Seven Falsehoods About Health Care

Summary
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 seniors' lives 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.

But on the other hand, has Congress figured out how to pay for this overhaul? Not yet. Or will it really save families $2,500 a year as the president keeps claiming? Good luck on that one, too.

In this article we offer a run-down of seven falsehoods we've taken on recently, with some additional updating and research thrown in.

Analysis
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 (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:

American Recovery and Reinvestment Act of 2009 : Nothing in this section shall be construed to permit the Council to mandate coverage, reimbursement, or other policies for any public or private payer. … 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.

As for the health care bills themselves, the House's H.R. 3200 sets up a center to conduct and gather such research within the Agency for Healthcare Research and Quality, an entity the CBO called "the most prominent federal agency supporting various types of research on the comparative effectiveness of medical treatments." Like the stimulus legislation, the bill states that: "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 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 U.S. will institute a system like that of the U.K., where the government provides and pays for health care. But 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, as we've said severaltimes.

For more, see: "Doctor’s Orders?" Feb. 20

"Government-Run Health Care?" April 30

False: The Bill Is Paid For
At least, it isn't paid for yet.
President 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. But neither the House bill nor the Senate HELP Committee 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 HELP Committee bill racks up more, $597 billion over 10 years.

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 "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?

"Obama’s Health Care News Conference," July 23