Open Wide and Say, AHA!

English: Barack Obama signing the Patient Prot...

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

Few events in American life are more controversial than healthcare reform, the Affordable Care Act, also known as “ObamaCare”. The prejudice against it from the right has been so intense and prolonged that the mere term became a pejorative on sites like Fox News and myths about it began to flourish. I was pleased then to read in a recent (October/November 2012) issue of AARP magazine some good journalistic research putting some of these myths to rest. In hopes of foiling some of the nonsense, and for all you young people out there who haven’t reached AARP age yet, here’s a summary of most of the points made.

Myth: The new law cuts Medicare drastically, so I won’t be able to get quality health care.
Truth: The ACA prohibits cuts to guaranteed Medicare benefits. Its provisions include measures to hold down costs, cut fraud and abuse, and encourage preventive care to avert chronic conditions like diabetes and heart disease.

Myth: “I’ll have to wait longer to see my doctor — or I won’t be able to see my doctor at all.”
Truth: If your current plan allows you to see any doctor in the plan, nothing will change, and many of the ACA’s provisions are aimed at improving quality of care, including some that encourage more physicians to become primary care doctors.

Myth: “If I have Medicare, I will need to get more or different insurance.”
Truth: Not true, Medicare stays the same and there’s no requirement for you to get more coverage.

Myth: What about the statement that the new law “raids Medicare of $716 billion?
Truth: AARP is too polite to accuse Mitt Romney of lying, but this statement is not true. The non-partisan Congressional Budget Office recently “estimated that the changes to Medicare in the ACA will reduce spending by a total of $716 billion between 2013 and 2022, which is where the number comes from. Most of this comes from changes to provider payments and correcting overpayments to insurance companies that offer private Medicare plans. These savings are to be used to pay for free preventive care, to close the prescription drug “doughnut hole”, and to increase coverage for the uninsured.

Myth: The law is going to bankrupt America.
Truth: The nonpartisan CBO and the nonpartisan Joint Committee on Taxation say that’s not only false but that the ACA is estimated to save taxpayers more than $200 billion over the next nine years.

Myth: The new law will drive up premiums astronomically.
Truth: Nobody has a crystal ball but it’s clear that bringing the 18 to 29 age group into the plan is going to help subsidize it for less healthy people. This is going to be vastly more efficient than private insurance. Just consider, by already having required private market insurance companies to rebate premiums that exceed 80 to 85 percent of actual costs, approximately “12.8 million Americans received an estimated $1.1 billion in rebates. (I have read elsewhere that between 20 and 30 percent of every healthcare dollar in the private insurance system is eaten up by administration.)

Myth: If I can’t afford to buy health insurance, I’ll be taxed – or worse.
Truth: The law provides exemptions for hardship, and even beyond that there are no criminal penalties. At the most extreme, the IRS will withhold unpaid premiums from tax refunds.

Myth: I’m a small business owner and I’ll pay big fines if I don’t provide health insurance to my employees.
Truth: Penalties apply only to companies with 50 or more workers. Further, there are tax credits available to ease the burden, up to 50 percent of their cost of covering their employees.

Myth: The ACA basically turns our healthcare system into universal care. So now some government bureaucrat will decide how and when I get treated.
Truth: The ACA broadens the insurance base by extending it to the majority of Americans, it does not convert it to a government system. Private plans and employer plans continue. The choice of plan is not dictated and consumers will choose their providers. The big thing is having more people covered.

Myth: If my state doesn’t set up an insurance exchange, I can’t get health coverage.
Truth: If one’s state doesn’t do it, the federal DHS will.

Government can do a lot for people and there is a huge difference when an organization has as its goal doing what science says is right for good health as opposed to maximizing profit. The ACA is already influencing the system toward better health, although it’s ultimately not going to solve the core problem, excessive cost. Only a single-provider government system can do that. But until an educated public can overcome its entrenched prejudice, and unless Grover Norquist drowns it in his bathtub we will have ObamaCare.  It is making real progress and its purpose is not to exploit but to help.

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About Jim Wheeler

U. S. Naval Academy, BS, Engineering, 1959; Naval line officer and submariner, 1959 -1981, Commander, USN; The George Washington U., MSA, Management Eng.; Aerospace Engineer, 1981-1999; Resident Gadfly, 1999 - present. Political affiliation: Independent, tending progressive as the GOP recedes from its Eisenhower roots.
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12 Responses to Open Wide and Say, AHA!

  1. jwhester says:

    Thanks for this. Unfortunately these myths are petrified in the minds of many, and only after many years of ACA in effect will these fears diminish for many who consume right-wing media.

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  2. Bravo, my friend. Everyone, including Democrats (so they can explain it to others), should read this informative summary. Well done.

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  3. Very good! I should actually open and read the AARP instead of tossing it onto the hearth where it soon gets covered by the other magazines we don’t find time to read. I’m glad to see this.

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    • Jim Wheeler says:

      Right, Helen, it’s easy to think of the AARP magazine and bulletin as institutional propaganda but my clear perception over the years is that they produce lively and often controversial, up-to-date articles to the highest standards of journalism.

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  4. Thanks for this, as I draw dangerously near that AARP threshold. (Yep, I turned the big 5-0 in December. I’m now officially an old fart! 😉 😀 )

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    • Jim Wheeler says:

      Alas, John, it is all too easy to avoid the thought that one will enter that stage of seniority. Welcome to the geezer ranks! I hope that you will find some solace, as did I, in knowing that it is not the end and that you have lots of company. Lots, and that includes bundles of Boomers soaking in semi-selfdenial. AARP is a high-class outfit and one of the strongest lobbying groups in the country; Congress knows that geezers vote.

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  5. As an aside, I add that the law provides immense protection and expanded coverage for women’s health. As a female, it is reassuring to know that my annual exams (that screen for breast cancer, cervical & uterine cancer, etc) are now a guaranteed protective service (I paid a copay, many of my friends had to pay $100’s of dollars out of pocket for this exam and many would just forgo it due to costs). It also guarantees women the right to delay and space out childbirth (key for limiting the number of women and children in poverty, allowing women to finish their education, and allowing families and women, not insurance companies, to determine a woman’s sexual health). Many men are unaware of the limitations put on women’s health (especially reproductive health) simply because y’all are note exposed to it! Trust me, for women this is a huge victory.
    As we see free and lower-income women’s health clinics (primarily Planned Parenthood, but there are others) disappearing across the country (there are only 820 PP facilities in all 50 states, imagine driving 200 miles and staying in a hotel to get your pap smear?!), this is KEY for access to women’s health services.

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    • Jim Wheeler says:

      Thank you, Jen, for this comment. As an intelligent, educated and thoughtful young woman, your opinion on this carries far more weight than mine ever could. There are an infinity of possible futures for our country exploding every microsecond with the butterfly effect and one of them derives from a future firmly grounded in the beneficent public healthcare you describe. I only hope you and I have made a contribution to promote it here.

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  6. ansonburlingame says:

    To all,

    Sorry to again rain on the parade, at least to a degree. But here goes.

    The AARP is a political lobbying organization that has long sought HC of all sorts for people at 50 years of age and older. That is the mission, in part, of that organization. Just try to “touch” Medicare as we know it in all its ramifications and AARP works hard to prevent that from happening as a political lobbying organization.

    Based on several years of watching and participating in the HC debate in America I have read all sorts of different sources, including blogs. One thing for sure that I learned several years ago is that ACA in no way tried to affect Medicare as we know it. To do so would have a been a political time bomb that counters every effort by the Dem Party to increase the coverage of HC for all Americans.

    So in Jan 2013 to post a link to an AARP article written during the Presidential campaign (Sept 2012) promoting support for ACA is like reading an article written by a national lobbying organization trying to promote “new energy policies”. My point is simply that there are always two sides to a poltical argument and to pick a lobbying article and promote it as “ground truth” supporting only one side is disenginuous to say the least.

    Just read the above on one point. ACA cuts payments to providers by $716 Billion over ten years. SOME of that money comes out of the pockets of Doctors, Hospitals, etc. the people performing the services. But that money is not saved for deficit reduction. It is then used to pay for other Medicare services or ACA services. NET result is more services are provided but NO savings is gained. Once again money is taken from “Peter” to pay “Paul”. That is not deficit reduction; it is traditional redistribution of money using the power of the government.

    Finally, I have NO objection at all with increasing HC coverage for all Americans as a primary goal. BUT, I also demand that such increases be paid for and stop the incessant borrowing for every “need” imaginable. Some medical needs are more important than others but politicans cannot make such judgements and hope to be reelected.

    Welcome to the world of progressive socialism, American style, a goal sought by the majority of Americans today. Now go read and link an article written by a “learned physician” who is going to get out of the medical practice because he cannot afford to practice any longer. As well note previous blogs written by yours truly, reporting again, egregiously low payments ($66 dollars total for a CAT scan billed at $1780 dollars) AND HIGH ($32,000 dollars for a 30 minute procedure that in turn caused a stroke for the patient) Medicare payments.

    Here is another one for you. A local orthepedic surgeon in Joplin will be paid about $500 by Medicare for knee surgery akin that that which RGIII will undergo today. Considering the years of training and experience and cost of liability insurance for that doctor, do you believe such payment to him is “fair”. Again, welcome to progressive socialized medicine, American style today.

    Finally, go with my wife, if you have the time, to visit a friend in Oklahoma, a life long friend. For 12 months she has been suffering from terminal cancer and is now getting close to the end. Her Medicare bills are for sure in excess of $100,000 at this point, considering extensive hospitalization (months), etc. over the last year or so. Had she entered hospice care six months ago I wonder how many “pap smears” would have been paid for with that money?

    Anson

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  7. Jim Wheeler says:

    @Anson,
    1. AARP is indeed a political lobbying organization, but that in itself says nothing about their integrity, which I believe to be very high.
    2. It is hardly “disingenuous” to note that the ACA uses $716 Billion to expand coverage for millions of additional people rather than sending the money back to the treasury for other spending. After all, the intent of the ACA is to cover more people more effectively and the expectation is that providing the presently-uninsured with preventive care will reduce future illness and hence future costs. If you are against that concept, then I’d like to hear why. By the way, if there are any other items in the AARP article you feel are disingenuous, I’m up for discussing them.
    3. The cost of additional coverage is to be paid for by mandating insurance coverage of most of those not presently insured, a requirement yet to be levied and which is bringing many protests. If it were not for EMTALA, I would protest too, but as a people I submit we are not entitled to both and nobody is going to overturn EMTALA.
    4. If $500 is too little for the orthopedic surgeon, why is he still in the business? Judging by the modern and prosperous orthopedic clinic and hospital I see rising just across the state line near Galena Kansas I would say that most orthopedists are far from starving. Then you bemoan the excessive $100,000 cost of healthcare in the terminal cancer case, so I’m not sure what point you’re trying to make, unless it’s that the present cost structure makes little sense, in which case I agree, and I hasten to add that if it weren’t for the Medicare structure it would be even worse. Someone is sure making big money in the $100,000 case you cite. It reminds me of the guy who sat with Dick Armey on his foundation’s board and who is paying Armey $8,000,000 to retire from it. That guy is the CEO of a for-profit cancer company and that $8 million came out of the pockets of the sick and desperate. A system designed to make a profit will be managed to maximize profit.

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  8. ansonburlingame says:

    Jim,

    As you may have noted, I have more or less withdrawn from attempts to debate liberals on social and defense matters. What is the point becomes the question and for sure such attempts by me anger the liberals and frustrates the hell out of me.

    There is not doubt that a system designed to make a profit will of course “make a profit”. That became the overpowering motivation for the industrial revolution for sure and much that has happened since then in the world.

    But a system that is designed for equality will in turn maximize equality as well. That for sure is the ultimate goal of socialism and communism as well as the less extreme social democracies developed by the west in today’s world.

    So politically, we have “profit” vs “equality” in America today. And the extremes of those positions are ridiculous, at least to me. Go read the letter in today’s Globe bemoaning a salary of about $500,000 for the CEO of Empire and calling for him to only be paid “5 figures” (less than $100,000).

    I submit that writer has NO IDEA the responsibilities of the CEO for “anything”. He as well would probably think that a “collective” of Empire employees could make better decisions.

    Finally, I do not believe AARP has any more “integrity” than any other lobbying organization, at least in general. Lobbyists promote CAUSES, policies to support such causes, like “free” HC for all older Americans (in the case of AARP). And any competent lobbyist organization is going to “go after all the money available”. Hell that is their MISSION, to fund their causes. So to suggest any particular lobbying organization provides real ground truth, in general, is yes, disingenuous, in my view. It would be like me saying Fox News always gets it “right” as well.

    You of course will try to tell me that AARP is far more “honest” than …… Do you say that because you support AARP in general in the cause they promote or do you have a lie detector imbedded in the “system of AARP”?

    Of course I will read things such as the AARP positions on Medicare. I WANT to understand the rational from BOTH sides. But then I TRY to make up my own mind and then write accordingly. You have heard be before on “battling with links” as if MY link is better than yours. More often than not I use a “link” to try to show how “dumb” the opposing positions might be and try hard NOT to use a link to simply show it is ground truth for any political cause. At least that is what I TRY to do, but sometimes, for sure, fall short in such efforts.

    Finally, for me to go line by line over the AARP positions a write to counter most of those lines, well “Henry” would again say that I “write to much”!!

    Anson

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