Rep. Cantor's "Bad Medicine" Is Just That - BAD

August 03, 2009 2:02 pm ET

Late in the evening of July 31, 2009, Rep. Eric Cantor (R-VA) released a document titled "Bad Medicine: Five Things You Need to Know About the House Democrats' Health Care Bill."  Rep. Cantor, however, is stubbornly holding onto several weak Republican talking points.

Rep. Cantor Isn't A Fan Of The Popular And Efficient Medicare

Rep. Cantor: "Doctor Payments Based on the Medicare Model.  Plan would reimburse providers at Medicare payment rates for at least the first three years, with a 5% bonus payment.  After that, reimbursement could be no more than Medicare rates."  [, accessed 8/3/09]

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]

Medicare Recipients Report "Higher Overall Satisfaction" Than Those Receiving Private Insurance.  As reported by Health Affairs: "Compared with the employer-coverage group, people in the Medicare group report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher overall satisfaction with their coverage." [Health Affairs, 5/12/09]

Rep. Cantor Might Be A Little Confused About Rationing

Rep. Cantor: "Rationing. A new Health Care Commissioner would have unprecedented authority to determine what is 'acceptable' health care coverage and set all the rules for what an health [sic] care coverage must include in addition to what treatments patients could receive and at what cost." [, accessed 8/3/09]

Insurance Companies Currently Practice Rationing.  According to the Associated Press: "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." [Associated Press, 8/2/09]

The Health Care Commissioner Would Operate From The Findings Of Comparative Effectiveness Research:

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]

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." [, 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." [, 3/19/09, emphasis added]

Rep. Cantor Should Familiarize Himself With Full CBO Remarks And Findings

Rep. Cantor: "CBO director Elmendorff said on July 16th that, '...the legislation significantly expands the federal responsibility for health care costs...The way I would put it is that the [cost] curve is being raised...'"  [, accessed 8/3/09, emphasis original]

CBO Director: Long Term Projections Difficult To Predict Accurately.  During a question and answer period following his testimony in front of the Senate Budget Committee, CBO Director Douglas Elmendorf said: "But it is very hard to look out over a very long term and say very accurate things about growth rates.  So most health experts that we talk with focus particularly on what is happening over the next 10 or 20 years, still a pretty long time period for projections..." [Hearing on CBO Long-Term Budget Outlook, 7/16/09]

CBO: House Bill Would Increase Revenue By $83 Billion And Result In A $65 Billion Net Increase In The Federal Deficit Over Ten Years.  In its letter to Chairman Rangel, the Congressional Budget Office wrote: "According to CBO's and JCT's assessment, enacting H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period.  That estimate reflects a projected 10-year cost of the bill's insurance coverage provisions of $1,042 billion, partly offset by net spending changes that CBO estimates would save $219 billion over the same period, and by revenue provisions that JCT estimates would increase federal revenues by about $583 billion over those 10 years.  By the end of the 10-year period, in 2019, the coverage provisions would add $202 billion to the federal deficit, CBO and JCT estimate.  That increase would be partially offset by net cost savings of $50 billion and additional revenues of $86 billion, resulting in a net increase in the deficit of an estimated $65 billion. It is important to note that the figures presented here do not represent a complete cost estimate for the coverage provisions of the legislation." [, 7/17/09; emphasis added]

Rep. Cantor Repeats Convenient Stats From Dubious Source

Rep. Cantor: "2 out of 3 Workers will Lose Coverage.  Independent analysis by the Lewin Group shows that 2 out of every 3 people would lose their current coverage, including over 114 million people who receive health benefits through their employer or other current coverage." [, accessed 8/3/09, emphasis original]

The Lewin Group Is Neither Independent Nor Reliable

The Lewin Group Is Owned By "One Of The Nation's Largest Insurers."  The Washington Post reported that "the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers." [Washington Post, 7/22/09]

Lewin Group Accused Of "Distributing Skewed Data." According to the Washington Post, "the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the 'usual and customary' doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care." [Washington Post, 7/22/09]

Lewin Group Studies Buried If Insurance Industry Clients Are Not Happy With Findings.  According to the Washington Post, "not all of the firm's reports see the light of day. For example, a study for the Blue Cross Blue Shield Association was never released, Sheils said. 'Let's just say, sometimes studies come out that don't show exactly what the client wants to see. And in those instances, they have [the] option to bury the study -- to not release it, rather,' Sheils said. Asked to comment, Blue Cross Blue Shield Association spokesman Brett Lieberman said, 'We're still working with Lewin on a study, and, you know, we don't talk about our studies until they're done.'" [Washington Post, 7/22/09]

Additionally, The Lewin Group Has Issued Contradictory Figures

Lewin VP: Sen. Schumer's Plan Would Result In Only 10-12 Million People Moving To The Public Option.  According to NPR, Lewin Vice President Shiels "did add that in general, the mood in Congress seems to be moving toward a more constrained sort of public insurance program; most likely one that would pay somewhat more than Medicare and limit enrollment. For example, Sheils says, Democratic Sen. Charles Schumer of New York 'has a plan which would require the public program to pay private payer rates - the same rates that other private insurers have to pay - and under that scenario we get only between 10 and 12 million people dropping private coverage.'" [NPR, All Things Considered, 6/10/09]

Rep. Cantor, Fear-Mongering Extraordinaire

Rep. Cantor: "If You Like What You Have, You Can't Keep It...It will be Illegal to Renew your Current Health Insurance and you will be left only with plans approved by a new federal regulator - plans that can't compete with a new government run plan."  [, accessed 8/3/09, emphasis original]

House Bill Allows For Continuation Of Current Coverage.  According to "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." [, 7/22/09]

Rep. Cantor Is Fighting Against Legislation That Will Help Small Businesses

Rep. Cantor: "Raises Taxes on Small Businesses through Surtax Increase." [, accessed 8/3/09]

More Than Nine Out of Ten Small Businesses Will Not Be Affected By Surtax. According to the Center on Budget on Budget and Policy Priorities, "More than nine in ten small businesses would feel no impact whatsoever," meaning "some 96 percent of taxpayers with business income would not owe the surcharge." [Center on Budget and Policy Priorities, 7/17/2009]

Even Those Paying the Surcharge Will Not See Any Impact On Business. According to Citizens for Tax Justice, the surcharge will only affect business profits, and "a small business owner deducts any money that she paid to employees as compensation, as well as any other operating is only business profits that are taxed."  In addition, "even purchases of equipment to expand business operations would not be affected..." [Citizens for Tax Justice, 7/15/2009]

Health Care Reform Can Save Small Businesses 36% Of Their Health Care Costs and Reduce Profit Losses By More Than 50%. With health care reform, "small businesses can save as much as $855 billion, a reduction of 36 percent."  In addition, "over the next ten years...small businesses will lose $52.1 billion in profits to high healthcare costs.  Healthcare reform can reduce these losses by more than 56 percent, saving $29.2 billion in small business profits..." [Small Business Majority, 6/11/2009]

Health Care Reform That Includes Shared Responsibility Will Save Workers Billions In Wages.  According to a recent study, "Reforming healthcare, and providing support to small businesses under a new system of shared responsibility, can save workers up to $309 billion in wages over the next ten years. [Small Business Majority, 6/11/2009]