FACT CHECK: Distortions rife in health care debate

Nurses Activism

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WASHINGTON-Confusing claims and outright distortions have animated the national debate over changes in the health care system. Opponents of proposals by President Barack Obama and congressional Democrats falsely claim that government agents will force elderly people to discuss end-of-life wishes. Obama has played down the possibility that a health care overhaul would cause large numbers of people to change doctors and insurers.

To complicate matters, there is no clear-cut "Obama plan" or "Democratic plan." Obama has listed several goals, but he has drawn few lines in the sand.

The Senate is considering two bills that differ significantly. The House is waiting for yet another bill approved in committee.

A look at some claims being made about health care proposals:

CLAIM: The House bill "may start us down a treacherous path toward government-encouraged euthanasia," House Republican Leader John Boehner of Ohio said July 23.

Former New York Lt. Gov. Betsy McCaughey said in a July 17 article: "One troubling provision of the House bill compels seniors to submit to a counseling session every five years ... about alternatives for end-of-life care."

THE FACTS: The bill would require Medicare to pay for advance directive consultations with health care professionals. But it would not require anyone to use the benefit.

Advance directives lay out a patient's wishes for life-extending measures under various scenarios involving terminal illness, severe brain damage and situations. Patients and their families would consult with health professionals, not government agents, if they used the proposed benefit.

CLAIM: Health care revisions would lead to government-funded abortions.

Tony Perkins of the Family Research Council says in a video, "Unless Congress states otherwise, under a government takeover of health care, taxpayers will be forced to fund abortions for the first time in over three decades."

THE FACTS: The proposed bills would not undo the Hyde Amendment, which bars paying for abortions through Medicaid, the government insurance program for the poor. But a health care overhaul could create a government-run insurance program, or insurance "exchanges," that would not involve Medicaid and whose abortion guidelines are not yet clear.

Obama recently told CBS that the nation should continue a tradition of "not financing abortions as part of government-funded health care."

The House Energy and Commerce Committee amended the House bill Thursday to state that health insurance plans have the option of covering abortion, but no public money can be used to fund abortions. The bill says health plans in a new purchasing exchange would not be required to cover abortion but that each region of the country should have at least one plan that does.

Congressional action this fall will determine whether such language is in the final bill.

CLAIM: Americans won't have to change doctors or insurance companies.

"If you like your plan and you like your doctor, you won't have to do a thing," Obama said on June 23. "You keep your plan; you keep your doctor."

THE FACTS: The proposed legislation would not require people to drop their doctor or insurer. But some tax provisions, depending on how they are written, might make it cheaper for some employers to pay a fee to end their health coverage. Their workers presumably would move to a public insurance plan that might not include their current doctors.

CLAIM: The Democrats' plans will lead to rationing, or the government determining which medical procedures a patient can have.

"Expanding government health programs will hasten the day that government rations medical care to seniors," conservative writer Michael Cannon said in the Washington Times.

THE FACTS: Millions of Americans already face rationing, as insurance companies rule on procedures they will cover.

Denying coverage for certain procedures might increase under proposals to have a government-appointed agency identify medicines and procedures best suited for various conditions.

Obama says the goal is to identify the most effective and efficient medical practices, and to steer patients and providers to them. He recently told a forum: "We don't want to ration by dictating to somebody, 'OK, you know what? We don't think that this senior should get a hip replacement.' What we do want to be able to do is to provide information to that senior and to her doctor about, you know, this is the thing that is going to be most helpful to you in dealing with your condition."

CLAIM: Overhauling health care will not expand the federal deficit over the long term.

Obama has pledged that "health insurance reform will not add to our deficit over the next decade, and I mean it."

THE FACTS: Obama's pledge does not apply to proposed spending of about $245 billion over the next decade to increase Medicare fees for doctors. The White House says the extra payment, designed to prevent a scheduled cut of about 21 percent in doctor fees, already was part of the administration's policy.

Beyond that, the nonpartisan Congressional Budget Office said the House bill lacks mechanisms to bring health care costs under control. In response, the White House and Democratic lawmakers are talking about creating a powerful new board to root out waste in government health programs. But it's unclear how that would work.

Budget experts also warn of accounting gimmicks that can mask true burdens on the deficit. The bipartisan Committee for a Responsible Federal Budget says they include back-loading the heaviest costs at the end of the 10-year period and beyond.

Copyright © 2009 The Associated Press. All rights reserved.

http://www.google.com/hostednews/ap/article/ALeqM5g5ewCvsGcSPBeHJurb6qYZLVU8OgD99QQ2OG0

I have a PPO and I've had problems. That must mean that our healthcare system is great!:rolleyes:

Specializes in PACU, ED.
Exactly you can go to the list of doctors on their Preferred Plan Option (PPO) - not anyone that you might want to go to. You cannot go to the one that you think is best through rigorous research - no you have to go to the best one on the list you have that contracts WITH YOUR INSURANCE COMPANY!!!

True, and this will not change with the new health care bill. Once again, you will only be able to use government health insurance with doctors who accept that as payment just as it is with medicare today.

Specializes in Acute post op ortho.
Another thing is, you can't make all these people be compliant with their meds and diets. So what is Obama gonna do to the docs whose patients are noncompliant diabetics, not pay them? That's not fair at all to the physician.

That would be like applying "The No Child Left Behind" law to health care.

Hm....make doctors & nurses' pay dependent on patient compliance.

It's not so far fetched......it's exactly what's being done to teachers.

True, and this will not change with the new health care bill. Once again, you will only be able to use government health insurance with doctors who accept that as payment just as it is with medicare today.

Actually in certain specialties there are very few doctors who will take medicare. For instance it is really hard to find a dermatologist who takes medicare. You think you have to wait a while to see a dermatologist with normal insurance or cash...

Specializes in Acute post op ortho.

Speaking of distortions....

Misinformed critics commonly charge that the infant mortality rate in America is higher than in numerous other nations. A closer inspection of the facts, however, reveals that this is only because the definition of “live births” in other nations differs markedly from the definition in the U.S.—thereby making the comparisons utterly invalid.

In Switzerland, for instance, a newborn infant must be at least 30 centimeters long in order to be classified as “living.” In France and Belgium, babies born prior to 26 weeks gestation are automatically registered as “dead”—even if they go on to survive for several hours, days, or even weeks before ultimately dying. And when they do eventually die, they do not inflate infant-mortality rates because they were never technically considered “alive.”

In the U.S., by contrast, a “live birth” is any infant that “breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles”—regardless of the infant’s size or prematurity. If such high-risk American infants ultimately die, they do inflate our country’s infant-mortality statistics.

It’s apples and oranges, get it?

Specializes in Critical care, tele, Medical-Surgical.
Speaking of distortions....

Misinformed critics commonly charge that the infant mortality rate in America is higher than in numerous other nations. A closer inspection of the facts, however, reveals that this is only because the definition of "live births" in other nations differs markedly from the definition in the U.S.--thereby making the comparisons utterly invalid.

In Switzerland, for instance, a newborn infant must be at least 30 centimeters long in order to be classified as "living." In France and Belgium, babies born prior to 26 weeks gestation are automatically registered as "dead"--even if they go on to survive for several hours, days, or even weeks before ultimately dying. And when they do eventually die, they do not inflate infant-mortality rates because they were never technically considered "alive."

In the U.S., by contrast, a "live birth" is any infant that "breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles"--regardless of the infant's size or prematurity. If such high-risk American infants ultimately die, they do inflate our country's infant-mortality statistics.

It's apples and oranges, get it?

That has been posted repeatedly in this forum

People in other modern first world countries don't go broke or become homeless because they get sick or are in an accident.

That's been posted a lot too.

While we are talking about distortions why don't we discuss 2 very, very commonly used statistics. The first is based on WHO rankings and the second is based on # uninsured.

#1: US ranks 37th in the world in health care

This is based on the WHO rankings, which if you are not familiar with, you will be surprised to see what it is made up of. The WHO rankings are a ranking of how socialized a system is and not the quality of health care. They were so controversial in 2000 when they were published that the WHO has not released another ranking. So let me break it down for you.

The rankings are made from 5 factors weighted as below:

1. Health Level: 25 percent

2. Health Distribution: 25 percent

3. Responsiveness: 12.5 percent

4. Responsiveness Distribution: 12.5 percent

5. Financial Fairness: 25 percent

Health level” is a measure of a countries “disability adjusted life expectancy” which on the surface makes sense as a measure of the health of a country. Life expectancy is related to many factors not related to health care. In fact, if you remove the homicide rate and accidental death rate from MVA’s from this statistic, citizens of the US have a longer life expectancy than any other country on earth. So basically take out the things not tied to health care and our life expectancy actually is the best. Hmmm... wonder why the WHO didn't do that...

Financial fairness”- this one is a joke and is essentially a political tool pushing more socialized systems. It measures the % of income spent on health care which means it places a more value on systems that force the wealthy to pay for the country's health care. This factor doesnt measure the quality of health care but rather how the costs are "equaled" out. So a country in which all health care is paid for by the gov't via a progressive tax system but delivers terrible care, would score perfectly in this ranking. Well, seems like this is not a measure of a health care system at all but rather the intentions of the WHO to push their political agenda. This allows socialized systems to seem better without them having to be better.

Health Distribution and Responsiveness Distribution” measure inequality in the other factors. In other words, another thing that does not actually measure the quality of health care delivery. It is possible, for example, to have great inequality in a health care system where the majority of the population gets “excellent” health care, but a minority only gets “good” health care. This system would rank more poorly on these measures than another country that had “equal” but terrible health care throughout the system.

So you see the WHO rankings are BS. They artificially prop up socialized systems where things are "equal" and the cost is placed on the wealthy. Notice that 62.5% of the rankings are based on how socialist a system is. So if obama's plan goes through, without anyone even getting care through the obama plan, our rankings in the WHO rankings would immediately skyrocket without our healthcare actually changing. How is that a measure of health care then?

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#2- 46 million Americans are uninsured because they cannot afford coverage

Again, a commonly cited statistic that ostensibly shows just how bad the American system is. All the data comes directly from the US census bureau. 46 million is usually cited by people trying to promote gov't expansion to "fix" the problem. They use it to show that people cannot afford health care. This figure, like the last, is very misleading.

Let me break it down for you:

a) 10 million of those "46 million" are not US citizens.

b) 17 million more can afford health insurance but chose not to buy it- 8.3 million make $50-75K and 8.7 million make $75K -100K

note: $50,000 is between 200-300% of the poverty level for a family of 4. $100K is 450% of the poverty level for a family of 4.

c) 10-14 more million are eligible for gov't programs like Medicare, Medicaid, or SCHIP but don't apply for it or did not list it in the Census report (but were found to be part of these programs).

d) 5-10 Million were uninsured only temporarily. The number from the survey was a snap shot and also includes those between jobs who are temporarily insurance-less but end up getting insurance during the year.

Now there is some overlap between these groups that has not yet been accounted for. The work here has already been done for us by Anthem as well as a few other groups all with the same findings.

The study by Anthem bluecross blue shield in 2003 looked at the overlap, those who chose not to buy insurance as well as those temporarily uninsured. The real number of uninsured Americans is 8.2 million

Convenient that no one cites this number. I guess soap boxing is harder to do with a statistic like 2.7% actually dont have health care because they cannot afford it. 2.7% is not a statistic that would move people to action though.

The study by Anthem bluecross blue shield in 2003 looked at the overlap, those who chose not to buy insurance as well as those temporarily uninsured. The real number of uninsured Americans is 8.2 million

Convenient that no one cites this number. I guess soap boxing is harder to do with a statistic like 2.7% actually dont have health care because they cannot afford it. 2.7% is not a statistic that would move people to action though.

I'm sure we can trust Anthem, a for-profit insurance company, to give us accurate, dependable numbers indicating that there's really no healthcare coverage problem, so nothing really needs to be changed ...

Just like all the Republicans keep earnestly quoting studies from the Lewin Group, a "respected" healthcare think tank, but fail to mention that the Lewin Group is just a division of United Healthcare, another for-profit insurance company ...

PS -- Just because you don't agree with the WHO rankings, that doesn't make them "BS."

I'm sure we can trust Anthem, a for-profit insurance company, to give us accurate, dependable numbers indicating that there's really no healthcare coverage problem, so nothing really needs to be changed ...

Just like all the Republicans keep earnestly quoting studies from the Lewin Group, a "respected" healthcare think tank, but fail to mention that the Lewin Group is just a division of United Healthcare, another for-profit insurance company ...

PS -- Just because you don't agree with the WHO rankings, that doesn't make them "BS."

Oh it wasn't just anthem. The Kaiser Family Foundation found the exact same findings as Anthem because the data is directly from the US census bureau. It is not skewable. In case you didn't know, the kaiser family foundation is a liberal non-profit organization that is not associated with Kaiser Permanente or Kaiser Industries. Fight all you want but the data is solid, the analysis is the same between both those with conflicts of interest (anthem) and those without (KFF).

PS -- Just because you don't agree with the WHO rankings, that doesn't make them "BS."

The WHO rankings are supposed to rank health care systems. When they do not actually rank health care they are poor rankings. When their rankings skew data in favor of their own ideals they are poor rankings (and biased i might add). When a health care system could shoot up in the rankings just by change how health care is paid for without actually changing who gets care, the quality of care, availability of care or any other measure of actual care, they are poor rankings.

62.5% of the rankings were based directly on how socialized the system was, not on the care the system delivers. That is obsurd. The only measure of actual care did not have its confounders controlled. Counfounders not controlled for: namely lifestyle, accidents/homocides, definitions of life/birth, and many others. Guess what, you control those confounders and our rank jumps very, very considerably.

Are we the best, still probably not. We have improvements to be made (universal, compatible EMR for one) but we are not 37th.

They don't dictate my provider. I can do a search of providers on the insurance website and choose who I want to provide care to me. I never got anything from my insurance company stating I must see such and such doctor. I'm very happy with my insurance and would rather keep it and see the doctor associated with the hospital where I work instead of going to see another doctor who is not associated with my hospital.

This is the same as ther government plan. You will be given a list of providers who participate in the plan, just as in your insurance.

Specializes in Critical care, tele, Medical-Surgical.

I received in an e-mail a request to "Please act today by joining the League and donating to us today"

It was titled "Obama's 5 Big Lies on Healthcare". Here they are with my thoughts in bold.

#1: 'You Keep Your Doctor, You Keep Your Insurer'

An employer can change insurance carriers NOW and in the future with or without healthcare reform.

#2: The Elderly Will Not Face Rationing or Medicare Cuts

No evidence that this is a lie. They quote a NYT editorial.

#3: There Will Be No "Death Panels."

This claim of a lie is not true.

#4: The Obama Plan Contains Costs

I don't know whether it does or not and neither does this group. But who do they think should be denied healthcare?

#5: Illegals Are Not Covered by Obamacare

They will be treated in the ER just as they are now. That's all. Nothing changes.

I didn't add links because I've already posted the House and Senate bills.

So whoever wants to claim these alleghations are true I will look at quotes with links. Facts not suppositions.

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