Myths and falsehoods about health care reform
August 20, 2009 7:25 am ET — 156 Comments
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.
MYTH 5: Health care reform will raise your taxes
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."
MYTH 6: Health care reform would tax all small businesses
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.
MYTH 7: Health care reform would add $1 trillion-plus to deficit
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.