Lies, Damn Lies, and No Statistics About Health Reform

The blatant lies about health care reform are not even the most distressing. It's the more subtle distortions that cause the most harm -- the lies with a small grain of truth or logic within them.
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Driving down the LA 405 toward Orange County Sunday night, I couldn't find a radio station that was covering the historic House vote on health reform. Except for Fox News Radio. Even before the vote began, what I heard were lies, distortions, and more damn lies. And no facts offered, not even weak ones. The same talking points that have been circulating all year without any substantiation -- A government takeover of the medical care system. Government telling you how and when to die. Socialism. The end of freedom as we know it. Economy in crisis. Abortion for everyone.

"Lies, damned lies, and statistics" is a phrase describing the persuasive power of numbers, particularly the use of statistics to bolster weak arguments, and the tendency of people to disparage statistics that do not support their positions. On Fox radio there were no facts, only disparagement, ignorance and anger.

The next morning on Fox TV News, the anchor, Martha MacCallum, had an interview with a woman named Charmaine Yoest of a Right to Life group. Charmaine, without a trace of embarrassment, proceeded to declare that if you have a health plan through your employer you would now have to pay for abortion. Of course this is not true. Reform will not dictate anything to employers regarding abortion. But ironically, most employers' health plans do include coverage for abortion, even if they do not specifically state it. Why? It's so much cheaper than pregnancy!

Charmaine went on to confuse things even further - the individual mandate, the requirement to buy insurance, would "force" you to buy insurance that covers abortion. Not true. Not even close to true. But the anchor didn't have the facts to dispute her, so the lie sailed out into the ears of the listeners with nary a pushback of any kind.

In an interview with, Rep. Paul Ryan (R - Wisc) laid out the type of "talking points" that have few facts to back them up. The obvious purpose is to repeat the same phrases over and over again and hope that no one notices you never proved your point. Ryan, who is one of the smarter Representatives on these issues, concluded his interview with, "This is a government takeover of our healthcare system. It is the government basically running the entire healthcare system, turning large insurers into de facto public utilities, depriving people of choice, depriving people of options, raising people's prices, raising taxes when we need new jobs." While there are things you can criticize about this legislation, saying that it offers people no choice is not one of them!

Not all Republicans have been talking in vague non-substantiated phrases, however.
David Frum, a conservative commentator (who by the way lost his job at AEI over this) made some very interesting comments on the
CNN site.

Frum says, "I've been on a soapbox for months now about the harm that our overheated talk is doing to us. Yes, it mobilizes supporters -- but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead. Now the overheated talk is about to get worse. Over the past 48 hours, I've heard conservatives compare the House bill to the Kansas-Nebraska Act of 1854 -- a decisive step on the path to the Civil War. Conservatives have whipped themselves into spasms of outrage and despair that block all strategic thinking. Or almost all. The vitriolic talking heads on conservative talk radio and shock TV have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination."

The blatant lies, however, are not even the most distressing. It's the more subtle distortions that cause the most harm -- the lies with a small grain of truth or logic within them. It is so easy to say that there will now be a new tax on Medicare beneficiaries, without noting that only beneficiaries who earn more than $200,000 (or $250,000 for a couple) will be charged.

Here are some of the lies and distortions that I am hearing. You may be hearing them too, and feel free to share them in your comments. Might be a good idea to be prepared to "discuss" the facts when you hear them. This website cites 20 ways you can lose your "freedom" over health care - I comment (in italics) on a few of the ones that are most distorted in an attempt to demonstrate how you can take small piece of truth and turn it into a lie.

"The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.

1. You are young and don't want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the "privilege." (Section 1501)

It's true there is a fine if you don't buy insurance. But it isn't a $750 fine. It starts with a rather modest $95 fine in 2014 when the exchanges begin, and would increase if the individual refuses to buy insurance, year after year. But why is an individual mandate important? Because if everyone is not in the "pool", then only the old and sick remain, and premiums go up. It's a basic principle of insurance - the young help the old; the sick help the healthy; the good drivers help the bad ones. You simply can't live in society where everyone gets to do exactly what they want all the time. Besides - if you get sick and need health care, even if you can't pay for it, someone else will. So refusing to buy insurance is basically a selfish act.

2. Think you'd like a policy that is cheaper because it doesn't cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that's what the customer wants. (Section 2712).

It's true that preventive services will be required in the benefit packages. But this statement reflects a very contradictory impulse - on the one hand you don't want to have your premiums cover people who don't take care of themselves, yet you don't want to take advantage of preventive services and take care of yourself?

3. You are an employer and you would like to offer coverage that doesn't allow your employers' slacker children to stay on the policy until age 26? Tough. (Section 2714).

It's true that the law allows adult children will be able to stay on their parents' plans until age 26. It's not true that it's prohibitively expensive for employers or that children who stay on their parents' plans are all slackers. Even if an employer did not want to extend coverage by a year or two (most already cover until age 23 or 24) few would describe those children as slackers. What an arrogant point of view? Plenty of young adults are working but their businesses don't offer coverage. Or they may still be in school or have a pre-existing condition and can't get individual coverage. So there's a kernel of truth but an accusation that twists the debate in a rather nasty direction.

4. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.You're a single guy without children? Tough, your policy must cover pediatric services. You're a woman who can't have children? Tough, your policy must cover maternity services. You're a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

This is also true that there will be a benefit package that covers a variety of services. What is not true is that you can't pick and choose among them. Since when have you EVER been able to select the services that insurance covers for you? No one buys only the services they "think" they need (except for women who want abortion coverage who will now have to buy a separate rider for it). For decades, insurance plans have offered "packages" of services that you buy that always include something you may not need. Again, the principle of insurance is that you spread risk across the population and you offer services for that whole population. If this was such a violation of freedom, why haven't more people refused their employer sponsored insurance or complained before?.

5. If you are a physician and you don't want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It's not like the government will ever use it to intervene in your practice and patients' care. Of course not. (Section 3003 (i))

The sarcasm here is not particularly helpful. The fact is that the Secretary of HHS is prohibited by the new law from using information to tell a physician how to practice. So distrust government, fine, but let's find out more about the physicians we trust with our health. What's wrong with that?

Bottom line - the debate over the value of health reform has now been ramped up considerably, and facts are hard to come by. If you support health reform, here are some things you can do:

1.If you receive one of those mass emails with half truths or no truths in them, you may want to pick one of the issues, rebut it and send it around to everyone who got the first email.
2.If you hear someone on talk radio telling lies or getting hysterical about our loss of freedom, you could consider calling in and asking the caller or host to provide facts to back up their assertions. (Good luck with that. I've tried it and it's a painful experience!)
3.If you see an article in a newspaper, magazine - online or print - spend a minute correcting the record. Write a letter to the Editor. Comment online. Engage in the process.

Here are some resources to help you set the record straight:

1) A timeline for what will happen in health reform and when.

2) A side by side comparisonof the Senate bill that is now the law of the land along with the reconciliation "fixes" that the Senate hopes to pass.

3) A description by the White House as to what is in the Bill in Summary form with some Q and As as well.

4) If you are really a detail person, and want to rebut Rep. Boehner when he screams "Have you read the bill?", here is how to find the text of the Senate bill passed by the House and signed by the President.

Last August, I wrote a blog about the distortions being shouted about at Town Halls. I rebutted them one by one. Sadly, these same "talking points" are still being circulated. So check this blog out for further ammunition.

If those of us who care about reform don't fight back, we cede the argument to the opposition.


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