Top 10 myths about the proposals for our health care system.
1. The bills permit the euthanization of the elderly and chronically ill ("death panels").
This myth stems partly from a provision in one of the bills under consideration that would provide funding for seniors to receive counseling on end-of-life issues such as living wills. The Republican Senator who's been leading the charge for such a provision called this myth "nuts." Politifact rated this claim their "Lie of the Year."
2. The bills introduce government-run health care ("socialized medicine") to the US.
As much as some liberal reformers would like a socialized medical system like Britain's, where hospitals are run by the government, such a system is not even remotely under consideration in the current legislative process. A socialized insurance option is under consideration, but will almost certainly be limited to only a fraction of the national market for health insurance, if it's included at all.
In any event, it's impossible for any bill to introduce socialized medicine to the US, because Americans already have a few socialized health care systems. The VA medical system, which is government-run, is often held up as an exemplary health care provider. On the other hand, the military hospital system has been beset by problems that have made headlines in recent years.
3. There's a single "Obamacare" bill being debated.
Although President Obama has endorsed several general principles for what a health care bill must include, he's left the details of creating such a bill to Congress. As such, there's a patchwork of separate bills under consideration from several different committees in the House and Senate. Once these bills exit their respective committees, they'll have to be voted on in each chamber, then reconciled.
4. The bills bring rationing of care to the US.
New York Times economics columnist David Leonhardt offered the best rejoinder to this myth that I've seen: "There is no such thing as a free lunch. The choice isn't between rationing and not rationing. It's between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it's hard to argue that we are now rationing very rationally." He goes on to describe all the ways in which the US currently rations care. Read the whole thing.
5. The bills prohibit individuals from buying extra care.
No proposals under consideration would prevent individuals from purchasing the best medical care they can afford. This myth stems partly from a claim that a provision in one of the House bills would prevent people from buying private individual insurance. Politifact rates that claim "Liar, liar, pants on fire."
6. All profit from health care is "good" profit.
One American's "wasteful spending" is another's "bottom line." Almost every cost-saving measure under consideration would hurt someone's profits. If we bargain down payments for treatments, pharmaceutical companies and health care providers stand to lose money. If we trim inefficiencies in administering insurance plans, insurance providers will lose. If we make Americans healthier through nutritional interventions, the food industry gets burned.
In some cases, these hits to profit are counterbalanced by boosts to revenue. For example, regulations will reduce the amount of money insurers get from beneficiaries, but subsidies and mandates increase the number of beneficiaries they have. But in most cases, controlling spending means limiting profit. This is one reason a large-scale health-care overhaul in America has been scuttled during every previous attempt.
7. Medicare is more wasteful and costly than private insurers.
Medicare's costs are spiraling out of control, no doubt, but less drastically than in the private insurance system. Here's a somewhat technical rebuttal from Health Affairs of the claim that Medicare has done a worse job of controlling costs than private insurers.
8. The bills leave the US with a system like Britain's or Canada's.
Although the British and Canadian health-care systems are often brought up by critics of a health care rethink, none of the plans under consideration resemble either system very much (although details of the different bills borrow from elements in health care systems all over the world). Journalist T.R. Reid, who has reported extensively on health care, clusters different health care systems around the world into four broad categories. The category that describes the current proposals for the US health care system would shift it closer to systems in Germany, Japan, France and Belgium than to systems in Britain or Canada. Here's Factcheck.org debunking the claim that the plans on the table would shift the US to a Canadian system.
9. The bills cost more than the status quo.
So far, the costliest outcome on the table is not changing the health care system. President Obama has stipulated that the final health care bill must not add to the federal deficit, although even the CBO can't predict the future. But as the New America Foundation has reported at length, "The economic cost of failing to fix our broken health care system is greater than the upfront expense of comprehensive health reform."
10. The US has the best health care system in the world.
As far as I can tell, no one who's taken a serious look at health care systems around the world would include the American system among the top performers. Almost every study I've seen has put the US health care system near the bottom of the list of health care systems in industrialized nations, despite the fact that America far outspends anyone else. The US is tops in many things. Health care is not one of them.
