Refuting the anti-reform myths

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By Consumers Union on Tuesday, March 16th, 2010

We’ve spent a lot of time responding to the myths about health reform legislation — in part because they’re so pervasive in the public realm, and in part because they’re continually repeated by the opposition in their effort to kill reform.

Our health policy analysts Lynn Quincy and Steve Findlay address some of the biggest myths over at Health Affairs blog, including the oft-repeated claims that reform will destroy Medicare, will bust our budget, and should be slowed-down and done in small bits.

Below are their fact-based responses to those myths, and make sure to read their responses to the entire list here, including other false claims that reform is a government-takeover of healthcare and doesn’t address rising health costs.

It will destroy Medicare.This is a distorted and disingenuous allegation. The legislation seeks to reduce Medicare spending by roughly $500 billion over the next decade, compared to current projections. But Medicare spending is not “cut” at all. If the Senate bill becomes law, Medicare spending will still rise from an estimated $517 billion in 2010 to $896 billion in 2019, according to the forecasters at CMS. That’s about 10 percent less than would happen if the Senate bill does not become law. Almost all that 10 percent comes out of inefficient programs (such as Medicare Advantage). The legislation also puts the federal government in the lead of reforming a health system where at least 20 percent (the estimates go up to 30 percent) of expenditures are wasted on inefficient or wasteful medical services. In addition, the legislation strengthens Medicare in many ways: adding new preventive care benefits, reducing the size of (and perhaps elim! inating) the Part D drug benefit doughnut hole, and, according to both the CBO and the CMS actuaries, lengthening by almost ten years the time before the Medicare Hospital Trust Fund dips into the red.

It spends $1 trillion we don’t have and will bust the budget. The trillion-dollar expense has been cited out of context for the entire year of debate. Bear this in mind: as a nation, we’ll spend a projected $35 trillion on healthcare from 2010 through 2019 without health reform. If we were really adding a trillion more dollars in that ten-year period, that would add 3 percent to the $35 trillion. However, the respected number crunchers at the Centers for Medicare and Medicaid Services Office of the Actuary estimated in January that the legislation would actually increase national health spending over the next decade by just 0.6 percent because it reduces wasteful spending, mostly in Medicare. Also, 90 percent of that $1 trillion in new spending is allocated to helping people buy coverage: expanding Medicaid and tax subsidies to help ! families buy private health insurance. What’s more, this new spending is paid for and, according to the Congressional Budget Office does not add to the federal deficit.

Incremental would be better. And let’s slow down, too.Twenty-five years of incrementalism has not solved our core problems—in fact, they’ve gotten worse during that time. In addition to both the rising number of uninsured and soaring costs, the delivery of care today is more fragmented than a decade ago, with little or no reduction in the risk of harm to patients from poor quality and service. That said, some incrementalism is appropriate, and we believe this legislation includes it. For example, we think it’s a good idea to proceed deliberatively and incrementally, and based on evidence, when it comes to changing the way doctors and hospitals get paid, in order to insure against disruptions. But incrementalism that expands coverage to three million people over the next decade is pointless; it’s not incrementalism, it’s token reform.

There is also one argument we find particularly compelling: virtually every major federal healthcare program that has been enacted over the last fifty years—from Medicare and Medicaid to COBRA, SCHIP, and the Medicare Part D drug benefit—has improved the health, financial security, and well-being of the U.S. population and, ultimately, has been embraced and supported by the public.

Many of these programs were politically contentious and took years to enact. But today, few people outside Washington and health policy circles remember or care about the political blood on the floor, how many pages the bill was, or the final vote tally. All they know is that they gained new options and benefits. In the end, it’s not about the political process; it’s about programs and policies that make people’s lives better.

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