Whew! It only took three weeks longer than expected to complete the copy edits for my upcoming book, get permissions to use quoted text, figures and tables, revise or remove the figures, tables and text for which permission couldn’t be obtained (or cost more than budgets would allow), and document everything in tracking spreadsheets and file folders. In light of this experience it’s easy to understand why it’s easier to most politicians and pundits just make things up when they decide to weigh in on a topic.
Speaking of making things up, the most interesting piece of healthcare news I’ve seen recently is here: a leaked presentation of “research findings” that is meant to guide Democratic candidates on how to sell their newly passed healthcare reform law to voters. The answer seems to be by backing away from it and claiming that it can “be improved”.
Doesn’t that imply that you created something that wasn’t very good in the first place?
Lord knows, Americans can be forgiven for thinking that they were supposed to be getting a sweet deal when the “Patient Protection Act” healthcare reform bill was passed earlier this year. After all, this is the legislation that Vice-President Biden excitedly characterized as “A big f***ing deal”. President Obama recently assured us that “reform has actually added at least a dozen years to the solvency of Medicare — the single longest extension in history — while helping to preserve Medicare for generations to come.” And a spokesman for House Speaker Nancy Pelosi recently claimed that the new healthcare law “could create 250,000 to 400,000 jobs a year”. Presumably in the same way that hurricanes create lots of jobs in the clean-up and construction industries.
But it seems as if reality is finally catching up to the rhetoric that was originally used to sell this legislative lemon. I’m one of the most non-partisan people you’ll find, being equally discouraged and disgusted by a lack of common sense and honesty on the part of both Democrats and Republicans. But the assertions used by President Obama and the Democratic leadership in selling this 2,400+ page monstrosity have gone above and beyond the call of duty. These folks had their minds made up, and didn’t wish to be confused, restrained or even influenced by facts.
The all-encompassing nature of the deception was well documented a couple of weeks ago by Mary Katharine Ham of the Weekly Standard and Townhall political editor Guy Benson. Together they researched and wrote an extensively researched and linked article entitled “ObamaCare: The sum of all fears”. It’s well worth reading. In it they document the fallacy of eight of the most prominent promises made by the President and others who had a hand in creating this law. These include:
- If you are satisfied with your existing health care arrangement, you can keep it.
- That this reform will lower America’s health care spending.
- That this reform will lower Americans’ health care premiums.
- Obamacare will not lead to a doctor shortage, or escalate the primary-care physician shortfall.
- There will be no government rationing of medical care.
- “The firm pledge” – Ninety-five percent of Americans will not see any form of tax increase because of Obamacare (or anything else).
- Health care reform won’t add “a single dime” to the deficit—and will actually cut it.
- Health care reform will help businesses—employers and employees, alike.
My particular favorite piece of contradiction is the video here of the President arguing vigorously that a mandate to buy health insurance was not a tax,
only to have his own Justice Department argue a few months later that – not only is it a tax, but that makes it immune from lawsuits that have been filed based upon the individual mandate portion of the law. To quote the New York Times story on this:
“When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”
And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.
Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.”
Why on Earth do we Americans allow our politicians – of any party – to get away with this sort of dishonesty? It is unrestrained doublespeak like this that has helped turn healthcare into hellthcare over the past twenty years.
But back to the new “modern”, post-PPACA “talking”, er, “ducking points”. What are they and why are they designed this way?
The presentation is based upon polling and focus-group research conducted by Herndon Alliance Research between April and August of 2010. It points to a “challenging environment” for supporters of the PPACA legislation. What makes it challenging?
- “Straightforward ‘policy’ defense fails to be moving voters’ opinions about the law.
- Public is disappointed, anxious and depressed by current direction of the country – not trusting.
- Voters are concerned about rising health care costs and believe costs will continue to rise.
- Women in particular are concerned that health law will mean less provider availability – scarcity an issue.
- Many don’t believe health reform will help the economy.”
Why, voters don’t seem to trust their political leaders anymore! How strange that this should be the case after the passage of a healthcare proposal that does none of the things that its proponents said that it would do.
The recommended course of action as result of this mess? To focus on the goodies and ignore any potential costs or consequences. Simple, folksy, “personal” stories that ignore the big picture are the tool of choice. Here’s the example provided by the consultants:
“My name is Lindsay. I’m 23 years old and I have a 6 year old son named Jacob who has asthma. We got our health insurance from my husband’s employer, but he lost his job recently. He found a new job that pays OK, but his new health insurance company will not give Jacob coverage because he has a pre-existing condition. I wait tables too, but we just can’t afford to pay medical expenses out of pocket. I know that new health insurance law isn’t perfect, but starting in September, it will be illegal for insurance companies to deny children with pre-existing conditions healthcare coverage. I can’t tell you what a relief it is to me that Jacob will get the care that he needs. I really hope this new law does not get repealed.”
This is a touching story, and it should be possible to obtain health coverage without regard to pre-existing conditions. But how much is Lindsay going to have to pay for Jacob’s insurance given the way this law was structured? Does she know that having Congress remove any sort of cap on benefits will mean that she and her husband could be stuck with helping to pay for someone else’s $10 million hospitalization? Was she told that all of the new government departments, rules and regulations would increase the cost of care for everyone, while further alienating Jacob’s doctors? Of course, that’s if she can find a doctor for Jacob at all. The Association of American Medical Colleges is now projecting a shortage of about 150,000 primary care physicians over the next ten years. With tens of millions of new patients being added to the Medicaid program by 2014, many patients will have trouble finding a doctor much, much sooner.
The consultants are also careful to provide of list of things that shouldn’t be said:
- Don’t assume the public knows the health reform law passed or if they know it passed understand how it will affect them. [Ed. note: I can pretty much guarantee that no one is going to truly understand all of the ways in which this law is going to affect them. Not even the people who wrote the law…];
- Don’t list benefits outside of any personal context;
- Don’t barrage voters with a long list of benefits [Ed. note: That would, of course, assume that one could actually come up with a long list of benefits.];
- Don’t use complex language or insider jargon;
- Don’t use heated political rhetoric or congratulatory language;
- Don’t say how the law will reduce costs and deficit.
This last point is perhaps the most important because, of course, the law really won’t reduce costs or the deficit. But Lindsay doesn’t need to know about that either. After all, it’s Jacob who will be footing the bill.
The hellth of it is that it didn’t have to be this way. In passing this legislation and signing it into law, our elected Leaders made a conscious decision to push a healthcare reform plan that was designed for bureaucrats, by bureaucrats. The bill’s framers either didn’t know, or didn’t care about what’s really wrong with the current healthcare system or why. It’s doubtful that they asked a single practicing physician – or people who work with practicing physicians – for input along the way. Instead, the emphasis was continuously focused on buying votes and imposing more bureaucratic controls on an industry that has been more shaped and damaged by thoughtless bureaucracy than any other.
They did this because they could, and because it matched the way they believe medicine should work, rather than the way in which it really does. They did it without regard to whether it was sound medical or economic policy. And they voted like sheep, right along party lines; regardless of the best interests of the people they ostensibly represent.
The least they can do now is take full, complete and unadulterated credit for it.