I. Health Care Myth vs. Facts

HEALTH CARE MYTHS and FACTS ABOUT HR3200
Source: http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/04/13/the-end-of-private-health-insurance-not.aspx

• If passed, 114M Americans are expected to leave private health insurance.
Myth If the bill passes, approximately 114 million Americans are expected to leave private health insurance. Why? Their employers will drop the insurance because the taxpayer-subsidized plan will be 30 to 40 percent cheaper.
Fact Employers will not be able to offer the public option exclusively. They will instead be able to buy into an exchange where they can offer employees more than one option, including the public option. This is what all Federal employees already have.

• It will eliminate private insurance and employer-sponsored coverage.
Myth The public option will eliminate private insurance and erode employer-sponsored coverage.
Fact The House bill actually increases the number of people who receive coverage through their employer by 2 million (in 2019) and shifts most of the uninsured into private coverage.

• You can’t get private insurance through employer.
Myth If you don’t have private insurance the year that this bill is passed, you can’t get that later on from your employer.
Fact The bill says nothing of the sort.

In fact, section 311 of the tri-committee House health care reform bill allows employers to meet coverage requirements by offering employees “coverage under a qualified health benefits plan (or under a current employment-based health plan.

The bill defines a “qualified health benefits plan” as “a health benefits plan that meets the requirements for such a plan under title I and includes the public health insurance option.” Title I of the bill does not prohibit employers from enrolling employees in private plans.

• The Public Option will drive private insurance out of business.
Myth The Public Option with Drive private insurance out of business.
Fact The report by the nonpartisan Congressional Budget Office said the public option proposed by Democrats would not drive private insurers out of business and most people would still choose to get their medical coverage through employers. Republicans often Site the Lewin Group as a source to propagate this myth. See Lewin Group information here at Myth 8

Lewin Group, which is a wholly-owned subsidiary of UnitedHealthCare

Any individual insurance policy (as opposed to a group insurance policy) that is in effect today will be permitted to remain in effect; however, any new [individual] policies issued after the law becomes effective will be required to comply with the standards set out in the section relating to policies offered via the new Health Insurance Exchange. It’s grandfathering, not elimination.

• Taxpayers will pay for abortions
Myth A Government-run Plan mandates use of taxpayer money to fund abortions.
Fact 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, similar to all other coverage decisions.

Further, Representative Lois Capps introduced an amendment to prohibit abortion under the minimum benefits package (see source link 2). The minimum benefits package is the basis upon which the public option is formed. Rep. Capps’ amendment was adopted by slim margin (30-28). It also contains provisions to align the language with existing state notice and consent rules.

Finally, none of the health care reform proposals pending in Congress would prohibit PRIVATE insurers from covering abortions, as they currently do.

• It will outlaw private coverage.
Myth It will ban private health insurance for individuals. Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.
Fact It doesn’t outlaw private insurance. “There will be individual policies available, but people will buy those policies through the national health insurance exchange,” she said. 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. The line the editorial refers to is a clause that says the health insurance companies cannot enroll new people into the old plans.

Individual private health insurance means coverage that someone buys on his or her own from a private company. In other words, it’s for people who can’t get coverage through work or some other group, and the rates tend to be much higher.

Background: Page 16 defines what coverage will be considered “grandfathered coverage”; that is, coverage in existence today which would not be in compliance with new standards imposed by the law.
What it says: Any individual insurance policy (as opposed to a group insurance policy) that is in effect today will be permitted to remain in effect; however, any new policies issued after the law becomes effective will be required to comply with the standards set out in the section relating to policies offered via the new Health Insurance Exchange.
What it does: The purpose of the provision is to bring policy offerings into line with the minimum benefit tiers and provisions required under the new law.Ref. US Health Crisis
Cost/Taxes

• Illegal immigrants will be covered by ObamaCare.
Myth 5.6 Million illegal immigrants will be covered by ObamaCare.
In another form: All non-US citizens, illegal or not, will be provided with free healthcare services.
Fact Illegal immigrants are specifically excluded from coverage. Of course, this means that they will be continue to get their healthcare from expensive emergency rooms, so that may not actually be a good thing.

The section on page 50 of HR 3200 aligns Health Insurance Exchange policies with other laws currently in effect, such as the Public Health Service Act, State law, and ERISA. Health care cannot trump other laws already in effect.

” 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.” (see the second source)

Both the House and Senate versions of President Obama’s health care reform plans contain passages explicitly excluding illegal immigrants from receiving federal money to purchase health insurance from either a private or government-run health plan.(see 3rd source: CNSNews)

• It’s too expensive for people to afford.
Myth It’s too expensive for people to afford.
Fact Rates are set based on income as it relates to the poverty level. From the bill itself (HR 3200) :
income levels as a percentage of poverty:
 133% through 150% pay 1.5% – 3% of income
 150% through 200% pay 3% – 5% of income
 200% through 250% pay 5% – 7% of income
 250% through 300% pay 7% – 9% of income
 300% through 350% pay 9% – 10% of income
 350% through 400% pay 10% -11% of income

• Healthcare reform (including public option) will bust the budget.
Myth Healthcare reform (which includes a public option) will bust the budget.
Fact The actual number will be about $24B/yr, which could be eliminated by some more tweaking. On top of that, there would be tax savings by reducing the amount of ER-provided healthcare, which ends up being paid for by all of us. The CBO has also reported that the House plan is budget neutral and will create a 6 billion dollar surplus

• The proposed surcharge on taxes is burdensome to Americans.
Myth The proposed surcharge on taxes to the wealthiest Americans to help pay for this is burdensome. People also cite this myth as a tax on the middle class.
Fact This actually is referring to the wealthiest of Americans.

The surcharge is on the amount OVER $350K/yr that a family makes, not on their entire income. So if a family makes $400K/yr, they are paying a surcharge of 1% on $50K. That’s only an additional $500.00

• Covering everyone will cost a lot of money.
Myth Covering everyone will cost a lot of money.
Fact On the contrary, keeping people healthy will save money.

The cost gap between the United States and Canada has only widened since 1993, and per capita health care expenditures in the United States are now almost double those in Canada ($6,401 vs. $3,359). Canada’s per capita health expenditures rose about 65% from 1993 to 2005, while costs in the United States rose by over 90%.
Yet infant mortality in the United States is higher and life expectancy at birth is less than in Canada. It is also noteworthy that despite Canada’s much lower expenditures on health care, Canadians consult with physicians far more often than do Americans. The average number of physician consultations per capita was 6.0 in Canada, versus 3.8 in the United States.

• Employer-provided health insurance is cheaper than a public option.
Myth Employer-provided health insurance is cheaper than a public option.
Fact The amount an employee pays is less than half of the total cost. What the employer pays is really just the amount that they aren’t paying you because they’re paying your share. It’s still a hidden cost.

• Healthcare & Bankruptcy in America are isolated issues.
Myth Healthcare and bankruptcy in America are isolated issues. One has very little to do with the other.
Fact This year, an estimated 1.5 million Americans will declare bankruptcy. Many people may chalk up that misfortune to overspending or a lavish lifestyle, but a new study suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills. Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007.

• Administrative costs for Health Care Reform will be too much.
Myth Administrative costs will be too much, thus rendering Health Care Reform ineffective.
Fact Blue Cross of Massachusetts employs more people to administer coverage for 2.5 million people in New England than are employed in all of Canada to administer single payor for 27 million Canadians.

Under our current system, the United States has $480 billion in excess spending each year in comparison to Western European nations that have universal health insurance coverage. The costs are mainly associated with excess administrative costs and poorer quality of care.

In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita. Since then these costs have been rising. We already have enormous administrative costs. Health Care reform is another way to address this. By cutting Administrative costs, it makes insurance less expensive to Americans. Currently costs are passed onto consumers in the form of higher insurance premiums.

• Health Care & Home Foreclosures are isolated issues.
Myth Health care reform and our current housing crisis are not related to one another.
Fact Study shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.

About 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs.

• National security is more important than healthcare.
Myth Health Care reform would take valuable taxpayer money away from our nation’s defense spending. We must make sure we are secure, first.
Fact Health care spending is 4.3 times the amount spent on national defense.

• More Tort Reform will cut health care costs.
Myth Tort reform is a way to cut costs in our current health care system. If we cut medical malpractice suits, the Doctors will not have to pay such high malpractice insurance. Capping the amount of money medical malpractice victims can potentially collect for noneconomic damages will directly reduce malpractice insurance premiums
Fact Tort reform has not led to health care cost savings for consumers. If anything, it has led to less civil rights for citizens with no appreciable result in lowering the cost of malpractice s

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7 Responses

  1. Thank you for the post. It is nice to see someone else who sounds like they may have actually read the bill. I’m not particularly for the healthcare bill as it now stands, but I hate to see all the mis-information out regarding it. My blog is also covering the bill. I’m detailing what it actually says, plus I have a page there that has the Stephen Fraser MD email which has so many erroneous statements in it. In the same type of format you have here, I’ve put what the bill actually says for each issue. This is at http://www.FaithfulinPrayer.wordpress.com

    I believe they should have had a committee put together this bill. It should have been made up of an equal number of democrats and republicans along with physicians, hospitals, insurance companies, insurance commissioners, medicare, medicaid, employers, etc. This way more people may have bought into it.

  2. MYTH
    The federal government has a mandate to, or the Constitutional authority or the ability to efficiently implement and manage a health INSURANCE program.

  3. I support this initiative because, morally, we must work toward providing care for all. And I salute President Obama for taking this issue head-on. We wouldn’t be having this discussion without his leadership.

    But we need to do more than “tweak” this bill to create the culture change that moves our nation fom “sick care” to true “health care.” Four key areas of change:
    (1) Put health care decisions, including health coverage, in the hands of the consumer. Move away from employer-sponsored insurance and toward greater consumer choice, which leads to greater consumer awareness and education.
    (2) Make nonprofit hospitals, systems and insurance companies more accountable to their communities. Encourage them to “think globally” by developing regional delivery systems from primary care through crisis intervention and hospice whose decisions are based on what’s best for patients and the community overall, rather than what satisfies an individual administrator’s or physician’s desire for the latest shiny toy.
    (3) Stop subsidizing tobacco and sugar. This is an oversimplification, but we must take control of — and responsibility for — lifestyle decisions that have devastating consequences for both physical health and the costs of health care.
    (4) Continue the drive toward electronic records and the usability of data. Crucial!

  4. Donna I agree with you on your major points but would “tweak” them as follows. We do need to do more than “tweak” this bill, We need to trash this bill and look at reforms that truly addresses the problems in the current system.

    (1) Put health care decisions, including health coverage, in the hands of the consumer. Move away from employer-sponsored insurance and toward greater consumer choice and consumer control over his/her insurance policy and coverage options. Health insurance coverage should be
    available similar to auto, home owner and life insurance coverage.

    (2) Make nonprofit hospitals, systems and insurance companies more accountable to their communities. Encourage them to “think globally” by developing regional delivery systems from primary care through crisis intervention and hospice whose decisions are based on what’s best for patients and the community overall, rather than what satisfies an individual administrator’s or physician’s desire for the latest shiny toy.
    I think your right about accountability and the best encouragement would be for payment to them to come directly from the consumers in a competitive market, rather than a third party payer such as an insurance company or the government who are total disconnected from the patient and the cost. They’re entitled to all the shiny new toys they can afford in a system that rewards results and customer satisfaction.

    (3) Stop subsidizing tobacco and sugar. This is an oversimplification, but we must take control of — and responsibility for — lifestyle decisions that have devastating consequences for both physical health and the costs of health care. Great point.

    (4) Continue the drive toward electronic records and the usability of data. Crucial! Good point! as long as individual
    privacy issues are addressed.

  5. Very good article I enjoy your site keep up the amazing articles

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