Saturday, August 8, 2009

Obama wants to kill your grandma: Five right-wing myths about healthcare reform, and the facts

According to Mike Madden's August 6, 2009 article "Obama wants to kill your grandma: Five right-wing myths about healthcare reform, and the facts" on Salon.com:
Turning America socialist apparently wasn't enough for him -- now President Obama is trying to make old people kill themselves, callously deny important medical procedures, funnel tax dollars to abortion clinics and wiggle the government's way into every doctor's office in America.

At least, that's the sense you might have about the healthcare reform proposals Congress is considering from listening to opponents describe them. Already, conservative activists have erupted against the plan, with protesters hanging Democratic lawmakers in effigy and disrupting town hall meetings.

As both the House and the Senate clear out of the Capitol for the month, expect the viral buzz -- and the TV battle -- about what's in the bills to grow louder and louder. The White House finally seems to have realized that the administration can't win the policy debate without addressing some of the attacks from the right. Aides recently released a video rebutting some of the claims about what healthcare reform would and wouldn't do. An administration official told Salon Wednesday that the White House will soon launch a Web site modeled on the "Fight the Smears" site Obama's campaign ran last fall, where voters can find -- and debunk -- some of the rumors about the reform proposals, and the White House is already collecting chain e-mails at "flag@whitehouse.gov," an address Obama aides set up to receive them.

But the administration might already be behind the curve. Over the last few weeks, opponents have managed to get out their spin on the bill through talk radio, blogs, chain e-mails and other channels. And their talking points depend on a notably elastic approach to the truth. Here's a fact check of some of the more alarming claims that the right is making about healthcare reform, claims that are already hardening into myth.

Myth 1: Democrats want to kill your grandmother. This claim seems too outlandish on its face to get much traction, but Republicans actually made some headway on it recently. Two House GOP leaders put out a statement warning that the healthcare reform bill "may start us down a treacherous path toward government-encouraged euthanasia." To hear opponents of reform talk about it, the legislation would force seniors to go in for sessions once every five years -- and more frequently if they're sick -- where doctors will encourage them to end their lives. Rep. Virginia Foxx, R-N.C., summarized the scare tactic pretty well on the House floor last week, when she said the bill would "put seniors in a position of being put to death by their government," and therefore, wouldn't be pro-life. The GOP has pushed this line especially hard with some of the conservative groups behind the government's intervention in the Terri Schiavo case a few years ago, hoping to get antiabortion allies on board fighting reform. "Can you imagine the response of the American people when they find this out?" one-time GOP presidential candidate Fred Thompson asked about the alleged euthanasia scheme on his radio show last month. "They're going to counsel you on preparing you to die," Rush Limbaugh pronounced a few weeks ago. Proof of how far this attack has spread came last week, when a caller to an AARP forum asked Obama about it directly. (Probably unwisely, the president tried to make light of the question, saying there weren't enough government employees to go meet with old people to talk about end-of-life care.)

There is a kernel of truth at the root of this attack: The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover. But the consultations wouldn't be mandatory; if your grandmother doesn't want to go talk to her doctor about end-of-life care, she won't have to. Because Medicare doesn't pay for this kind of planning now, only 40 percent of seniors who depend on the government insurance say they have an advance directive that tells healthcare providers what measures they do and don't want used to prolong their life, even though 75 percent say they think it's important. The lack of planning actually costs a lot of money. Medicare spends billions and billions of dollars annually on expensive treatment during the last year of a dying patient's life. Without allowing Medicare to pay for end-of-life consultations, it's hard to know whether patients even want to go to such expensive lengths.

Myth 2: The government -- i.e., you -- will have to pay for abortions. This is another way the GOP is stirring up antiabortion activists against healthcare reform -- by warning that your tax dollars will be used to pay for someone else's abortion. An ad by the Family Research Council dramatizes the issue about as creepily as possible. "To think that Planned Parenthood is included in the government-run healthcare plan and spending tax dollars on abortions," a distraught older man tells his wife, sitting at their kitchen table after opening a letter from the government. "They won't pay for my surgery, but we're forced to pay abortions." The narrator lays out what's going on: "Our greatest generation denied care, our future generations denied life." A House Republican aide says the GOP thinks this could be the most potent type of viral attack against reform, since antiabortion Democrats will have trouble voting for the legislation if it includes taxpayer funding for the procedure.

But only the most extreme antiabortion reading of the legislation would say it does that. The words "Planned Parenthood" and "abortion" don't appear anywhere in the text, despite conservative buzz that it would funnel millions of dollars to killing babies. (A proposal in the Senate version of the reform legislation would require insurance plans to cover preventive care and screening visits to community health providers, which could include Planned Parenthood.) Even an AP story that Matt Drudge was hyping on Wednesday as proof that the government would be funding abortions didn't go quite that far -- instead, the story detailed a fight over whether women who buy government-subsidized private insurance through a proposed exchange system should be able to have abortions covered by their plans. Pro-choice lawmakers are trying to craft a compromise that would require insurance companies to pay for abortions out of premiums paid by patients, not out of tax dollars. Pro-choice Rep. Lois Capps, D-Calif., amended the House version of the legislation to state that abortion is not part of an "essential benefits package" that all insurance plans must provide -- meaning someone could offer a special "pro-life health insurance" plan that doesn't cover abortions, even under the reforms.

Myth 3: Obama will ban all private health insurance. Allegedly, the House proposal for healthcare reform bans private insurance. This rumor comes complete with a citation: "Right there on Page 16 is a provision making individual private medical insurance illegal," the unflaggingly pro-business paper Investors Business Daily wrote in an editorial last month. Other right-wing blogs and news outlets picked up on the idea, as well. It fits in with a broader message Republicans have been using: The reform will lead to a total government takeover of healthcare.

The IBD line is literally true -- Section 102 of the House bill says insurance companies can't independently issue any new individual policies after the legislation takes effect (though existing policies are grandfathered in). But it misses the point. Private plans aren't banned, but rather shifted into the new health insurance exchange the legislation would set up. You can still get a private policy, but the way in which you buy it changes. If you wanted to buy your own insurance, you have to do it through the government-run insurance exchange. Your policy becomes part of broader risk pools, which makes the premiums cheaper and keeps insurance companies from dumping them once they get sick. PolitiFact looked into the claim and rated the IBD editorial "pants on fire," its lowest rating -- as in, "Liar, liar, pants on fire."

Myth 4: The government can't possibly run a healthcare program. Opponents of reform trot out comparisons to government services frequently when they try to argue against a public, government-funded healthcare plan. Republicans drew up a chart that purports to show how convoluted the bureaucracy involved in any government plan would be. This message doesn't make Obama the enemy, it makes government inefficiency the enemy. "If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid and healthcare done by the government," conservative economist Arthur Laffer told CNN this week.

If that doesn't quite make sense, there's a reason -- Medicare and Medicaid are, of course, government-run healthcare programs. Medicare in particular is quite popular; polling shows some seniors are anxious that the reform will affect the care they already get from the government. (In fact, Democratic pollster Celinda Lake says she frequently encounters voters who say they want to keep the government out of their Medicare.) The Department of Veterans Administration also runs a healthcare system that experts praise for its well-developed health information technology network, which lets doctors see results of tests and procedures any patient has had anywhere in the network -- eliminating the wasteful duplication that Obama says he wants to cut out of the larger healthcare world, as well.

Myth 5: Unlike private insurance, government bureaucrats will ration care. This line also makes government the enemy. "You may want healthcare that your doctor has prescribed for you," Peter Ferrara, of the anti-tax, anti-government Institute for Policy Innovation, wrote on the National Review last month. "But the rationing bureaucracy in Washington that doesn’t even know you, or your doctor, may decide that your doctor doesn’t know what he’s talking about, or that you are too old for the government to pay for your hip replacement to stop the pain, or to get an expensive triple bypass or a pacemaker operation to save your life." Since the Obama administration keeps talking about encouraging doctors to shift to outcome-based pay scales and evidence-based guidelines for what treatments or procedures to use, opponents don't have much trouble painting a troubling picture of faceless government hacks denying the care you -- or your loved ones -- need.

Of course, there are already plenty of faceless hacks denying people care right now; they just work for private insurance companies, not the government, and they're denying care because that helps keep the insurers' profit margins up. At a recent House hearing, just three insurance companies testified that they had "rescinded" -- or dropped -- coverage for nearly 20,000 patients between 2003 and 2007, often after patients had submitted claims they thought would be covered. Even Republicans seem to know the insurance companies can be bad. "I would always rather the devil I know than the devil I don't know," House GOP boss John Boehner said last week, explaining why going after the government works even though private insurance companies would seem to be just as much of a villain.

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