Sunday, October 24, 2010
Health Care and the Campaign - NYTimes.com
Republican candidates and deep-pocketed special interests are spreading so many distortions and outright lies about health care reform that it is little wonder if voters are anxious and confused.
Here are a few basic facts that Americans need to keep in mind before they go to the polls, and afterward. First, most aspects of the reform do not go into effect until 2014. Second, things are indeed bad out there: The costs of medical care and insurance premiums are (still) rising, and some employers are (still) dropping coverage. But for that, you should blame the long-standing health care crisis and the current bad economy. Health reform is supposed to help with these problems.
Here is a look at the claims being made on the campaign trail — and the distortions they contain:
PURE NONSENSE: John Raese, the Republican candidate for the Senate in West Virginia, is claiming that the law will require patients to go through a bureaucrat or panel to reach a doctor. That is flat out untrue. You will still choose your own doctor or insurance plan without interference. Nor, despite other claims, will the law provide subsidized insurance to illegal immigrants. They are precluded from using even their own money to buy policies on new exchanges.
The Obama administration will not be compiling a federal health record on all citizens, including each individual’s body mass index, as Ann Marie Buerkle, a Republican running for a House seat in upstate New York, has claimed on her Web site. The administration is offering incentives to doctors to record various vital statistics in electronic medical records and report the data in the aggregate, to help understand national health trends.
WE CALL THAT CAPITALISM: Republican politicians never tire of denouncing health care reform as a “government takeover” — or socialism. What is true is that the law relies heavily on private insurers and employers to provide coverage. It also strengthens regulation of those insurers and provides government subsidies to help low- and middle-income people buy private insurance on the exchanges.
Those exchanges will promote greater competition among insurers and a better deal for consumers, which last time we checked was a fundamental of capitalism.
WHAT ABOUT MCDONALD’S? Conservative commentators pounced after the fast food chain and several other large employers that provide skimpy, low-cost policies to their workers warned that they might drop their health plans entirely if forced to comply with the new law. They particularly objected to a requirement that they begin raising the low annual limits on what their plans are willing to pay for health care.
In response, the administration has granted some 30 waivers for one year (Rush Limbaugh promptly accused the administration of allowing these employers to “break the law”) and has signaled willingness to smooth out other bumps on the road toward full reform. In 2014, all plans will have to meet minimal standards and large employers will have to provide coverage or pay a stiff fine.
WHAT ABOUT MY PREMIUMS? Some Republicans are also claiming that health reform is driving up premiums. There have been sharp increases in some states, primarily in response to soaring medical costs. Some insurers may also be trying to increase their profits before the reform law holds them in check. A few very welcome provisions that take effect early, like requiring insurers to cover preventive care without cost-sharing, will play a minor role in premium increases for next year.
Reform has also energized federal officials and many state regulators to challenge and force down big increases sought by insurers. The Justice Department just filed suit against Blue Cross and Blue Shield of Michigan for allegedly using its market power to drive up costs for its competitors and its own subscribers.