"Obamacare": Debunking The Myths Of Health Insurance Reform

July 30, 2009 5:30 pm ET

As Congress heads home for the August recess, Media Matters Action Network wants to make sure members are armed with the facts regarding the myths about health insurance reform. Each of these statements shares the common bond of both being completely false, and having been spoken by Republican members of Congress during the past week.

MYTH: Health care reform will provide health insurance to illegal immigrants.

I don't want my tax dollars to help provide health care for an illegal immigrant.

REBUTTAL:

The House bill specifically forbids federal dollars from going to the health insurance policies of undocumented workers residing in the United States, saying no federal payments will be allowed to benefit those "who are not lawfully present in the United States." 

House Bill: "No Federal Payment for Undocumented Aliens." According to America's Affordable Health Choices Act of 2009, Page 143, Line 3, Section 246: "No Federal Payment for Undocumented Aliens.  Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States." [America's Affordable Health Choices Act of 2009, accessed 7/22/09

President Obama: Health Care Reform Should Not Cover "Illegal Immigrants."  As reported by CBS News, "Asked by CBS News' Katie Couric in an exclusive interview whether illegal immigrants should be covered under a new health care plan, President Obama responded simply, 'no.'" [CBSNews.com, 7/21/09; emphasis added]

MYTH: A government-run plan will encourage seniors to choose an early death.

The President and Congressional Democrats want to cut health care costs by encouraging America's seniors to end their lives early and forgo expensive life-extending measures in their twilight years.

REBUTTAL:

The House bill does include language that offers senior citizens free counseling meant to answer any possible end-of-life questions they may have.  The counseling is voluntary and will provide professional, knowledgeable, and compassionate information to seniors on such issues as will preparation, medical power of attorney, resuscitation wishes, and other matters. 

"Advance Care Planning Consultation" Would Provide Seniors With Professional Advice On Will Preparation, Power Of Attorney, And Other Complicated Issues.  PolitiFact.com reported: "Sec. 1233 of the bill, labeled 'Advance Care Planning Consultation' details how the bill would, for the first time, require Medicare to cover the cost of end-of-life counseling sessions. According to the bill, 'such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.'" [PolitiFact.com, 7/16/09]

  • Counseling Is NOT Mandatory. In regards to the "mandatory" assertion, PolitiFact.com reported: "For his part, Keyserling said he and outside counsel read the language carefully to make sure that was not the case. 'Neither of us can come to the conclusion that it's mandatory.' he said. 'This new consultation is just like all in Medicare: it's voluntary.' 'The only thing mandatory is that Medicare will have to pay for the counseling,' said Dau." [PolitiFact.com, 7/16/09]

Patients Suffer When Their Doctors Are Not Aware Of Their Wishes.  According to CNN: "Discussing end-of-life care is difficult for everyone involved, but it should be done early on, doctors say.  Many aging parents and grandparents resist talking about it because of the emotional pain the issue will cause their younger relatives; and the children who will become responsible don't want to appear ungrateful or self-serving by mentioning it, [Dr. Arthur Kellerman, Emory University] said. Many doctors don't want to talk about it either, he said.  'There are a lot of my colleagues who don't bother having that conversation. They just intubate them, and ship them up to an ICU, and say 'next,'' Kellerman said." [CNN.com, 7/23/09]

Consultation Will Include An Explanation Of The Patient's Choices.  According to the Politico: "The provision states that as part of an advanced care consultation, an individual and practitioner shall have a consultation that includes 'an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.'" [Politico, 7/28/09]

Health Care Facilities Have Been Required To Provide End-Of-Life Information To Patients Since 1990.  Politico reported: "The government has long encouraged medical providers to discuss such life and death issues with patients. Congress passed the Patient Self-Determination Act in 1990, requiring health care agencies, including hospitals and long-term care facilities to give patients information on state laws regarding advance directives such as a living will." [Politico, 7/28/09]

Bush Administration Outlined End-Of-Life Counseling.  According to Politico: "In 2003, under the Bush administration, the Agency for Healthcare Research and Quality issued a 20-page report outlining a five-part process for physicians to discuss end-of-life care with their patients." [Politico, 7/28/09]

MYTH: The government-run plan will allow taxpayer funds to pay for abortions.

The passage of health care reform would mandate abortion coverage in all publicly offered options, thus making taxpayer dollars available to fund abortions.

REBUTTAL:

Abortion is not mandated in any reform legislation.  Currently, private insurance companies make their own decisions on whether or not abortion is a covered procedure.  Current reform efforts will continue in that vein and allow consumers to choose a plan, through the Exchange, that is provided by a company that is in line with their own moral decision about abortion. 

Abortion Is Not Mandated In The Reform Legislation.  According to Planned Parenthood: "Nothing in any of the current health care reform bills mandates abortion coverage - or any other type of medical procedure - in the Exchange. Abortion is not mandated any more than any other medical procedure in health care reform." [PlannedParenthood.org, accessed 7/30/09]

A Majority Of Americans Support Some Sort Of Abortion Coverage. The Mellman Group found that 66% of Americans support covering abortion under reform measures and 72% "would feel angry if Congress mandated by law that abortion would not be covered under a national health care plan." [Mellman Group Poll via the National Women's Law Center, 7/6/09]

97% Of Planned Parenthood's Services Are Not Abortion Related.  Planned Parenthood provides a variety of services - 97% of which are not abortion related.  According to their 2007 summary report, they provided 10.9 million services:

  • 31% (3.4 million) - Sexually Transmitted Diseases/Infections Testing and Treatment, for men and women
  • 17% (1.9 million) - Cancer Screening and Prevention
  • 11% (1.2 million) - Other Women's Health Services, including pregnancy testing and prenatal care
  • 3% (305,000) - Abortion Services
  • 2% (255,000) - Other Services, including adoption referrals
  • 36% (3.8 million) - Contraception, including tubal ligation and vasectomy surgeries

[PlannedParenthood.org, accessed 7/30/09, figures rounded]

MYTH: We don't need an overhaul of health care.

Why do we need to reform health care? I'm happy with what I have.

REBUTTAL:

Most Americans with health insurance are happy with the level of service and care they receive, and we don't want to change that.  However, there are millions of people who can't get health insurance.  And those people cost you, and everyone else with insurance, more because they often can't pay for the care they do receive.  Your premiums go up each year in part to help cover the cost of those who can't afford to go to the doctor and end up having to go to the emergency room instead.

Americans Are Suffering Under The Current Health Insurance System.  Under the current system, 44,230 Americans lose their health insurance every week.  That number translates to 191,670 a month and 2,300,000 a year.  [Families USA, "The Clock Is Ticking," July 2009]

46 Million Americans Have No Health Insurance. According to the National Coalition for Health Care: "Nearly 46 million Americans, or 18 percent of the population under the age of 65, were without health insurance in 2007, the latest government data available." [NCHC.org, accessed 6/8/09]

1 Out Of Every 10 American Children Has No Health Insurance. The National Coalition for Health Care stated: "The number of uninsured children in 2007 was 8.1 million - or 10.7 percent of all children in the U.S." [NCHC.org, accessed 6/8/09]

The Majority Of Americans Want Drastic Health Care Reform This Year. According to a USA Today/Gallup poll released on July 14, 2009, "56% of Americans in favor and 33% opposed to Congress' passing major healthcare reform legislation this year." [Gallup.com, 7/14/09]

Currently, Private Health Insurance Companies Do Not Value Their Customers

BCBS Retroactively Cancelled Plan After Six-Year-Old's Tumor Surgery.  According to the Los Angeles Times, "when Steve and Leslie Shaeffer's daughter, Selah, was diagnosed at age 4 with a potentially fatal tumor in her jaw, they figured their health insurance would cover the bulk of her treatment costs. Instead, almost two years later, the Murrieta, Calif., couple face more than $60,000 in medical bills and fear the loss of their dream home...Shortly after Selah's medical bills hit $20,000, Blue Cross stopped covering them and eventually canceled her coverage retroactively, refusing to pay for treatment, including surgery the insurer had authorized in advance." [Los Angeles Times, 9/17/06]

After Caesarean Section, Company Told Woman She Would Be Insurable If She Had Been Sterilized.  The New York Times reported on a woman who was turned down for private health insurance because her first child was delivered via caesarean section: "Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, [the insurance company] did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified." [New York Times, 6/1/08]

MYTH: A public option will result in Americans being forced out of their current plans.

REBUTTAL:

It is frightening to think that the government could force you from your current health coverage plan, especially if you are satisfied with the service.  Democrats have directly addressed this issue and have a clause written into the legislation ensuring that Americans currently covered by insurance policies will not lose their coverage with the installation of health insurance reform policies.  We don't want to take anything from you - we just want to make sure those without insurance have the ability to provide health coverage for their families.

House Bill Allows For Continuation Of Current Coverage.  According to PolitiFact.com: "The House bill allows for existing policies to be grandfathered in, so that people who currently have individual health insurance policies will not lose coverage." [PolitiFact.com, 7/22/09]

MYTH: The health care system in this country would fare better if all Americans received a tax credit to purchase insurance on their own.

Instead of offering a government-run public option, Congress should provide tax credits to families so they are able to purchase insurance on their own.

REBUTTAL:

The cost of a family's health insurance is rising quickly - last year it had almost reached $13,000 and is on track to be nearly $25,000 per year by 2016.

New America Foundation: Family Health Coverage Will Be Nearly $25,000 By 2016.  According to the New America Foundation, under the current system of health care delivery in the United States, the full cost of an employer-based health plan for a family will be $24,291 by 2016.  [New America Foundation, The Cost of Doing Nothing, November 2008]

"The Total Premiums To Cover A Family Are Up To $12,680."  The National Conference of State Legislatures reported: "In 2008 the average fully insured individual faced an employee share of $725 for 1-person coverage and a $3,354 annual share for family coverage.  The total premiums to cover a family are up to $12,680 according to the annual Kaiser/HRET survey of Employer-Sponsored Health Benefits." [NCSL.org, accessed 1/13/09, emphasis added]

Without Reform, Premiums Will Continue To Be Unaffordable For Many Americans.  According to a new study released by Families USA: "In 2008, the uninsured paid an average of 37 percent of the cost of care that they received out of their own pockets.  However, they cannot usually afford to pay the whole bill on their own, and a portion goes unpaid (this is called 'uncompensated care').  To cover the cost of this uncompensated care, health care providers charge higher rates when insured people receive care, and these increases are passed on to those who have insurance in the form of higher premiums, known as a 'hidden health tax.'  In 2008, for example, this 'hidden health tax; increased premiums for family health coverage by an average of $1,017, and, for single individuals, by $368." [Families USA, Coverage for America: We All Stand to Gain, accessed 7/22/09, parentheses original]

Individual Health Plans May Not Cover An Individual's Basic Needs.  The Washington Post reported: "If you have poor health, there can be a catch: Insurers can decline to offer you a policy, exclude coverage for certain conditions or charge you high premiums. Those with serious conditions such as HIV, cancer or diabetes, as well as those with common conditions such as obesity, can feel the snub. 'In the past four or five years, I've had people turned down just because of height and weight,' says Jerry Patt, an independent agent in Gaithersburg who has been in the business for more than 35 years. 'They could be having no medical problems whatsoever, but their build was not acceptable.'" [Washington Post, 6/22/07, emphasis added]

MYTH: Free-market principles should be utilized to fix health care and Americans should be allowed to purchase insurance across state lines.

Instead of offering a government-run public option, Congress should allow the purchase of insurance across state lines.

REBUTTAL:

Each state has a different set of regulations and taxes they apply to insurance companies.  If purchasing health insurance across state lines was allowed, health insurance companies would relocate to those states with the laws best suited to the company's profit margin and Americans would suffer.

States Vary Greatly On The Types Of Regulations Imposed Upon Insurance Companies.  Bonnie Burns, Training and Policy Specialist for California Health Advocates, testified that "there is inconsistent regulatory authority from one state to another over insurance products offered for sale in each state, the premiums companies charge, and premium increases they impose. Although the National Association of Insurance Commissioners (NAIC) Model Act for Long- Term Care Insurance and Model Regulation to implement the Model Act serve as an advisory regulatory foundation for state laws and regulation, many state legislatures change or refuse to adopt certain provisions of those Models, if they adopt them at all...Regulatory authority and oversight as a result may be very strong in some states and minimal in others." [Congressional Quarterly, 7/24/08, emphasis added]

Americans Suffer When Purchasing Insurance On The Individual Market

Many Americans Have Been Priced Out Of Health Care.  As Ezra Klein points out on his blog: "If you look at waiting times, you'll see that relatively few Americans wait more than four months for surgery, which helps folks claim that America doesn't ration care, and makes our system look pretty good on the waiting times metric. Here's what they don't tell you: When you look at who foregoes care, the international comparisons reverse themselves. About 23% of Americans report that they didn't receive care, or get a test due to cost. In Canada, that number is 5.5%." [Ezra Klein blog, The American Prospect, 12/5/08, emphasis added]

American Families Already Faced With Cancer Diagnosis Also Have Difficulty Paying For Health Care.  According to a Lake Research Poll: "Half (52%) of families with a person under 65 who has had a cancer diagnosis say they have had difficulty paying for health care costs.  Additionally, close to half (47%) of those currently receiving cancer-related care has had difficulty affording care." [ACSCAN.org, 5/20/09]

Rather Than Waiting In Line, Americans Simply Do Not Get Care. As Ezra Klein argues in the Los Angeles Times, "although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of us who can't afford care simply won't get it." [Los Angeles Times, 4/7/09, emphasis added]

Without COBRA Or Other Health Coverage, People "Are More Likely To Forgo Needed Medical Care And Incur Medical Debt."  A December 2008 report released by the Kaiser Commission on Medicaid and the Uninsured stated: "many workers find that after losing a job they are not able to afford the premiums required to continue employer-sponsored insurance through COBRA...Without insurance, these adults are more likely to forgo needed medical care and incur medical debt.  They are also at risk of having their health problems treated as pre-existing conditions if they later regain employer-sponsored coverage."  [KFF.org, accessed 1/14/09]

MYTH: A government option will result in health care rationing for Americans.

Government control of health care will only lead to delayed and denied care as some government bureaucrat makes arbitrary decisions about personal care.

REBUTTAL:

Americans' health care is already rationed, by the private health insurance industry.

Private insurance companies ration care to Americans every single day.  They reject applications based on pre-existing conditions and family history.  They rescind coverage after an illness has been diagnosed.  Their premiums and deductibles are so high that millions of Americans are forced to delay care or declare bankruptcy due to high costs.

Some Insurance Companies Treat Caesarean Sections As A Pre-Existing Condition.  According to the New York Times:  "Insurers' rules on prior Caesareans vary by company and also by state, since the states regulate insurers, said Susan Pisano of America's Health Insurance Plans, a trade group. Some companies ignore the surgery, she said, but others treat it like a pre-existing condition. 'Sometimes the coverage will come with a rider saying that coverage for a Caesarean delivery is excluded for a period of time,' Ms. Pisano said. Sometimes, she said, applicants with prior Caesareans are charged higher premiums or deductibles." [New York Times, 6/1/08]

Insurers Justify Exclusion Policies, Saying "They Need These Strategies To Protect Themselves."  The New York Times reported, "with individual coverage, insurers in many states can vary their prices based on medical history, exclude certain services or reject anyone they consider a bad risk...Insurers say they need these strategies to protect themselves, because some customers apply only after they get sick or pregnant, skewing the pool toward people with high expenses." [New York Times, 6/1/08]

Many Americans Have Been Priced Out Of Health Care.  As Ezra Klein points out on his blog: "If you look at waiting times, you'll see that relatively few Americans wait more than four months for surgery, which helps folks claim that America doesn't ration care, and makes our system look pretty good on the waiting times metric. Here's what they don't tell you: When you look at who foregoes care, the international comparisons reverse themselves. About 23% of Americans report that they didn't receive care, or get a test due to cost. In Canada, that number is 5.5%." [Ezra Klein blog, American Prospect, 12/5/08, emphasis added]

American Families Already Faced With Cancer Diagnosis Also Have Difficulty Paying For Health Care.  According to a Lake Research Poll: "Half (52%) of families with a person under 65 who has had a cancer diagnosis say they have had difficulty paying for health care costs.  Additionally, close to half (47%) of those currently receiving cancer-related care has had difficulty affording care." [ACSCAN.org, 5/20/09]

Rather Than Waiting In Line, Americans Simply Do Not Get Care. As Ezra Klein argues in the Los Angeles Times, "although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of us who can't afford care simply won't get it." [Los Angeles Times, 4/7/09, emphasis added]

MYTH: Increased Comparative Effectiveness Research will give the government reasons to deny care.

REBUTTAL:

Comparative Effectiveness Research, or CER, is simply the study of how well various treatments work for patients.  CER is not a new practice; President Bush allocated more than $300 million last year alone.  Doctors and patients use the results of CER to make every medical decision, as it is this research that helps determine what might work best for each individual patient.

Comparative Effectiveness Research Is The Comparison Of Medical Treatments.  According to the Washington Post's Business Columnist, Steven Pearlstein, "comparative effectiveness research" refers to "research done by doctors and statisticians who troll through large number of patient records to determine, for any particular disease, which treatments work best." [Washington Post, 2/13/09]

The Stimulus Bill Allocated $1.1 Billion For CER. According to the New York Times: "The $787 billion economic stimulus bill approved by Congress will, for the first time, provide substantial amounts of money for the federal government to compare the effectiveness of different treatments for the same illness. Under the legislation, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions." [The New York Times, 2/15/09]

NIH Had A Budget Of $335 Million For Comparative Effectiveness Research Last Year.  According to the Washington Post's Business Columnist, Steven Pearlstein, "there's nothing particularly new about comparative effectiveness research -- the National Institutes of Health, along with the Agency for Healthcare Research and Quality, have been doing it for years, with a budget last year of about $335 million." [Washington Post, 2/13/09]

CER "Would Fill Gaps In The Evidence Available To Doctors And Patients." The New York Times reported: "For many years, the government has regulated drugs and devices and supported biomedical research, but the goal was usually to establish if a particular treatment was safe and effective, not if it was better than the alternatives. Consumer groups, labor unions, large employers and pharmacy benefit managers supported the new initiative, saying it would fill gaps in the evidence available to doctors and patients." [The New York Times, 2/15/09]

Applied Properly, CER Empowers Patients To Make The Best Choices For Their Own Medical Care. In a post on U.S. News, Michelle Andrews wrote, "This is good stuff, not only for the medical establishment but also for patients, who are increasingly expected to play an active role in managing and paying for their healthcare." [USNews.com, 3/23/09

Council "Will Not Recommend Clinical Guidelines."  The published guidelines for the Council are very clear about the decisions its members will make: The Federal Coordinating Council For Comparative Effectiveness Research "will not recommend clinical guidelines for payment, coverage or treatment." [HHS.gov, 3/19/09, emphasis added]

Research Must Be Conducted By An Impartial Third Party, Such As The Government

Conducting Research Trials Is Not Always Financially Beneficial For Private Companies. According to a December 2007 report released by the Congressional Budget Office titled Research on the Comparative Effectiveness of Medical Treatments: "For drug manufacturers, the costs of conducting additional trials to demonstrate safety and efficacy for a broader set of patients or conditions may outweigh the benefits from the increased sales that would result; in particular, the potential gains from finding a favorable result for a different population would have to be weighed against the risk that safety and efficacy could not be demonstrated conclusively." [CBO.gov, 12/07]

MYTH: The government option is the first step towards a single-payer system like Canada and Great Britain.

REBUTTAL:

Neither of those systems is being used as a model to reform American health care.  Our solution will be uniquely American and will ensure the continuation of the private health insurance industry, preserving American choice and entrepreneurship.

Health Care Reform Will Be Uniquely American.  Sen. Max Baucus, who is spearheading health care reform from the helm of the Senate Finance Committee, said: "We are not Europe.  We are not Canada...We need a uniquely American solution.  It has to be a partnership of public and private players." [Washington Post, 5/11/09]

President Obama: "Keep The Private Sector Honest, Because There's Some Competition Out There."  During the Health Care Summit at the White House, Senator Grassley commented to President Obama, "there's a lot of us that feel that the public option that the government is an unfair competitor and that we're going to get an awful lot of crowd out, and we have to keep what we have now strong, and make it stronger." President Obama replied: "The thinking on the public option has been that it gives consumers more choices, and it helps give -- keep the private sector honest, because there's some competition out there. That's been the thinking. [Health Care Summit, Transcript via Talking Points Memo, 3/5/09]

"A Public Plan Would Provide An Essential Option" For Americans.  Harold Pollack, public health policy researcher at the University of Chicago's School of Social Service Administration and faculty chair of the Center for Health Administration Studies, wrote in an op-ed: "A public plan would provide an essential option--and an equally essential backup--for millions of Americans living with chronic illnesses or disabilities." [The New Republic, 3/10/09]

Sen. Baucus: The Reformed Health Care System "Will Be A Public/Private Hybrid." American Prospect published a quote of Senator Baucus saying: "We need health insurer reform to get rid of preexisting conditions and other ways insurers discriminate. That's part of our plan here, and the CEOs of many larger insurance companies are on board. They know this change is coming. They may lose the current model but they pick up on volume with 46 million people coming into the system...And that will be a public/private hybrid. There may come a time when we can push for single payer. But that time is not yet, and so I'm not going to waste my time." [American Prospect, accessed 3/6/09]

MYTH: Government-run health care will put a bureaucrat between you and your doctor. 

I don't want some faceless Washington bureaucrat making health care decisions for me and my family.

REBUTTAL:

The private health insurance industry bureaucrats are standing between you and your doctor right now.  They hire outside firms to determine how much you might cost them.  Private insurance companies make decisions on who does and does not get health care based solely on how much they value your life. 

Insurance Bureaucrats Stand Between Americans And Their Doctors.  Dr. Howard Dean said on MSNBC: "Right now there is a bureaucrat between you and your doctor, and it's that private health insurance bureaucrat." [MSNBC transcript and video via MadvilleTimes, accessed 6/17/09]

Americans Face Denials For Coverage From Insurance Companies Every Day.  Americans are already facing the denial of treatments from their private insurance companies, according to the Wall Street Journal. As Diane Archer, director of the Health Care Project at Institute for America's Future recently argued in the New York Times: "As any doctor will tell you, when a private health insurance plan delays or denies a physician-recommended service, it is deciding who gets care and what kind of care people get." [Wall Street Journal, 9/25/08; New York Times, 5/8/09]

Insurance Companies Hire Agencies To "Do Computerized Searches" Of A Person's Health Record.  According to the Miami Herald, "to make sure that applicants are not lying, insurers hire a data-gathering service -- Medical Information Bureau, Milliman's Intelliscript or Ingenix Medpoint. Intelliscript and Medpoint do computerized searches of a person's drug use, gleaned from pharmacy benefits managers and other databases." [Miami Herald, 3/28/09]

Insurers Use The Data To Deny Coverage And To Charge Higher Premiums.  According to a Business Week report, "Two-thirds of all health insurers are using prescription data-not only to deny coverage to individuals and families but also to charge some customers higher premiums or exclude certain medical conditions from policies, according to agents and others in the industry." [Business Week, 7/23/08]

"Pre-Existing Condition Exclusions" Included In Coverage After An Individual Has Gone Without Health Insurance.  According to the Kaiser Commission on Medicaid and the Uninsured: "If an individual is uninsured for 63 days or more, pre-existing condition exclusions can be imposed by their new health plan for most health conditions for which treatment, advice or diagnosis were received in the six months prior to enrolling in an employer-sponsored insurance plan.  Insurers can typically refuse to cover medical care related to pre-existing conditions for up to one year." [KFF.org, accessed 1/14/09]

Some Insurance Companies Treat Caesarean Sections As A Pre-Existing Condition.  According to the New York Times:  "Insurers' rules on prior Caesareans vary by company and also by state, since the states regulate insurers, said Susan Pisano of America's Health Insurance Plans, a trade group. Some companies ignore the surgery, she said, but others treat it like a pre-existing condition. 'Sometimes the coverage will come with a rider saying that coverage for a Caesarean delivery is excluded for a period of time,' Ms. Pisano said. Sometimes, she said, applicants with prior Caesareans are charged higher premiums or deductibles." [New York Times, 6/1/08]

MYTH: A government plan will create an increased bureaucracy for Americans to contend with.

We don't need more government bureaucracy that will turn a visit to the doctor's office into a visit to the DMV.

REBUTTAL:

Are you satisfied with the current insurance company bureaucracy?  Currently, insurance company bureaucracies extend outside their walls as they pay other firms to investigate your past to determine how much you might cost them.  And if it's too much, they deny your coverage.  And even if they offer you coverage and you pay your dues in full and on time, if you get sick they will have one of their employees find any simple mistake on your application in order to rescind your coverage. 

With increased government involvement in the health insurance delivery system, these things just won't happen.

Major Insurance Companies Pay For Access To Private Medical Information.  According to a Business Week report: "Most consumers and even many insurance agents are unaware that Humana, UnitedHealth Group, Aetna (AET), Blue Cross plans, and other insurance giants have ready access to applicants' prescription histories. These online reports, available in seconds from a pair of little-known intermediary companies at a cost of only about $15 per search, typically include voluminous information going back five years on dosage, refills, and possible medical conditions. The reports also provide a numerical score predicting what a person may cost an insurer in the future." [Business Week, 7/23/08, emphasis added]

Insurance Companies Hire Agencies To "Do Computerized Searches" Of A Person's Health Record.  According to the Miami Herald, "to make sure that applicants are not lying, insurers hire a data-gathering service -- Medical Information Bureau, Milliman's Intelliscript or Ingenix Medpoint. Intelliscript and Medpoint do computerized searches of a person's drug use, gleaned from pharmacy benefits managers and other databases." [Miami Herald, 3/28/09]

Insurers Use The Data To Deny Coverage And To Charge Higher Premiums.  According to a Business Week report: "Two-thirds of all health insurers are using prescription data-not only to deny coverage to individuals and families but also to charge some customers higher premiums or exclude certain medical conditions from policies, according to agents and others in the industry. Some carriers are also using the data to charge small employers higher group rates." [Business Week, 7/23/08]

Insurers Justify Exclusion Policies, Saying "They Need These Strategies To Protect Themselves."  The New York Times reported, "with individual coverage, insurers in many states can vary their prices based on medical history, exclude certain services or reject anyone they consider a bad risk...Insurers say they need these strategies to protect themselves, because some customers apply only after they get sick or pregnant, skewing the pool toward people with high expenses." [New York Times, 6/1/08]

MYTH:  A government option will force private insurance companies out of business.

REBUTTAL:

The introduction of more competition in the health insurance market will not put private companies out of business - it will force them, in true free-market style, to meet the demands of consumers and to start providing quality coverage to all Americans.

Currently, There Is A Severe Lack Of Competition Among Insurance Providers

Only A Few Insurance Companies Dominate The Market, Leaving Americans With Limited Choices In Health Care. According to the American Medical Association, 94 percent of United States health care markets are considered highly concentrated, meaning that one company or a small group of companies control a great deal of the market. [American Medical Association, "Competition in Health Insurance," 2008 Update]

New York Times: Fears Of A Public Plan Putting Private Plans Out Of Business Are "Overblown." According to the New York Times: "What many critics seem to fear most is that a new public plan would sweep away its private competitors and evolve over time into a full-fledged single-payer system (sometimes called Medicare for all). No matter how fair the competition between public and private plans might be at the start, they warn that the government would find it irresistible to rig the outcome through its regulatory and pricing powers and its ability, in a pinch, to subsidize the public plan with taxpayers' money. That fear seems overblown. Innovative, nimble private plans with well-integrated service systems might outperform any government plan, just as some now outperform Medicare through better coordination of services, stronger preventive care and broader benefits. A new public plan is neither the cornerstone of health care reform nor the death knell of private insurance. It should be tried as one element of comprehensive reform." [New York Times, 4/6/09; emphasis added]

Senate Democrats Have Proposed That Public Health Care Should "Comply With All The Rules And Standards That Apply To Private Insurance" To Ensure That Private Insurance Can Compete.  According to the New York Times: "In an effort to defuse the most explosive issue in the debate over comprehensive health care legislation, a top Senate Democrat has proposed that any new government-run insurance program comply with all the rules and standards that apply to private insurance. The proposal was made Monday by Senator Charles E. Schumer of New York, the third-ranking member of the Senate Democratic leadership, in a bid to address fears that a public program would drive private insurers from the market." [New York Times, 5/5/09]

House Democrats Are Committed To A Public Health Care Option Which Will "Spur Competition Within The Insurance Industry." The Hill reported: "[Majority Leader] Hoyer indicated that House Democrats are committed to including a public plan option in their bill. 'We believe that a public option clearly is going to be necessary' to provide consumers with an alternative to private insurance and to spur competition within the insurance industry, Hoyer said." [The Hill, 3/26/09]

  • Speaker Pelosi Is Looking For A Public Option To Make Private Insurers More Competitive. According to Bloomberg: "House Speaker Nancy Pelosi said the House this year will consider health-care legislation including an option for a government-run program that would compete with insurers. 'This is a big agenda, and I believe it should have a public option in it for it to be really substantial,' Pelosi told reporters at her weekly news conference in the U.S. Capitol. Pelosi said the Democratic-controlled House will be 'aggressive' in its approach to a health-care overhaul, which is a centerpiece of Obama's agenda. She said a government role in health care will help U.S. companies be more competitive." [Bloomberg, 3/26/09]

MYTH: The stimulus package failed, so what reason is there to believe health care reform won't fail too?

REBUTTAL:

The stimulus package was meant to take effect over two years.

The effects of the stimulus will take place over the next two years.  Just as the economy didn't get to this point in a few months, we can't expect the solution to take hold in such a short amount of time.  The analogy the president uses is true: the economy - and health care - is a cruise ship, not a speed boat; it takes some time for the boat to change direction after the captain has turned the steering wheel. 

Obama Warned: "This Is A Big Problem, And It's Going To Get Worse." Before taking office, President-elect Obama told the country, "When you think about the structural problems that we already had in the economy before the financial crisis, this is a big problem, and it's going to get worse... Things are going to get worse before they get better." [ABC News, 12/7/08]

Obama: "There Are No Quick Fixes."  At a news conference on March 24, 2009, President Obama said: "It's important to remember that this crisis didn't happen overnight, and it didn't result from any one action or decision. It took many years and many failures to lead us here, and it will take many months and many different solutions to lead us out.  There are no quick fixes, and there are no silver bullets." [Presidential News Conference, 3/24/09]

Krugman: Claims That The Stimulus Has Failed Are "Insane." Writing on his New York Times blog, Nobel Prize-winning economist Paul Krugman called claims that the stimulus has failed "insane" because "hardly any of the money has flowed to the economy yet." [New York Times, 6/25/09]

MYTH: An employer mandate will hurt small businesses.

Changing the current system has the potential to destroy small American businesses - especially if Congress enacts an employer mandate.

REBUTTAL:

Recently, the two Senate Committees currently working on the health care bill removed the mandate for employers to provide health insurance coverage to their employees.  And the House bill has specific provisions to exclude very small businesses from the mandate as well as providing a simple description for what would occur if the employer did not provide health coverage.  Congress wants to do everything it can to support American businesses, while at the same time ensuring all Americans have access to quality health care.

Study: 10% Increase In Health Care Costs Result In Loss Of More Than 120,000 American Jobs. According to Business Week, "the study estimated that a 10% increase in excess health care costs would reduce employment by about 0.24 percent in the motor vehicles industry, where 80% of workers are covered by employers. The retail industry, however, where only one third of workers are covered, saw only a 0.13% percent drop in employment. Economy-wide, a 10% increase in excess health care costs growth would result in about 120,800 fewer jobs, $28 billion in lost revenues, and $14 billion in lost GDP value." [Business Week, 7/23/09]

"Administrative Costs Make It Inefficient For Insurers To Sell Coverage To Small Employers."  Dr. Linda Blumberg of the Urban Institute gave the following testimony to the House Committee on Small Business: "Fixed administrative costs make it inefficient for insurers to sell coverage to small employers. The per-person price of buying insurance for a small group of individuals will always be higher than buying those same benefits for a large group." [Urban Institute, 9/18/08]

Small Businesses "Are Especially Vulnerable To The Weaknesses" Of The Health Care System.  According to National Federation of Independent Business, "our current system of health insurance and health care is financially unsustainable and threatens the health and financial security of the American people. Small business owners and their employees are especially vulnerable to the weaknesses of our current system." [NFIB.com, accessed 3/18/09]

Small-Business Owners Cut Health Coverage To Cut Operation Costs.  According to the New York Times, "even before the recession, owners of the smallest businesses had struggled to absorb the inexorable annual rise in health premiums. The share of firms with fewer than 10 workers that offer health benefits has declined by 16 percent since 2001, to 49 percent, according to an annual survey by the Kaiser Family Foundation and the Health Research and Educational Trust, while the rate in larger firms essentially stayed flat. The economic downturn has only accelerated the pressure on small-business owners to pinch every penny, and many feel they have few options but to go after employee health coverage." [New York Times, 2/2/09]

Small-Business Owners Face Difficult Decision Of Cutting Benefits For Workers That Are Like Family.  According to the New York Times, "for many small-business owners, it can be excruciating to reduce or eliminate benefits for employees who have long been treated as family and who continue to work at their sides, every day." [New York Times, 2/2/09]

MYTH: Democrats in Congress keep trumpeting the benefits of a public option, but refuse to accept the plan for themselves and their families.

Many opponents of health care reform assert that members of Congress should enroll in the public option they are forcing down America's throat - even citing a House Ways & Means amendment to that effect that was defeated in committee.

REBUTTAL:

Republican Senator Tom Coburn of Oklahoma introduced a sarcastic amendment requiring members of Congress to enroll in the public option - and the Democrats passed it!  Democrats are not against enrolling in the option they make available to the American public.  We're all in this together.

Senate HELP Committee Passed Amendment To "Require Members Of Congress To Enroll In The Government-Run Public Plan."  According to Congressional Quarterly, "the panel adopted by 12-11 an amendment by Tom Coburn, R-Okla., that would require members of Congress to enroll in the government-run public plan created by the legislation. 'We should take the lead, sacrifice and demonstrate our faith on how good we think this will be, Coburn said." [Congressional Quarterly, 7/14/09, subscription required]

Government-Administered Medicare Is Actually More Efficient Than Private Insurance. The Council for Affordable Health Insurance, "a research and advocacy association of insurance carriers," published a report stating: "Administrative costs are lower under Medicare than for private health insurance." The report added, "our best estimates indicate Medicare at slightly above 5% of total Medicare cost in 2003, whereas the government currently reports about 2%... The private market administrative costs are expected to remain at about 9% of total private insurance cost, excluding premium taxes, commissions, and profit. With such items, private costs would be slightly under 17%." [CAHI, Medicare versus Private Health Insurace: The Cost of Administration, 1/6/06]

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