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Tuesday, August 04, 2009

Because they're lying, that's why

by folkbum

You might be wondering why I haven't written much about the health care debate lately. In part, things have been crazy round these parts, and I haven't written much at all lately. In part, Keith has been doing a fine job.

Mostly, though, it's because the "other side" in this debate refuses to be honest about it. You see it in the comment threads here; I have also tried engaging them in comment threads elsewhere. They lie, and when you explain to them exactly how they're lying, they refuse to acknowledge it and make up something else.

Now, I don't know the origin of all of the crap they're throwing out there. One thing I do know, though, is that all these people who claim to have "read the bill" (HR3200, available in html here and downloadable as a ginormous pdf from lots of places) either haven't or don't have a clue what they're reading.

A friend forwarded an email from Americans for Prosperity this morning, for example, that reads in part,
You see, we had just detailed the “end of life” mandatory counseling provision of the Obama/Pelosi health care takeover for the crowd. Dr. Larry Hunter had just explained that on page 425 and 426 the House bill states that if you are a Medicare recipient you will receive counseling to learn about “end of life” options, including hospice and palliative care.
On this blog, it's called "Obamacare Euthanasia." Berry Laker, in a long list of misreadings of the bill found via Dad29, writes, "Government mandates program for orders for life-sustaining treatment (i.e. end of life). The government has a say in how your life ends." This blog, from which I've been banned for pointing out previous blatant lies, says, "End of life plan for each American citizen ordered by the government."

Scary-sounding stuff, to be sure, but flat-out lies. The section in question from HR3200 begins with the words, ”Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended …” If you look at the law to be amended, you can see that it's the "Definitions of Services, Institutions, Etc." part of the law that describes services that are reimbursable under Medicare. The provision in HR3200 does not make such sessions mandatory and does not force anyone to do anything or file their living will with the federal government. It does not send a G-Man to your door to tell you how and when you're going to die. Instead, the provision simply says that the doctor can get paid for the time he or she spends talking to you about your living will--something that doesn't happen now. It was originally introduced by a Republican Senator and endorsed by the AARP; the AARP is not so dumb as to endorse a provision that kills off their dues-paying members, are they? No matter how patiently I explain this, the other side refuses to acknowledge reality.

The other side reports with glee every time something bad happens in England (McIlheran does it here, for example), because they deliberately choose to conflate the British socialized National Health Service (where health care workers are government employees) with the reforms being proposed by Congress and the White House, none of which are socialized medicine, "government-run health care," or even single-payer. They'll tell you that HR3200 demands rationing of care. Berry Laker: "YOUR HEALTH CARE WILL BE RATIONED! [. . .] THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get." He also prints that in red text, because all-caps is apparently not enough emphasis. But the parts of the bill he points to (sections 122 and 123) say nothing of the kind. Section 122 is the Essential Benefits Package Defined section, which sets minimum standards for health insurance coverage, not maximums that lead to rationing. Section 123 establishes an advisory committee whose job it is to periodically review those minimums and decide if they're sufficient.

As part of that, they'll lie to you and tell you that HR3200 outlaws private insurance. Freedom Eden displays that in her sidebar: "Obamacare: You Will Lose Your Current Insurance. Period. End of Story. Right there on Page 16 is a provision making individual private medical insurance illegal." Community columnist Kathy Banaszak repeats the lie in the JS this morning. This blogger claims, "Of course it outlaws private insurance. It’s right there in the bill. [. . .] I read the goddamn bill, unlike John Conyers." If he had read the bill, of course, he would have noticed Title II (pages 72-143, so not like it's buried) of the bill, "Health Insurance Exchange and Related Provisions," which establishes a nation-wide network of private insurers--something the right has been clamoring for. Yes, there is a "public option" defined in Title II, but it is in addition to, not in place of, private insurance.

The "page 16" lie has its origins in a lying editorial from Investors Business Daily, which misreads the definition of a "grandfathered health plan"--a plan that exists now but cannot enroll new members after the bill takes effect--and reads that as the end of private insurance altogether. In fact, those "grandfathered" plans are defined (p. 72-73) as "acceptable coverage," meaning they won't be changed or taken away by the bill. And insurance companies and businesses are free to--are, in fact, encouraged to--offer private health care plans (meeting new minimums) and enroll people after the bill takes effect.

A similar lie shows up in Berry Laker's list: "Government will RESTRICT enrollment of special needs people!" he screams, also in red. But, again, that's about grandfathered plans.

There's more, of course. There's the one about how the government will have real-time access to your financial records. The reality is that bill requires, as part of modernizing the system through electronic records, a real-time "determination of an individual’s financial responsibility at the point of service." In other words, not a full picture of your portfolio, but rather whether or not you owe a co-pay.

There's the one about the "national ID card," because the bill says you should have an insurance card. (I already have one! It's the end of the world!)

There's the one about "government will tell you [doctors] where your residency will be, thus where you’ll live" (Berry Laker, again), based on the section that slightly amends an already existing law (see here, scroll down to "(h) Payments for Direct Graduate Medical Education Costs").

There's the one about about the federal government setting pay for all doctors, based on the fact that doctors who voluntarily agree to be a part of the public option plan will be reimbursed at Medicare rates.

There's the one (seen an a LTE this morning) about how the plan doesn't apply to Congress, even though Congresspeople get their benefits through their employers, and, like all other employer-provided insurance in the bill, that's left alone.

There's the one about the feds mandating that everyone get vaccinations, based on the fact that the bill adds a "preventive services" section to another set of definitions in the Social Security Act.

I mean, I could go on for days just on Berry Laker's list alone. It's painful to see so many deliberate falsehoods and misreadings of the bill's language all in one place. (He conveniently offers page numbers, so feel free to download the bill and debunk away over there.)

One last one, though, and it's one we've seen in comments here and elsewhere. (Added: McIlheran used this lie in his lede Friday, citing bogus figures from an insurance-industry funded group.) The bill, HR3200, includes an employer mandate, meaning that all employers must either provide insurance to their workers or must pay a fine of 8% of payroll, which provides subsidies for people who cannot afford to buy into the insurance market (private plan or public option) on their own. The theory goes that since 8% of payroll is far less than what many employers are paying for insurance now, business will dump their employees and take the hit.

This is the dumbest thing I have ever heard.

I mean, I can't call it a lie, because, you know, there's no way to say that it won't happen. But it's an utterly illogical argument.

What's the penalty right now for a business dropping insurance coverage? If you said nothing, you win a prize. Right now, your boss could cancel your health insurance and pay nothing. Nada. Zilch. Zip. Zero. No "fine" at all. In fact, if you quit in protest, there is probably going to be a long line of people ready to take your place (and maybe work for less), unemployment being what it is, so there is no incentive at all for the boss to try to keep you happy.

Yes, many businesses are going ahead and dropping coverage. But that's still the minority. The vast majority of people still get their insurance at work. So how on earth does it make sense to say that companies that are not dropping coverage now when rates are rising and there's no penalty are going to do it in a heartbeat after the bill passes, adds a penalty (and, we hope, holds down rates)? Past behavior is always a good predictor of future behavior, and past behavior suggests that businesses generally don't want to stop offering insurance, even when there is no penalty for doing so.

To be clear: Not every conservative Cheddarspherean is engaging in the lies this way. A lot of them haven't touched health care reform at all, or if they have, they're leaving it up to Paul Ryan. (Ryan has his own problems, of course.) But I wish some of the respectable members of the Right Cheddarsphere would call out some of their own for spreading this crap.

Finally, it's obvious why they're lying: The reality of the health care proposals is not very scary. In fact, there's broad bipartisan support for the bulk of the reforms. However, this is not about getting good reform done. Some of the Republicans have let slip the truth: This is about getting Obama. This is what they want to be his Waterloo. If Republicans can stop this reform--the fiscal and physical health of the nation be damned--then Obama will be weak and broken and they can dance on the grave of progressives' hope. Many of the blogs I linked to about these lies, for example, are presently reveling in a send-up poster of Obama made-up like Heath Ledger's Joker. This is intensely personal for them! So rather than be honest about what's going in the actual language of the bill, they spread these lies and scary stories.

That's why I haven't been writing about health care. How do you debate someone who willfully misrepresents the proposals, refuses to accept facts as facts, and engages in Bizarro-world thinking? You can't. It's all I can do not to rip my remaining hair out in frustration.

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