathan Karl stated that "Republicans, even those close to Senator [Ted] Kennedy, are not buying" the argument that health care reform should be passed to honor Kennedy's memory, then aired a clip of Sen. Orrin Hatch (R-UT) claiming Kennedy "wouldn't want it passed if it wasn't good." [World News with Charles Gibson, 8/27/09]
REALITY: Kennedy strongly supported HELP bill. A Senate HELP committee press release announcing its July 15 passage of The Affordable Health Choices Act quoted Kennedy saying that "I could not be prouder of our Committee. We have done the hard work that the American people sent us here to do." And in a July 18 Newsweek op-ed, Kennedy wrote that ensuring Americans have access to quality health care is the "cause of my life," advocated for policies in the HELP bill -- including its public option and mandate that each American is covered by a health insurance plan -- and cited the "urgency" in the need for reform.
MYTH 4: Conservative claims about abortion and health reform are simply intended to prohibit federal funding
CLAIM: In asserting that health care reform would cause the government to pay for abortions, conservatives are simply trying to block possible federal funding for the procedure.
- Several media outlets -- including CBS, ABC, the Cleveland Plain Dealer, and the Los Angeles Times -- have purported to fact-check claims about government funding for abortion under health care reform but have ignored the fact that abortion rights opponents' proposed legislative solution to the issue would effectively eliminate abortion coverage from the private individual insurance market and would effectively strip abortion coverage from some who currently have it.
REALITY: Anti-abortion proposal would effectively ban abortion coverage for those participating in the exchange -- including for those who have such coverage now. A failed amendment to the House bill offered by Reps. Bart Stupak (D-MI) and Joe Pitts (R-PA) would effectively bar insurance companies from offering plans through the health insurance exchange that cover abortion. As Media Matters documented, such a provision -- if implemented as part of the current House health care reform bill -- would effectively cause a number of people who currently have abortion coverage to lose that coverage.
CLAIM: The health care system currently works fine, and only a purportedly small number of uninsured people would benefit from reform.
- RUSH LIMBAUGH: "There really isn't a crisis in health care in this country. The crisis in health care that -- if you wanna say, that does exist -- is the fear that a major illness or catastrophe could wipe you out, which isn't gonna change. In fact, the odds of you being wiped out by a catastrophe or accident once the government gets started running this stuff is greater than if the private sector -- but day-to-day, there's no health care crisis in this country. You can get it. So, it isn't about health care, per se. This is just about gaining control, taking money, and controlling people's lives, and wiping out Republicans -- a nice cherry on top." [Premiere Radio Networks' The Rush Limbaugh Show, 6/18/09]
- STEVE DOOCY: "Currently, 90 percent of all Americans have got some sort of health care coverage, which means they are effectively blowing up the system for 5 percent. Now, the 5 percent, you gotta worry about them -- you gotta worry about everybody who doesn't have it. But is it worth all of this for 5 percent?" [Fox News' Fox & Friends, 7/30/09]
REALITY: Roughly 25 million Americans were underinsured in 2007. According to Cathy Schoen, senior vice president of The Commonwealth Fund, "From 2003 to 2007, the number of adults who were insured all year but were underinsured increased by 60 percent. Based on those who incur high out-of-pocket costs relative to their income not counting premiums despite having coverage all year, an estimated 25 million adults under age 65 were underinsured in 2007." [Testimony from Schoen before the Senate Health, Education, Labor and Pensions Committee, 2/24/09]
The underinsured do not receive adequate care and face financial hardship. Schoen explained that the "experiences" of the underinsured were "similar" to those of the uninsured, noting that "over half of the underinsured and two thirds of the uninsured went without recommended treatment, follow-up care, medications or did not see a doctor when sick. Half of both groups faced financial stress, including medical debt." [Schoen testimony, 2/24/09]
Insurance companies currently rescind policies when their insured customers need treatment. 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.
Currently, insurance companies deny coverage based on pre-existing conditions. CNN senior medical correspondent Elizabeth Cohen wrote in a May 14 CNN.com article, "According to the Kaiser Family Foundation, 21 percent of people who apply for health insurance on their own get turned down, charged a higher price or offered a plan that excludes coverage for their pre-existing condition. ... The health insurance industry doesn't deny that people are rejected or charged higher premiums because of pre-existing conditions."
CLAIM: Progressive health care reform proposals will introduce a system of "rationing" into American medicine.
- SEAN HANNITY: "We're gonna have a government rationing body that tells women with breast cancer, 'You're dead.' It's a death sentence." [Fox News' Hannity, 6/19/09]
- MICHELLE MALKIN: "Big Nanny Democrats want to ration health care for everyone in America -- except those who break our immigration laws." [Malkin column, 7/22/09]
REALITY: Insurance companies already ration care. Insurance companies acknowledge that they ration care, restricting coverage of procedures and tests like MRIs and CAT scans and denying coverage for pre-existing medical conditions.
Sanjay Gupta: "I can tell you, as a practicing physician ... who deals with this on a daily basis, rationing does occur all the time." As Dr. Sanjay Gupta, CNN's chief medical correspondent, explained: "[P]eople always say, 'Is there going to be rationed care?' And I can tell you, as a practicing physician, as someone who deals with this on a daily basis, rationing does occur all the time. I mean, I was in the clinic this past week. And I -- you know, at the end of clinic, I get all this paperwork that basically says, 'Justify why you're doing such and such procedure. Justify why you're ordering such and such test.' And if the justification is inadequate, the answer comes back, 'Well, that's not going to be covered.' Which basically is saying that the patient is going to have to pay for it on their own, which is, in essence, is what rationing is, in so many ways." [CNN's Anderson Cooper 360, 8/12/09]
Insurance companies ration care by rescinding coverage. As former senior executive at CIGNA health insurance company Wendell Potter explained in June 24 Senate testimony, insurance companies restrict or deny coverage by rescinding health insurance policies on the grounds that people had undisclosed pre-existing conditions. President Obama recently cited one such example, noting that "[a] woman from Texas was diagnosed with an aggressive form of breast cancer, was scheduled for a double mastectomy. Three days before surgery ... the insurance company canceled the policy, in part because she forgot to declare a case of acne. ... By the time she had her insurance reinstated, the cancer had more than doubled in size."
CLAIM: House health care reform bill mandates end-of-life counseling that will pressure seniors to end their lives.
- BETSY McCAUGHEY: "And one of the most shocking things I found in this bill, and there were many, is on Page 425, where the Congress would make it mandatory -- absolutely require -- that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go in to hospice care. And by the way, the bill expressly says that if you get sick somewhere in that five-year period -- if you get a cancer diagnosis, for example -- you have to go through that session again. All to do what's in society's best interest or your family's best interest and cut your life short. These are such sacred issues of life and death. Government should have nothing to do with this." [FredThompsonShow.com, interview archives, 7/16/09]
- HANNITY: "Now, she [McCaughey] actually uncovered in this bill a particularly outrageous provision -- and by the way, there will be more to come in the Obamacare plan. According to McCaughey, she's saying under the House provision and the House version, perfectly healthy senior citizens are going to be forced to undergo, quote, 'end of life counseling,' apparently to encourage them to check out before their time is up." [ABC Radio Networks and Premiere Radio Networks' The Sean Hannity Show, 7/17/09]
REALITY: Advance care planning is not mandatory in the House health care bill. Section 1233 of America's Affordable Health Choices Act of 2009 -- which includes "Page 425" -- 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: McCaughey's claim that seniors would be encouraged to end their lives "is an outright distortion." "McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her 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]
CLAIM: Health care reform would establish a "death panel."
- GLENN BECK: "So, why is there no more discussion than there is on Sarah Palin and what she said over the weekend that there would be ... [a] death panel for her son Trig? That's quite a statement. I believe it to be true, but that's quite a statement." [Premiere Radio Networks' The Glenn Beck Program, 8/10/09]
- BRIAN KILMEADE: "[E]veryone's talking about seniors, and they're talking about the middle class and affordable health care. If the upper class is paying for the next two classes, and are seniors going to be in front of a death panel? And then just as you think, 'OK, that's ridiculous,' then you realize there's provisions in there that seniors in the last lap of their life will be sitting there going to a panel, possibly discussing what the best thing for them is." [Fox & Friends, 8/10/09]
REALITY: "Death panel" claims have been conclusively discredited. In one of more than 40 media reports debunking claims of euthanasia and "death panels," PolitiFact wrote: "We've looked at the inflammatory claims that the health care bill encourages euthanasia. It doesn't. There's certainly no 'death board' that determines the worthiness of individuals to receive care. ... [Palin] said that the Democratic plan will ration care and 'my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care.' Palin's statement sounds more like a science fiction movie (Soylent Green, anyone?) than part of an actual bill before Congress. We rate her statement Pants on Fire!" [PolitiFact.com, 8/10/09]
CLAIM: Under health care reform, you will be denied care, and it will be given to undocumented immigrants instead.
- DICK MORRIS: "The point about these death panels is that if you restrict the amount -- the lifesaving surgeries, and you tell someone, no, you can't have that bypass surgery -- but I'm going to die if I don't have it. Well, here's the grief counselor. That will happen. And whether they fund the grief counselor or the end-of-life counselor or not, the rationing will take place when they tell you, no, you can't have the surgery because we have to give it to a 40-year-old illegal immigrant instead." [Hannity, 8/17/09]
REALITY: House bill stipulates that those "not lawfully present" may not receive subsidies to purchase insurance. Under the "Individual Affordability Credits" section of the America's Affordable Health Choices Act of 2009:
SEC. 242. AFFORDABLE CREDIT ELIGIBLE INDIVIDUAL.
(a) DEFINITION. --
(1) IN GENERAL. -- For purposes of this division, the term ''affordable credit eligible individual'' means, subject to subsection (b), an individual who is lawfully present in a State in the United States (other than as a nonimmigrant described in a subparagraph (excluding subparagraphs (K), (T), (U), and (V)) of section 101(a)(15) of the Immigration and Nationality Act) --
SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
Senate HELP bill excludes those "not lawfully present" from federal funding. Under the "Making Coverage Affordable" section of the Affordable Health Choices Act:
(h) NO FEDERAL FUNDING. -- Nothing in this Act shall allow Federal payments for individuals who are not lawfully present in the United States.
CLAIM: Health care reform would be funded by broad-based tax increases.
- MARA LIASSON: "But the fact is, what have they been hearing? It has a $1 trillion price tag over 10 years, it's going to raise your taxes. I think --
CHRIS WALLACE: "Well, aren't those both true?" [Fox Broadcasting Co.'s Fox News Sunday, 8/2/09]
REALITY: The surtax in House bill applies only to income exceeding $350,000 per year for joint filers. The House health care legislation would establish a 1 percent tax on joint income exceeding $350,000 but not greater than $500,000 per year; a 1.5 percent tax on joint income exceeding $500,000 but not greater than $1 million per year; and a 5.4 percent tax on joint income exceeding $1 million per year. Single filers would be subject to the surtax starting at income exceeding $280,000 per year. In a July 15 Huffington Post piece, Rep. George Miller (D-CA) stated that "[o]nly the highest earning 1.2 percent of American households will pay a surcharge."
CLAIM: The House Democrats' bill will raise income taxes on small businesses.
- Wall Street Journal editorial: "The health-care bill is a jobs killer, with its 5.4-percentage point income surtax that would hit small business especially hard." [Wall Street Journal, 8/9/09]
REALITY: Ways and Means committee stated that according to JCT, only 4.1 percent of small-business owners would be affected by surtax. The legislation would establish a 1 percent tax on joint income exceeding $350,000 but not greater than $500,000 per year; a 1.5 percent tax on joint income exceeding $500,000 but not greater than $1 million per year; and a 5.4 percent tax on joint income exceeding $1 million per year. Single filers would be subject to the surtax starting at income exceeding $280,000 per year. The House Ways and Means Committee stated, "Using the broadest definition of a small business owner (i.e., any individual with as little as $1 of small business income), the nonpartisan Joint Committee on Taxation has estimated that only 4.1% of all small business owners would be affected by the health care surcharge."
CLAIM: House Democrats' bill would subject all small businesses to an 8 percent payroll tax as a penalty for not providing insurance to employees.
- GRETCHEN CARLSON: "[T]he real victim, potentially, of this health care reform ... is the small business owner. ... [T]hey are going to be hit potentially with this health care reform if they don't offer health care to their employees -- an 8 percent penalty on them." [Fox & Friends, 7/16/09]
REALITY: Companies with annual payrolls of less than $250,000 would pay no penalty under the House bill. The House bill would establish a 2 percent payroll penalty for employers with combined payroll between $250,000 to $300,000 that don't offer health insurance to employees; a 4 percent penalty for employers with $300,000 to $350,000 in payroll; a 6 percent penalty for employers with $350,000 to $400,000 in payroll; and an 8 percent penalty for companies with annual payrolls exceeding $400,000. Additionally, the bill establishes tax credits for small-business employers that do provide health care.
CLAIM: Health care reform "would add around $1 trillion to the deficit over the next 10 years."
- AP: "But even the nonpartisan Congressional Budget Office says that none of the health plans pending on Capitol Hill would control long-term spending, and that ones with the elements Obama wants would add around $1 trillion to the deficit over the next 10 years." [Associated Press, 8/3/09]
- Karl Rove claimed that House Democrats are "planning on a 1 trillion, 420 billion -- 420 million dollar price tag of additional spending over the next 10 years, and what they've done is, today, supposedly -- we haven't seen the details -- but they've trimmed that by 10 percent. So we're only going to beggar ourselves by $900 billion over the next decade and that's assuming they get all of the tax increases and all of the Medicare cuts that are built into this." [Hannity, 7/29/09]
REALITY: CBO found that House bill would increase the federal budget deficit by $239 billion over 10 years -- not $1 trillion. In a July 17 cost estimate of the bill as introduced, the CBO explained that its "estimate reflects a projected 10-year cost of the bill's insurance coverage provisions of $1,042 billion, partly offset by net spending changes that CBO estimates would save $219 billion over the same period, and by revenue provisions that JCT estimates would increase federal revenues by about $583 billion over those 10 years." CBO thus concluded the legislation "would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period." The CBO has not released full cost estimates of the health care reform proposals being considered by the Senate.
CLAIM: House health care reform bill would "outlaw individual private coverage."
- An Investor's Business Daily editorial falsely claimed that the House bill includes "a provision making individual private medical insurance illegal." The editorial later stated that the "provision would indeed outlaw individual private coverage." [IBD, 7/15/09]
- HANNITY: "The one thing that we do know in the health care bill is that it's gonna literally -- the bill says -- Investor's Business Daily had an article today -- and the bill says that if you don't have your insurance the year this legislation is implemented, you can't have a private insurance company. So that will end -- hang on -- that will end private insurance." [Hannity, 7/16/09]
REALITY: The bill does not "outlaw" private individual insurance. The provision to which the IBD editorial referred establishes the conditions under which existing private plans would be exempted from the requirement that they participate in the Health Insurance Exchange. Individual private health insurance plans that do not meet the "grandfather" conditions would still be available for purchase, but only through the exchange and subject to those regulations. As Health and Human Services Secretary Kathleen Sebelius noted, the assertion "that individuals would no longer be able to keep their personal coverage" is "just not accurate. It's not in any version of the House bill; it's not in the Senate bill." [MSNBC's Morning Joe, 7/22/09]
CLAIM: Obama "admitted" that he has not read the House health care reform bill.
- Limbaugh asserted that Obama "doesn't know what's in the bill! He admits he doesn't know." [The Rush Limbaugh Show, 7/21/09]
- "Obama Admits He's 'Not Familiar' With House Bill" [Heritage Foundation, 7/21/09]
- HANNITY: "The president even admitted before the press conference -- the day before -- he hadn't read the bill." [Hannity, 7/24/09]
REALITY: Obama actually said he was "not familiar" with opponents' false talking point that bill would ban private individual insurance. During a July 20 conference call, a blogger asked Obama to comment on the claim made in the July 15 IBD editorial -- which is false -- that the bill, in the blogger's words, "will make individual private medical insurance illegal." Obama responded, "You know, I have to say that I am not familiar with the provision you're talking about."
CLAIM: The co-op "compromise" eliminates the need for the public option.
REALITY: Progressive experts argue public plan is necessary for successful reform. Numerous media figures and outlets have characterized Sen. Kent Conrad's (D-ND) cooperative health insurance proposal as a "compromise," "hybrid," or bipartisan "alternative" to a public insurance option without noting the view by progressive experts that a public option is necessary for health care reform to be successful and that any departure from that will result in the failure of reform efforts. These experts dispute suggestions that Conrad's co-op proposal is a plausible midway point between competing methods of addressing health care reform, because, they say, it precludes a fundamental component of effective reform: bargaining power against the health care industry. For example, former Clinton Labor Secretary Robert Reich described the co-op proposal as a "bamboozle" and said that "[n]onprofit health-care cooperatives won't have any real bargaining leverage to get lower prices because they'll be too small and too numerous. Pharma and Insurance know they can roll them. That's why the Conrad compromise is getting a good reception from across the aisle." And University of California-Berkeley professor Jacob Hacker argued that Conrad "has offered no reason to think that the cooperatives he envisions could do any of the crucial things that a competing public plan must do." Additionally, ABC's Charles Gibson reported that "several health care experts" have said, in Gibson's words, "[I]f you take out the public option in terms of insurance, there's going to be no restraints on the cost of insurance." [ABC's World News with Charles Gibson, 8/17/09]
CLAIM: Obama is pushing a single-payer system like Canada's or a nationalized health care system like the United Kingdom's.
- BRET BAIER: "President Obama spent a good deal of time at that news conference [on June 23] talking about health care reform, and Canada's medical system has been cited as a possible model." [Fox News' Special Report with Bret Baier, 6/29/09]
- Hannity said, "I think Obama certainly" wants a Canadian-style "single-payer system." [Hannity, 7/20/09]
- CHARLES KRAUTHAMMER: "[Obama]'s a man who's expressed ... a radical domestic agenda, which involves, as he puts it every time, a holy trinity of health care reform, by which he means nationalizing health care. ... And this is all in the service of leveling the differences between rich and poor and leveling the differences between classes." [Special Report, 4/29/09]
- JOE SCARBOROUGH: "Of course -- of course it's -- not only is it naïve, it's reckless to suggest that in the midst of a banking crisis that may have a $2 trillion price tag that you are going to choose this time to nationalize health care with a $635 billion down payment." [Morning Joe, 3/9/09]
REALITY: Obama has rejected Canadian-style single-payer system and U.K.-style nationalized health care. During a March 26 online town hall discussion, Obama was asked: "Why can we not have a universal health care system, like many European countries, where people are treated based on needs rather than financial resources?" He replied, in part, "I actually want a universal health care system," adding that rather than adopting a "single-payer system" like Canada's, "what I think we should do is to build on the system that we have and fill some of these gaps." Indeed, Obama has embraced the creation of a federally funded "public plan" as one of many insurance options available in the health care market, not the sole option, as in "single payer" systems such as Canada. And as PolitiFact.com noted in a March 5 post, "Obama's plan leaves in place the private health care system, but seeks to expand it to the uninsured" and "the plan is very different from some European-style health systems where the government owns health clinics and employs doctors," as in the United Kingdom.
CLAIM: Health care reform proposals are socialist and will lead to socialized medicine.
- GLENN BECK: "President Obama has his massive $1.5 trillion health care plan. It's hogging up the news cycle. The Republicans and, you know, a lot of people are starting to say, 'Isn't this socialist here? I mean, this is pretty crazy.' The answer to me on that one is really easy: Yep, it's good old socialism. You know, pretty much raping the pocketbooks of the rich to give to the poor. I think that's socialism." [Fox News' Glenn Beck, 7/21/09]
- LIMBAUGH: "The Obama budget also funds the relentless drive toward socialized medicine. And all that is just the beginning. The way to look at this budget is not with an economic lens, it is with a philosophical one. Liberals want to make America -- remake it in their image. And this is how you will pay for it." ["Rush's Morning Update," 2/27/09]
- Guest-hosting The O'Reilly Factor, Laura Ingraham stated: "Powerful arguments against socialized medicine have been around not for months, but for decades. Ronald Reagan was saying this back in 1961." After playing a clip from Reagan's recording, Ingraham added, "I have to believe that Ronald Reagan is smiling down on these town hall forums where law abiding and hard-working Americans are standing up for freedom." [Fox News' The O'Reilly Factor, 8/14/09]
REALITY: Conservatives have trotted out "socialized medicine" smear for 75 years -- and it's never been true. Numerous conservative media figures have revived the "socialized medicine" smear to undermine the efforts of Obama and congressional Democrats, most recently by promoting Ronald Reagan's 1961 attacks on a legislative precursor to Medicare. But as the Urban Institute wrote in an April 2008 analysis, "socialized medicine involves government financing and direct provision of health care services," and therefore, recent progressive health-care reform proposals do not "fit this description." The analysis also noted: "Similar rhetoric was used to defeat national health care reform proposals in the 1990s and, with less success, to argue against the creation of Medicare in the 1960s." Indeed, a Media Matters for America analysis found that dating as far back as the 1930s -- with respect to at least 16 different reform initiatives including President Franklin D. Roosevelt's consideration of government health insurance when crafting the 1935 Social Security bill; President Lyndon Johnson's 1965 legislation establishing Medicare; and the health-care initiative by President Bill Clinton and first lady Hillary Clinton in 1993 and 1994 -- conservatives have attempted to smear those proposals by calling them "socialized medicine" or a step toward that purportedly inevitable result.
CLAIM: Betsy McCaughey is a credible health care expert.
- JOHN ROBERTS: "Former New York Lieutenant Governor Betsy McCaughey is a long-time expert in public health and is currently the chairwoman of an advocacy group for patient safety." [CNN's American Morning, 6/24/09]
- ELIZABETH MacDONALD: "I want to go to my next guest. She's terrific. We're going to go fair and balanced now. She's Betsy McCaughey. She says that cutting health-care costs will only lead to worse care not better. Betsy is founder and chairman of the Committee to Reduce Infectious Deaths." [Fox Business' Cavuto, 5/11/09]
REALITY: Betsy McCaughey is a serial misinformer who has perpetuated numerous falsehoods about health care reform. The Atlantic's James Fallows has pointed to McCaughey as an example of someone for whom there "seems to be almost no extremity of being proven wrong which disqualifies" her from being given a platform in the media. Most recently, McCaughey falsely claimed that the House health care reform bill would "absolutely require" end-of-life counseling for seniors on Medicare "that will tell them how to end their life sooner" -- a claim that many in the media repeated. McCaughey repeatedly falsely claimed that the Senate HELP committee's bill "basically" "pushes everyone into an HMO-style plan." Additionally, McCaughey concocted the false claim, which was nonetheless widely repeated in the media, that a health IT provision in the economic recovery act enabled government bureaucrats to "monitor treatments" or restrict what "your doctor is doing" with regard to patient care. On multiple occasions, after being challenged on her false claims about health care legislation, McCaughey reportedly insisted that she was right about the ultimate effect of a bill despite misrepresenting what it actually said. McCaughey's influence over the health care debate is not new. As Fallows has written, "In the early 1990s McCaughey single-handedly did a phenomenal amount to distort discussion of health-care policy and derail the Clinton health bill. She did so through an entirely fictitious argument about what the bill would do."
CLAIM: Rick Scott is a credible health care expert.
REALITY: Rick Scott was chairman of a scandal-plagued hospital firm. Scott has repeatedly been quoted by CNN, Fox News, and The Wall Street Journal opposing Democrats' health care reform efforts. Frequently, media outlets that have hosted or quoted Scott have failed to note that he resigned as chairman of the nation's largest for-profit health care company in 1997 amid a federal Medicare fraud investigation. According to a July 26, 1997, Los Angeles Times article, Scott resigned from his former position as chairman of Columbia/HCA Healthcare Corp. "amid a massive federal investigation into the Medicare billing, physician recruiting and home-care practices of" Columbia/HCA, "the nation's largest for-profit health care company." According to a December 18, 2002, Justice Department press release describing a tentative settlement with HCA to resolve civil litigation, "When added to the prior civil and criminal settlements reached in 2000, this settlement would bring the government's total recoveries from HCA to approximately $1.7 billion." Media Matters has also documented repeated instances in which media outlets and figures have uncritically repeated or aired Scott's health care misinformation, including that of his advocacy organization, Conservatives for Patients' Rights.
CLAIM: Newt Gingrich is a credible health care expert.
REALITY: Newt Gingrich has a financial stake in opposing Democrats' reform proposals. Gingrich has been quoted by Politico opposing the public plan, but Politico did not explain that his Center for Health Transformation is a for-profit entity that receives annual membership fees from several major health insurance companies, which have a direct interest in whether a public insurance plan is part of health care reform. Moreover, Gingrich himself reportedly profits from his involvement with the group. Indeed, the group's website notes that the "Center for Health Transformation and The Gingrich Group are corporate for-profit organizations not affiliated with any other corporation or organization" [emphasis added]. Gingrich has also repeatedly spread misinformation about health care reform.
CLAIM: Medicare has failed, and so the government can't be trusted to "run health care."
- HANNITY: "But why would you have so much faith, trust, hope, and confidence? Are you happy when you go to the DMV? Are you happy with the Postal Service? Social Security is bankrupt. Medicare is bankrupt. Why do people have faith that the government can run health care?" [Hannity, 7/20/09, from the Nexis database]
REALITY: Medicare costs have risen more slowly than private insurance. As Nobel Prize-winning economist Paul Krugman noted, "since 1970 Medicare costs per beneficiary have risen at an annual rate of 8.8% -- but insurance premiums have risen at an annual rate of 9.9%. The rise in Medicare costs is just part of the overall rise in health care spending. And in fact Medicare spending has lagged private spending: if insurance premiums had risen 'only' as much as Medicare spending, they'd be 1/3 lower than they are."
Medicare is extremely popular. A May 2009 Commonwealth Fund study concluded that "elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans." And as Mark Blumenthal wrote for National Journal, a survey by the Centers for Medicare and Medicaid Services found that in 2007, "56 percent of enrollees in traditional fee-for-service Medicare give their 'health plan' a rating of 9 or 10 on a 0-10 scale. Similarly, 60 percent of seniors enrolled in Medicare Managed Care rated their plans a 9 or 10. But according to the CAHPS [Consumer Assessment of Healthcare Providers and Systems ] surveys compiled by HHS, only 40 percent of Americans enrolled in private health insurance gave their plans a 9 or 10 rating." Blumenthal added, "More importantly, the higher scores for Medicare are based on perceptions of better access to care. More than two thirds (70 percent) of traditional Medicare enrollees say they 'always' get access to needed care (appointments with specialists or other necessary tests and treatment), compared with 63 percent in Medicare managed care plans and only 51 percent of those with private insurance."
The government currently provides the "best care anywhere." In a 2005 Washington Monthly article headlined "The Best Care Anywhere," Phillip Longman wrote of the Veterans Health Administration (VHA): "Outside experts agree that the VHA has become an industry leader in its safety and quality measures. Dr. Donald M. Berwick, president of the Institute for Health Care Improvement and one of the nation's top health-care quality experts, praises the VHA's information technology as 'spectacular.' The venerable Institute of Medicine notes that the VHA's 'integrated health information system, including its framework for using performance measures to improve quality, is considered one of the best in the nation.' "