Myth vs. Fact

Fact Checking Sites:

Annenberg Public Policy Center

FactCheck.org

More Malarkey About Health Care

Jo Ciavaglia's Blog

Healthcare Reform Myths

Politifact

Articles

5 Myths and Facts about Medicare -- In Pictures - Beat

Busting Health Care Reform Myths - AARP

Don’t Let Health Care Myths Hide the Truth - AARP  

Regarding Impact on Small Businesses - Maggie Mahar’s blog

Regarding Insurance Company Windfalls - Maggie Mahar’s blog

Regarding Medicare and Medicaid Payments to Hospitals - Maggie Mahar’s blog analysis

Seven Concerns About The New Health Law - Kaiser Health News

Sorting Fact from Fiction on Health-Care Reform - Bloomberg Businessweek

Nine Top Myths vs. Facts

By now, it should be clear that health reform will not impose death panels, cover illegal immigrants, and pay for abortions. But here are some other myths that need a reality check.

1. The health reform bills will bring socialized medicine. False. Socialized medicine means the government employs health care providers and runs their organizations. Britain's system is socialized. Canada's is single payer (like Medicare): the government pays, but providers are separately employed and compete for business.
   
   
2. Foreign countries, with more regulated systems, are less efficient and have worse care. False. Our very mixed system (employer plans, Medicare and Medicaid, individual policies, etc.), with hundreds of insurance carriers, network contracts, managed care rules, and infinite variety of plan designs is must less efficient. About 20-30% of our total costs are for administration, including costs at hospitals and physician practices for billing clerks and doctors dealing with insurance companies. For example, physicians spend an average of 142 hours per year directly dealing with insurance companies (Commonwealth Fund study, May 14, 2009). Other countries' systems are more uniform, with much tighter regulations. Canada spends 6% of its costs for administration, France 4%, Taiwan <2%. Most advanced countries spend half to 2/3rds of what we spend on all costs and have better outcomes (life expectancy, childbirths without complications, etc,). Per T.R. Reid of the Washington Post, "Japan spends $3,400 per person annually on health care; we spend >$7,000."
   
   
3. Cost controls stifle innovation. False. Per T.R. Reid, "Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs." In the US, an MRI scan of the neck costs about $1,500. In Japan, it's $98. "Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)"
   
   
4. In other countries, you have to wait a long time for care. False. Per T.R. Reid again, "Canada makes patients wait weeks or months for non-emergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries." A 2009 survey of US physician appointment wait times in 15 metro areas showed an average time of about 20 days (4 weeks) for family practitioners and 5 specialty areas.
   
   
5. Health reform will ration care. False. Care is already rationed by insurance company plan designs, managed care rules and specific provisions on covered and excluded expenses, not to mention, benefit maximums, limited provider networks, rescission, pre-existing conditions limits, and unaffordable costs that force people to go without coverage or pick high deductible plans and defer care when they get sick. Comparative effectiveness research and best practice guidelines are just to inform doctors and patients about what works best and to provide options. Not having these resources drives up costs and wastes.
   
   
6. Reform will cut Medicare benefits. False. It doesn't touch current benefits and improves drug benefits.
   
   
7. We can't afford to cover the uninsured now. False.
   a. Yes, covering them costs money, but we already pay for 37% of their costs from hospitals and doctors shifting their costs in rates charged to other plans (Milliman 2009 study for Families USA). Providers absorb only 26% of the costs and the uninsured pay for another 37% themselves (at full "list rates").
   
   b. The total annual cost of health care is now $2.5 trillion. Covering the uninsured will only add a $100 billion per year, or a trillion over 10 years. But many studies (e.g., McKinsey & Co., Dec. 2008) have found that about 1/3 of our total costs are excessive or wasted dollars ($650 billion/year for 2006, including $91 billion for excessive administrative costs). If we can even cut some of these costs, we can easily cover the uninsured.
   
   c. In evaluating proposals, the Congressional Budget Office (CBO) only measures hard dollar costs and savings (e.g., reducing benefits, increasing taxes). It doesn't "score" potential savings from changing provider payments and efficiencies from electronic records and streamlined insurance administration.
   
   
8. The Massachusetts reform program, launched over 2006-07 is a failure. Partly. The program greatly reduced the number of uninsured to under 3% (vs. >15% nationally) and did not initially attempt to tackle excess costs (but will now). Still, costs within the health exchange have been held to 5 percent annual increases. Employers have a coverage mandate but could drop it and pay a modest penalty. But more employers have chosen to provide coverage, partly due to worker requests.
   
   
9. We don't need a public plan – insurance companies provide enough competition. False. According to the AMA, 94% of insurance markets are highly concentrated, due to mergers - there's little or no competition.