Myths and falsehoods about health care reform
August 20, 2009 7:25 am ET —
Media Matters for America identifies and debunks 14 myths and falsehoods surrounding the health care reform debate.
MYTH 1: There is no health care crisis
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."
MYTH 2: Health care reform will impose rationing
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."
MYTH 3: Health care reform provides for euthanasia, "death panel"
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]
MYTH 4: Health care reform legislation will cover undocumented immigrants
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.
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