WASHINGTON--So much for a slow news month. August feels like campaign season, with claims on health care coming at us daily. Does the House bill call for mandatory counseling on how to end the lives of the elderly sooner?
Absolutely not.
Will the government be dictating to doctors how to treat their patients?
No.
Do the bills propose cutting Medicare benefit levels?
No on that one, too.
Here is a run-down of seven falsehoods we¡¦ve taken on recently, along with some additional updating and research:
„P False: Government Will Decide What Care I Get (a.k.a., they won¡¦t give grandma a hip replacement).
This untrue claim has its roots in the American Recovery and Reinvestment Act of 2009 (a.k.a., the stimulus bill), which called for the creation of a Federal Coordinating Council for Comparative Effectiveness Research.
The council is charged with supporting and coordinating research that the government has been funding for years into which treatments work best, and, in some cases, are most cost-effective.
Supporters of this type of research say it can provide valuable information to doctors, improving care and also lowering cost.
Betsy McCaughey, a former Republican lieutenant governor of New York (and now a professing Democrat), wrote in an opinion piece that the government would actually tell doctors what procedures they could and couldn¡¦t perform.
The claim took off from there, popping up in chain e-mails and Republican press conferences.
It¡¦s not true.
The legislation specifically says that the council can¡¦t issue requirements or guidelines on treatment or insurance benefits.
¡§Nothing in this section shall be construed to permit the council to mandate coverage, reimbursement, or other policies for any public or private payer,¡¨ the stimulus bill says.
¡§None of the reports submitted under this section or recommendations made by the council shall be construed as mandates or clinical guidelines for payment, coverage, or treatment,¡¨ the bill says.
As for the health care bills themselves, House of Representatives Bill 3200 sets up a center to conduct and gather such research within the Agency for Healthcare Research
and Quality, an entity the Congressional Budget Office called ¡§the most prominent federal agency supporting various types of research on the comparative effectiveness of medical treatments.¡¨
¡§Nothing in this section shall be construed to permit the commission or the center to mandate coverage, reimbursement, or other policies for any public or private payer,¡¨ the House bill says.
The Senate Health, Education, Labor and Pensions Committee bill (not yet released in its entirety) calls for a similar center that ¡§will promote health outcomes research and evaluation that enables patients and providers to identify which therapies work best for most people and to effectively identify where more
personalized approaches to care are necessary for others,¡¨ according to the summary of the bill.
This claim also stems from a fear that the federal government will institute a system like that of the United Kingdom, where the government provides and pays for health care.
However, none of the bills now being debated in Congress call for such a system, and the president has said he doesn¡¦t want nationalized or single-payer health care.
„P False: the Bill Is Paid For.
At least, it isn't paid for yet.
President Barack Obama has repeatedly said that a health care overhaul "will be paid for¡¨ and that he won¡¦t sign a bill that isn¡¦t deficit-neutral.
Even so, neither the House bill nor the Senate bill meets that criteria.
According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the Senate bill racks up more, $597 billion over 10 years.
President Obama has also said he has ¡§identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now,¡¨ but the word, ¡§identified,¡¨ is the operative word.
These savings are estimates and whether around $650 billion (about two-thirds of the cost of health care over 10 years) can be saved remains to be seen.
Most of the money would come from Medicare, but cuts in payments to insurers and practitioners aren¡¦t popular measures that move easily through Congress.
So, the big questions remain.
Will the president break his promise and sign a bill that piles up hundreds of billions of additional debt?
Will the legislation have to be scaled back to cost less, and perhaps cover fewer of the uninsured?
Who will pay additional taxes?
Can pain-free reductions in other government programs be found?
„P False: Private Insurance Will Be Illegal.
In July, Investor¡¦s Business Daily published an editorial in which it claimed that HR 3200 would make private insurance illegal, but that newspaper was mistaken.
It was citing the part of the bill that ensures people with individually purchased coverage don¡¦t have to give up that coverage unless they want to.
Under the House bill, people who want to buy new individual, non-group coverage will have to purchase it through a new health insurance exchange.
They can still buy private insurance (the exchange, in fact, would offer a range of private plans, in addition to a new federal health insurance option).
However, those who were already buying their own insurance before the bill went into effect--about 14 million Americans--will have their plans grandfathered in.
The part of the bill Investor¡¦s Business Daily cites doesn't forbid insurers from issuing new plans. It says that new individual plans will not be considered grandfathered, and will have to be purchased through the exchange.
„P False: The House Bill Requires Suicide Counseling.
This claim is nonsense.
In an appearance on former U.S. Sen. Fred Thompson's radio show, Mrs. McCaughey also enthusiastically pushed the bogus claim that the House bill will require senior citizens to have regular counseling sessions on how to end their lives:
¡§The Congress would make it mandatory, she said on July 16, ¡§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 into hospice care, all to do what's in society's best interest, and cut your life short.¡¨
This is a misrepresentation.
What the bill actually provides for is voluntary Medicare-funded end-of-life counseling. In other words, if senior citizens choose to make advance decisions about the type of care and treatments they wish to receive at the end of their lives, Medicare will pay for them to sit down with their doctor and discuss their preferences.
There is no requirement to attend regular sessions, and there is absolutely no provision encouraging euthanasia.
Of course, senior citizens who talk to their doctors about end-of-life care might well choose to discuss what types of life-saving treatment they wish to refuse.
That choice has been federally guaranteed for almost 20 years. Euthanasia, on the other hand, is legal in only three states, making it even more unlikely to be a major part of the federal health plan.
„P False: Families Will Save $2,500.
Proponents speak constantly of holding down rising medical costs.
As recently as May 13, the president said legislation plus some voluntary measures by the private sector "could save families $2,500 in the coming years--¡§$2,500 per family," echoing a claim he made countless times on the campaign trail last year.
Don't start spending that $2,500 just yet.
For one thing, President Obama isn't actually promising to reduce health care spending below current levels, only to cut the rate of growth in spending.
Even that is proving to be far tougher to accomplish than candidate Obama led voters to believe.
We've already mentioned that the Congressional Budget Office says "savings" in Medicare spending resulting from the House bill would fall short of what is needed to pay for two-thirds of its cost, which is President Obama's goal. Those
savings come only in what the government pays, not in what families pay.
Squeezing more savings, even from Medicare, is proving difficult.
On July 17, President Obama's lead man on the subject, Office of Management & Budget Director Peter Orszag, wrote to congressional leaders seeking legislation setting up an independent agency, the Independent Medicare Advisory Council.
It would be made up of health care experts with the power to make a package of annual changes in the amounts Medicare would pay to doctors.
The president must either approve or disapprove the entire package as offered; if he approves, it goes into effect unless Congress passes a joint resolution stopping it, but when CBO took a look, it estimated that the new agency would save a total of only $2 billion over the next decade.
As for saving $2,500 for families, as opposed to saving money for the government, the CBO's letter, signed by Director Douglas W. Elmendorf, said:
¡§[E]xperts generally agree that changes in government policy have the potential to significantly reduce health care spending--for the nation as a whole and for the federal government in particular--without harming people's health.
¡§However, achieving large reductions in projected spending would require fundamental changes in the financing and delivery of health care.¡¨
As an example of the "fundamental" changes that might do the trick: CBO suggested moving away from the current system of paying doctors and hospitals for performing medical procedures and paying them instead a fixed fee per patient or some other payment based on "value."
Another CBO suggestion: "higher cost-sharing requirements." So far, we don't see those ideas in the bills being considered.
„P False: Medicare Benefits Will Be Slashed.
The claim that President Obama and Congress are cutting Medicare benefits for the elderly to pay for the health care overhaul is outright false, though that doesn't keep it from being repeated ad infinitum.
The truth is that the pending House bill extracts $500 billion from projected Medicare spending over 10 years, as scored by the Congressional Budget Office, by doing such things as trimming projected increases in the program's payments for medical services, not including physicians.
Increases in other areas, such as payments to doctors, bring the net savings down to less than half that amount, but none of the predicted savings--or cuts, depending on one's perspective--come from reducing current or future benefits for the elderly.
The president has promised repeatedly that benefit levels won't be reduced, reiterating the point recently in Portsmouth, N.H.
¡§Another myth that we've been hearing about is this notion that somehow we're going to be cutting your Medicare benefits,¡¨ President Obama said on Aug. 11. ¡§We are not.¡¨
Is he wrong?
Not according to AARP, by far the nation's largest organization representing the over-50 population.
In a "Myths vs. Facts" rundown, AARP said:
¡§Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.¡¨
To be sure, the president hasn't always thought that Medicare "savings" could be accomplished without actual cuts in benefits. Last fall, his campaign ran two television ads accusing U.S. Sen. John McCain (Rep., Ariz.) of wanting "a 22 percent cut in [Medicare] benefits."
The basis for the ads was a newspaper article in which a McCain aide said the Arizona Republican would cut Medicare costs, but the aide said nothing about cutting benefits, in fact, quite the contrary.
Some called the claim "false" when candidate Obama made it against candidate McCain, and it's still false now when President Obama's critics are making the same accusation against him.
„P False: Illegal Immigrants Will Be Covered.
One Republican congressman issued a press release claiming that "5,600,000 Illegal Aliens May Be Covered Under Obamacare," and we've been peppered with queries about similar claims.
They're not true.
In fact, the House bill (the only bill to be formally introduced in its entirety) specifically says that no federal money would be spent on giving illegal immigrants health coverage:
¡§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.¡¨
Also, under current law, those in the country illegally don't qualify for federal health programs.
It should be pointed out, too, that about half of illegal immigrants have health insurance now, according to the nonpartisan Pew Hispanic Center, which said those who lack insurance do so principally because their employers don't offer it.
