Friday, September 19th, 2014

Health care reform: A summary of recent distortions

After Rep. Joe Wilson shouted "You lie!" to President Obama, we put Wilson's claim to the Truth-O-Meter.
After Rep. Joe Wilson shouted "You lie!" to President Obama, we put Wilson's claim to the Truth-O-Meter.

The debate over health care reform has been defined by exaggerations and falsehoods. Republicans have falsely labeled the Democratic plan "government-run health care" and warned of death panels for the elderly and taxpayer subsidies for illegal immigrants. Democrats, meanwhile, have exaggerated the savings of their plan and made false claims about their favorite villains, the insurance companies.

Both sides have kept the Truth-O-Meter busy. PolitiFact has rated more than 80 health care claims since January, covering everything from the salary of insurance company executives to allegations about tax subsidies for abortion.  As congressional leaders prepare to bring their health care bills to the House and Senate floors, we've assembled this guide to help you sort out the truth on the health care bills. We should emphasize that the bills are in flux and details can change, but these rulings can serve as a general guide for the proposals under discussion.

Distortions from the opponents

Critics have portrayed the Democratic plan as a government takeover of health care, as a system that would prey on the elderly, use tax dollars to pay for abortion, and expand health care coverage for illegal immigrants. But in many cases, they have misstated the facts, or taken a grain of truth and exaggerated it.

Not a government takeover of health care. The Democratic plans would leave the current system of private insurance in place while increasing regulation for insurance companies, requiring everyone to buy health insurance, and providing more subsidies for low-income people. One aspect still up in the air is the public option, a health insurance plan that would be run by the government. People could choose whether to enroll in the public option. (An estimated 12 million would, according to the Congressional Budget Office.) But Republicans have consistently portrayed the entire plan as government-run. When Sen. Tom Coburn said that under Obama's plan, "all the health care in this country is eventually going to be run by the government ," we rated it False.

No death panels for Granny. The famous death panel rumor sprouted from a small clause in the health care bill involving Medicare. The new rule said Medicare would pay for a doctor's visit for the purpose of end-of-life planning, such as discussions of living wills or hospice care. Opponents equated that with lessons in how to kill yourself, but every expert on health care for the elderly that we consulted said the idea was ridiculous. Former Alaska governor Sarah Palin said that seniors and the disabled "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." We rated that Pants on Fire.

No new benefits for illegal immigrants. If they make a highlight reel of the health debate, they will surely include the moment when Republican Rep. Joe Wilson of South Carolina shouted " You lie !" at President Obama during an address to a joint session of Congress. Obama had said "the reforms I’m proposing would not apply to those who are here illegally." We found that Democratic plans did nothing to change the way illegal immigrants are currently treated in the health care system. So we rated Wilson's outburst as False. Republicans countered by saying the Democratic plan wasn't tough enough in verifying the identity of illegal immigrants to prevent them from fraudulently obtaining benefits. We checked a statement from the House Republican Conference, "Nothing in any of the Democrat bills would require individuals to verify their citizenship or identity prior to receiving taxpayer-subsidized benefits." We rated that Half True.

No taxpayer subsidies for abortion. Abortion has been one of the most contentious issues of the debate. Republican John Boehner said that the Democrat-backed House proposal (the Senate hadn't drafted one at that point) "will require (Americans) to subsidize abortion with their hard-earned tax dollars." We found that the federal government will not send tax dollars to abortion providers, so we rated his statement False. We later checked the main Senate version on a different aspect of abortion coverage. We found that health care plans that receive public money (to help low-income people pay for insurance) will be able to offer abortion coverage if those particular services are paid for with patient premiums, not the subsidies. So the National Right to Life Committee earned a True for its statement that a Senate bill "contains provisions that would send massive federal subsidies directly to both private insurance plans and government-chartered cooperatives that pay for elective abortion ."

Distortions from supporters

Supporters of the health care reform plans have offered plenty of exaggerations and falsehoods of their own.

Exaggerations about costs.  Democrats have at times implied that covering everyone will ultimately save the system money. President Obama has repeatedly said he wants all health care plans to cover preventive care, such as screenings for breast cancer or colon cancer. "That makes sense, it saves money, and it saves lives," he said during his address to Congress. Actually, the evidence shows that screening everyone still costs a more money than it ultimately saves. So get a screening because it may save your life, not because it will save you money. We rated Obama's statement that preventive care "saves money" False. Similarly, several of the Democratic plans would add to the budget deficit; the Senate Finance Committee proposal is the only one that does not. Democratic Rep. Russ Carnahan claimed that the nonpartisan Congressional Budget Office analyzed the House bill and found it paid for itself and then some, but we found Carnahan was using creative interpretation on the CBO numbers by counting other budget-friendly legislation that had not yet passed. We rated his statement False.

The villains. Health insurance companies have been a favorite target for supporters of health care reform, and the attacks are often wrong. In July, President Obama said health insurance companies were " making record profits, right now ." We reviewed their public filings and found that profits were actually down from previous highs, so we rated his statement False. The advocacy group Health Care for America Now blasted insurers for paying their CEOs $24 million a year. We found they were cherry-picking the highest example and that the average of others is considerably lower — just under $4 million. We rated the statement Barely True. The same group said the health insurers deny 1 out of 5 treatments prescribed by doctors. We found that statement was based on one study that included claims that were later approved, and other studies found a much lower denial rates. (Between 3 and 7 percent is a better estimate.) We rated their statement False. Finally, Obama told a story of a man who was denied cancer treatment because he hadn't reported gallstones that he didn't know about. "They delayed his treatment, and he died because of it ," Obama said. Actually, the man fought his insurer, received treatment, and died three and half years later. We rated Obama's statement False.

A few truthful statements

Despite all the falsehoods, we found some truth in the health care debate:

Consumers have seen dramatic increases in health care costs in recent years. Democratic Sen. Jay Rockefeller of West Virginia said that health care premiums for consumers have doubled since 2001. For individuals, the employee cost rose from $355 to $779 and for families it rose from $1,787 to $3,515. The former jump is easily double, while the latter is just shy of double. We rated his assertion True.

Democratic plans will leave the current system in place with new regulation. President Obama said if you " already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have." He's right, his plan makes lots of changes, but it does leave the major pieces of our health care system in place. We rated his statement True.

Increased coverage comes at price. The Republican National Committee said that Barack Obama and the Democrats have "proposed a tax for not having health insurance ." All the versions of health care reform include an individual mandate that requires people to have insurance or pay a penalty on their income tax return. We rated the statement True.