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The American Medical Association (AMA) releases an 11-minute spoken-word album (LP) featuring actor and promising conservative politician Ronald Reagan. Reagan speaks against what he and the AMA call the “socialized medicine” of Medicare, currently being considered in Congress as part of legislation proposed by Democrats Cecil King and Clinton Anderson; many refer to the legislation as the King-Anderson bill. The AMA, along with most Congressional Republicans and a good number of Democrats, has been fighting the idea of government-provided health care since 1945 (see 1962).
Socialism Advancing under Cover of Liberal Policies - Reagan begins by warning that as far back as 1927, American socialists determined to advance their cause “under the name of liberalism.” King-Anderson is a major component of the secret socialist agenda, Reagan says. “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,” he says. “It’s very easy to disguise a medical program as a humanitarian project.” No real American wants socialized medicine, Reagan says, but Congress is attempting to fool the nation into adopting just such a program. It has already succeeded in imposing a socialist program on the country by creating and implementing Social Security, which was originally envisioned to bring “all people of Social Security age… under a program of compulsory health insurance.” Reagan, following the AMA’s position, says that the current “Eldercare” program, often called “Kerr-Mills” for its Congressional sponsors, is more than enough to cover elderly Americans’ medical needs. (Author Larry DeWitt notes that in 1965, Kerr-Mills will be superseded by Medicaid, the medical program for the poor. He will write, “So Reagan—on behalf of the AMA—was suggesting that the nation should be content with welfare benefits under a Medicaid-type program as the only form of government-provided health care coverage.”) King-Anderson is nothing more than “simply an excuse to bring about what [Democrats and liberals] wanted all the time: socialized medicine,” Reagan says. And once the Medicare proposal of King-Anderson is in place, he argues, the government will begin constructing an entire raft of socialist programs, and that, he says, will lead to the destruction of American democracy. “The doctor begins to lose freedom,” he warns. “First you decide that the doctor can have so many patients. They are equally divided among the various doctors by the government. But then doctors aren’t equally divided geographically. So a doctor decides he wants to practice in one town and the government has to say to him, you can’t live in that town. They already have enough doctors. You have to go someplace else. And from here it’s only a short step to dictating where he will go.… All of us can see what happens once you establish the precedent that the government can determine a man’s working place and his working methods, determine his employment. From here it’s a short step to all the rest of socialism, to determining his pay. And pretty soon your son won’t decide, when he’s in school, where he will go or what he will do for a living. He will wait for the government to tell him where he will go to work and what he will do.” DeWitt will note that this is far more extravagant than any of the Medicare proposals ever advanced by any lawmaker: “It was this more apocalyptic version of Medicare’s potential effects on the practice of medicine that Reagan used to scare his listeners.”
Advocating Letter-Writing Campaign - Reagan tells his listeners that they can head off the incipient socialization of America by engaging in a nationwide letter-writing campaign to flood Congress with their letters opposing King-Anderson. “You and I can do this,” he says. “The only way we can do it is by writing to our congressman even if we believe he’s on our side to begin with. Write to strengthen his hand. Give him the ability to stand before his colleagues in Congress and say, ‘I heard from my constituents and this is what they want.’”
Apocalypse - If the effort fails, if Medicare passes into law, the consequences will be dire beyond imagining, Reagan tells his audience: “And if you don’t do this and if I don’t do it, one of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.” Reagan is followed up by an unidentified male announcer who reiterates Reagan’s points and gives “a little background on the subject of socialized medicine… that now threatens the free practice of medicine.” Reagan then makes a brief closing statement, promising that if his listeners do not write those letters, “this program I promise you will pass just as surely as the sun will come up tomorrow. And behind it will come other federal programs that will invade every area of freedom as we have known it in this country, until, one day… we will awake to find that we have socialism. And if you don’t do this, and if I don’t do it, one of these days, you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.” (Larry DeWitt 9/2004; Beutler 8/25/2009)
The American Medical Association (AMA), in conjunction with many Congressional Republicans and some Democrats, attempts to beat back attempts to create a new government-run program to provide medical care for the elderly, to be called “Medicare.” The AMA and its political allies have fought the idea of a government-provided health care program for senior citizens since 1945, when then-President Harry Truman first suggested universal health care for all Americans.
Minimal 'Eldercare' Considered Too Much - Currently, a modest health care program for senior citizens, called “Eldercare,” is the only government coverage American seniors have. It is based on a compromise proposal written by conservative Democratic Senator Robert Kerr (D-OK) and Representative Wilbur Mills (D-AR) and signed into law by President Dwight Eisenhower. Eldercare provides government benefits only for senior citizens who can demonstrate economic need, and states that choose not to participate in the program can opt out entirely. However, the AMA considers even this truncated program far too invasive, and fiercely opposes the more sweeping “Medicare” proposal, called King-Anderson after its main authors, Senator Clinton Anderson (D-NM) and Representative Cecil King (D-CA). The legislation is mired in Congressional committees. (Time 2/19/1965; Larry DeWitt 9/2004)
WHAM - The opposition to King-Anderson is led by the Women’s Auxilary of the AMA, which is given the task of coordinating the WHAM program—Women Help American Medicine. WHAM is directly dedicated to defeating the King-Anderson bill in Congress, “a bill which would provide a system of socialized medicine for our senior citizens and seriously curtail the quality of medical care in the United States.” The public campaign consists of the usual rallies and advertisements, most funded by corporate lobbyists working for the AMA and other health care firms. WHAM accuses King-Anderson proponents of being “socialists” and warns of federal bureaucrats violently invading “the privacy of the examination room.” WHAM coordinates an extensive grassroots effort under the rubric of “Operation Hometown,” enlisting local medical societies to speak out against King-Anderson, and providing pamphlets, reprints of press releases and articles, and talking points to local physicians.
Operation Coffeecup - Operation Coffeecup is a less visible, but just as important, element of the WHAM campaign. It centers around a series of “coffee klatches,” or “impromptu” get-togethers in kitchens and living rooms across America, hosted by WHAM members. WHAM members are told to downplay the significance of the events. One instruction tells them to portray the events as nothing more than “spontaneous” neighborhood get-togethers: “Drop a note—just say ‘Come for coffee at 10 a.m. on Wednesday. I want to play the Ronald Reagan record for you.’” The attendees are shown how to write equally “spontaneous” letters to members of Congress opposing the King-Anderson bill. The letters are carefully constructed to give the appearance of real, unsolicited missives written by concerned Americans, not the product of an orchestrated lobbying effort. Each WHAM member uses a 10-point checklist to ensure that the letters cover the points needed to make the argument against King-Anderson, and are not full of boilerplate, obviously copied-over material. The program is deliberately kept quiet, for fear that the media will portray it as an attempt to manipulate public opinion.
Reagan on Vinyl - The centerpiece of the Operation Coffeecup material is a vinyl LP entitled Ronald Reagan Speaks Out Against Socialized Medicine (see 1962). The album is a 19-minute recording featuring an 11-minute address by Reagan, followed by an eight-minute follow-up by an announcer. WHAM members are assured that Reagan’s work for the organization is unpaid and voluntary, though they are not told that his father is a top AMA executive. Instead, they are told Reagan is motivated entirely by his sincere political convictions. The hope is that Reagan’s message will inspire legions of housewives to write letters demanding that King-Anderson be defeated. The AMA claims that Operation Coffeecup prompts a “legion” of responses. (Larry DeWitt 9/2004)
Exposed - In June 1962, investigative reporter Drew Pearson exposes Operation Coffeecup in his newspaper column. Pearson writes: “Ronald Reagan of Hollywood has pitted his mellifluous voice against President Kennedy in the battle for medical aid for the elderly. As a result it looks as if the old folks would lose out. He has caused such a deluge of mail to swamp Congress that congressmen want to postpone action on the medical bill until 1962. What they don’t know, of course, is that Ron Reagan is behind the mail; also that the American Medical Association is paying for it.… Reagan is the handsome TV star for General Electric.… Just how this background qualifies him as an expert on medical care for the elderly remains a mystery. Nevertheless, thanks to a deal with the AMA, and the acquiescence of General Electric, Ronald may be able to outinfluence the president of the United States with Congress.” (Larry DeWitt 9/2004; Beutler 8/25/2009)
During a campaign debate between President Jimmy Carter (D-GA) and his Republican challenger, Governor Ronald Reagan (R-CA), Carter lambasts Reagan for his decades-long opposition to Medicare (see 1962). “Governor Reagan, as a matter of fact, began his political career campaigning around this nation against Medicare,” Carter says. Reagan counters with what author Larry DeWitt calls “a deft quip and a blatant denial.” He says, “There you go again.” When the laughter subsides, Reagan continues: “When I opposed Medicare, there was another piece of legislation meeting the same problem before the Congress. I happened to favor the other piece of legislation and thought it would be better for the senior citizens and provide better care than the one that was finally passed. I was not opposing the principle of providing care for them. I was opposing one piece of legislation versus another.” Reagan is referring to a Republican alternative called “Bettercare” that was little more than a voluntary insurance program funded by Social Security. Carter also states that Reagan had, in his career, advocated making Social Security a voluntary program, which as Carter notes, “would, in effect, very quickly bankrupt it.” Reagan had frequently advocated such a position while supporting Senator Barry Goldwater’s 1964 presidential campaign, and as recently as 1975 during his unsuccessful primary campaign for the presidency, but Reagan now denies taking such a stance: “Now, again this statement that somehow I wanted to destroy it, and I just changed my tune, that I am for voluntary social security, which would mean the ruin of it, Mr. President, the voluntary thing that I suggested many years ago was that a young man, orphaned and raised by an aunt who died, his aunt was ineligible for Social Security insurance, because she was not his mother. And I suggested that if this was an insurance program, certainly the person who’s paying in should be able to name his own beneficiaries. And that’s the closest I’ve ever come to anything voluntary with Social Security.” Though Reagan’s claims are at odds with his previous positions, his denials go virtually unchallenged in the media. (Blevin 2001; Larry DeWitt 9/2004; American Presidency Project 2009)
Former health care executive Wendell Potter, who left the insurance giant Cigna after fifteen years, appears on “Bill Moyers’ Journal.” He was formerly the head of corporate communications before he resigned his position, a post he calls “the ultimate PR job.” He says he was not forced to leave the company, and was extremely well compensated for his duties. He left after realizing that the health care industry is using underhanded and hurtful tactics to undermine the drive towards health care reform. He never went to his bosses with his observations because, he says, “for most of the time I was there, I felt that what we were doing was the right thing. And that I was playing on a team that was honorable. I just didn’t really get it all that much until toward the end of my tenure at Cigna.”
Health Care Expo Changed His Perceptions - In June 2007, Potter recalls, his perceptions were drastically changed by his visit to a health care exposition in Wise, Virginia (see June 2007).
Changing Plans - The industry shifted from selling primarily managed care plans, he says, to what they call “consumer-driven plans.” Despite the name, they are health care plans with high deductibles and limited coverage.
'Highlight Horror Stories' - Moyers shows Potter a copy of an “action plan” devised by America’s Health Insurance Plans (AHIP), the industry’s trade association. In large gold letters, the plan tells lobbyists and industry representatives to “Highlight horror stories of government-run systems.” Potter says that AHIP and other industry representatives try to paint government-run health care as socialism, and as inevitable failures. “The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them,” he says, “that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.” Moyers also notes that the AHIP plan targets the film Sicko, a 2007 documentary by leftist filmmaker Michael Moore that portrayed America’s health care industry in a dismal light. AHIP’s action plan is to “Position Sicko as a threat to Democrats’ larger agenda.” Potter says that was an effort to discredit the film by using lobbyists and AHIP staffers “to go onto Capitol Hill and say, ‘Look, you don’t want to believe this movie. You don’t want to talk about it. You don’t want to endorse it. And if you do, we can make things tough for you.’” If they did, AHIP would retaliate by running negative ads against the lawmakers in their home districts or other electoral punishments. AHIP focused strongly on the conservative Democratic Leadership Council. Another tactic, as delineated in the memo: “Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status.” Moyers says that AHIP attempted to “radicalize” Moore and portray him as an extremist who could not be believed. Many politicians used AHIP talking points in discussing Moore and his film. “So your plan worked,” Moyers observes. Potter agrees: “It worked beautifully.” The lesson that was lost from Moore’s film, Potter says, was that Americans “shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.”
Conservative Counter-Strategy - Moyers then displays a memo from Republican strategist Frank Luntz, who in the spring of 2009 wrote a strategy memo for health care reform opponents. The memo reads in part: “First, you have to pretend to support it. Then use phrases like, ‘government takeover,’ ‘delayed care is denied care,’ ‘consequences of rationing,’ ‘bureaucrats, not doctors prescribing medicine.’” He then shows film clips of House Minority Leader John Boehner (R-OH), Senate Minority Leader Mitch McConnell (R-KY), Senator Jon Kyl (R-AZ), and others using Luntz’s talking points in discussions on the floors of Congress. Potter says that many conservatives—Democrats as well as Republicans—“are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don’t understand from an insider’s perspective like I have, what that actually means, and the consequences of that to Americans. They parrot those comments, without really realizing what the real situation is.” He notes that Representative Zach Wamp (R-TN), who grew up very near Potter’s childhood home in Chattanooga, told reporters that half of America’s uninsured don’t want health care, they would rather “go naked and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.” Potter notes that the word “naked” is an industry term for people who choose not to buy health insurance. He calls Wamp’s comment “ridiculous” and “an example of a member of Congress buying what the insurance industry is peddling.” Moyers cites conservative Democrat Max Baucus, the chairman of the Senate Finance Committee, as another politician central to the health care reform process who is heavily influenced by corporate lobbyists—two of whom used to work on his own Senate staff. Potter says: “[I]t does offend me, that the vested special interests, who are so profitable and so powerful, are able to influence public policy in the way that they have, and the way that they’ve done over the years. And the insurance industry has been one of the most successful, in beating back any kinds of legislation that would hinder or affect the profitability of the companies.”
Fierce Opposition to Public Option - The “public option,” the idea that the government would extend a non-profit, government-run health care alternative for citizens, is fiercely opposed by the health care industry. Potter says the reason why is “[t]he industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate.” Government programs such as Medicare and the Veterans Administration’s medical providers are far more efficient than private, for-profit health care providers, and the industry fears that having to compete with such a program will slash their profits. Medical companies will do whatever it takes to keep their profit margins—and shareholder returns—above a certain threshold. They will deny more claims, kick more people off their rolls, purge employer accounts, whatever it takes. Potter, evidently bemused, says, “You know, I’ve been around a long time. And I have to say, I just don’t get this. I just don’t understand how the corporations can oppose a plan that gives the unhealthy people a chance to be covered. And they don’t want to do it themselves.… I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.” A public option would help “keep [health care corporations] honest,” he says, and they would inevitably lose profits.
Predictions - Right now the industry is primarily involved in what Potter calls a “charm offensive,” where it is attempting to give the perception that it, too, is for health care reform. But once Congress begins putting out specific legislative language, the industry and its flacks will begin attacking specific provisions. Moyers says the upshot is for the industry to either “kill reform” or prevent lawmakers from agreeing on a bill, just like what happened in 1993-94 under the Clinton administration. No matter what they say—favoring the elimination of pre-existing condition restrictions, for example—the industry will adamantly oppose reform of any kind. “They don’t want a public plan,” Potter says. “They want all the uninsured to have to be enrolled in a private insurance plan. They want—they see those 50 million people as potentially 50 million new customers. So they’re in favor of that. They see this as a way to essentially lock them into the system, and ensure their profitability in the future. The strategy is as it was in 1993 and ‘94, to conduct this charm offensive on the surface. But behind the scenes, to use front groups and third-party advocates and ideological allies. And those on Capitol Hill who are aligned with them, philosophically, to do the dirty work. To demean and scare people about a government-run plan, try to make people not even remember that Medicare, their Medicare program, is a government-run plan that has operated a lot more efficiently.… [T]hey want to scare you into thinking that through the anecdotes they tell you, that any government-run system, particularly those in Canada, and UK, and France that the people are very unhappy. And that these people will have to wait in long lines to get care, or wait a long time to get care. I’d like to take them down to Wise County. I’d like the president to come down to Wise County, and see some real lines of Americans, standing in line to get their care. (PBS 7/10/2009)
Betsy McCaughey, the chairman of the Committee to Reduce Infection Deaths, a former Republican lieutenant governor of New York, and a conservative opponent of health care reform, says that under the Obama administration’s reform proposal, elderly Americans would be encouraged to die earlier to save money (see February 9, 2009 and July 23-24, 2009). On conservative radio host Fred Thompson’s show, she says, “Congress would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.” These sessions will help elderly patients learn how to “decline nutrition, how to decline being hydrated, how to go in to hospice care… all to do what’s in society’s best interest or in your family’s best interest and cut your life short.” (St. Petersburg Times 7/23/2009) “These are such sacred issues of life and death. Government should have nothing to do with it.” Thompson calls McCaughey’s claim the “dirty little secret” of the health care reform proposal. (St. Petersburg Times 7/23/2009; Brown 7/28/2009) In August, progressive MSNBC host Rachel Maddow will tell her listeners: “That is not true at all, not a word of it. Not mandatory, not require, not every five years, not counseling, not tell them, not how to, not end their life. None of the words in that claim are true except maybe the two ‘that’s’ and the word ‘in.’ It’s not true, but it is convenient, and so it survives. And it is in fact being promoted more than ever. It’s convenient for the interests [that oppose] health care reform to scare old people about reform.” (MSNBC 8/12/2009) The next day, McCaughey publishes an op-ed in the New York Post advancing the same arguments. “One troubling provision” of the bill, she writes, “compels seniors to submit to a counseling session every five years… about alternatives for end-of-life care.… [The] mandate invites abuse, and seniors could easily be pushed to refuse care.” (McCaughey 7/17/2009)
Availability of Discussions Mandated Since 1990 - The provision in question states that as part of an advanced care consultation, an individual and practitioner will have a consultation that includes “an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.” Such explanations and consultations have been part of government-provided senior care since 1990; in 2003, the Bush administration issued guidelines for physicians’ discussion of end-of-life care with seniors.
Claims Contradicted - John Rother of the American Association of Retired Persons (AARP) counters with a statement: “This measure would not only help people make the best decisions for themselves but also better ensure that their wishes are followed. To suggest otherwise is a gross, and even cruel, distortion—especially for any family that has been forced to make the difficult decisions on care for loved ones approaching the end of their lives.” Jon Keyserling of the National Hospice and Palliative Care Organization adds: “I was surprised that any responsible legislative analyst would indicate this is a mandatory provision. That is just a misreading of the language and, certainly, of the intent.” McCaughey later responds to those statements by repeating her assertions, saying that doctors would “pressure” seniors to accept less costly services that would lead to quicker deaths. (St. Petersburg Times 7/23/2009; Brown 7/28/2009)
Debunked - McCaughey’s claims will soon be disproven (see July 23, 2009).
Republican National Committee chairman Michael Steele gives a very direct answer when asked if President Obama’s health care proposal constitutes socialism. During a presentation at the National Press Club, Steele is asked, “Does President Obama’s health care plan represent socialism?” He replies: “Yes. Next question.” MSNBC’s Rachel Maddow notes that Steele is “very sure that reforming health care is socialism even if he’s not actually all that sure what health care policy is,” and plays a video clip of Steele saying at a recent press conference: “I don’t do policy. I’m not—I’m not a legislator.” Steele acknowledges that Republicans made similar assessments of Medicare when it was proposed in 1965, and says: “I think that there’s a legitimate debate there about the impact that Medicare and Medicaid are having on the overall fabric of our economy. I think, though, in this case, unlike 1965, the level of spending, the level of government control and intrusion is far greater and much more expansive than anything we’ve ever seen.… So I think that what we’re talking about here is something far beyond anything we’ve seen in 1965 or since 1965. This is unprecedented government intrusion into the private sector, period. And you can sweeten that any way you want, but it still tastes bitter. And I think the American people know that.” According to Steele, Obama, House Speaker Nancy Pelosi (D-CA), and other Democrats are part of a “cabal” that wants to implement government-run health care. “Obama-Pelosi want to start building a colossal, closed health care system where Washington decides. Republicans want and support an open health care system where patients and doctors make the decisions,” he says. Adding Senate Majority Leader Harry Reid (D-NV) and House Energy and Commerce Committee chairman Henry Waxman (D-CA) into his statement, Steele continues: “Many Democrats outside of the Obama-Pelosi-Reid-Waxman cabal know that voters won’t stand for these kinds of foolish prescriptions for our health care. We do too. That’s why Republicans will stop at nothing to remind voters about the risky experimentation going on in Washington.” Obama and Congressional Democrats are moving too fast to try to enact health care reform, Steele says. “So slow down, Mr. President. We can’t afford to get health care wrong. Your experiment proposes too much, too soon, too fast. Your experiment with our health care could change everything we like about our health care, and our economy as well.” When asked why Republicans are not advancing their own health care proposals, Steele responds: “Now, you know, the Republicans can get up tomorrow and introduce its own bill, but you and I know how Washington works. The bill that matters is the one that the leadership puts in place. The Democrats have the leadership.” (Davis 7/20/2009; Alonso-Zaldivar 7/20/2009; MSNBC 7/27/2009)
The St. Petersburg Times’s “PolitiFact” debunks the recent spate of claims by Betsy McCaughey (R-NY) that the Obama health care reform proposal would mandate ‘death counseling’ (see July 16, 2009) and encourage seniors to die sooner to save money (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 23, 2009, and July 23-24, 2009). Days later, the Annenberg Political FactCheck organization will come to the same conclusions.
'Advance Care Planning Consultation' - According to HR 3200, the latest version of the health care reform legislation, the relevant section is entitled “Advance Care Planning Consultation.” This details how Medicare would pay for voluntary end-of-life counseling sessions. According to the legislation: “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.” Medicare will pay for one such session every five years, and will pay for interim sessions if a Medicare recipient’s health worsens in between those five-year sessions. Jon Keyserling, general counsel and vice president of public policy for the National Hospice and Palliative Care Organization, which supports the provision, says the bill does not encourage seniors to end their lives, it just allows some important counseling for decisions that take time and consideration. “These are very serious conversations,” he says. “It needs to be an informative conversation from the medical side and it needs to be thought about carefully by the patient and their families.” According to Jim Dau of the American Association of Retired Persons (AARP), the legislation does not encourage patients to end their lives. Dau says McCaughey’s claims are “not just wrong, they are cruel.” He adds: “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.” Keyserling says it is clear to him and his organization’s lawyers that such end-of-life counseling sessions are purely voluntary, like everything in Medicare. “The only thing mandatory is that Medicare will have to pay for the counseling,” says Dau. A press release from the AARP says that McCaughey’s characterization of the health care bill is “rife with gross—and even cruel—distortions.” (St. Petersburg Times 7/23/2009; Henig 7/29/2009)
'Scare Tactics' - The St. Petersburg Times concludes: “For our ruling on this one, there’s really no gray area here. McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would ‘tell [seniors] how to end their life sooner’ is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn’t just wrong, she’s spreading a ridiculous falsehood.” (St. Petersburg Times 7/23/2009) The non-partisan FactCheck.org, an organization sponsored by the Annenberg Public Policy Center, will write: “In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice, and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.” The organization will note that inflammatory “chain e-mails” are making the rounds making claims such as: “On Page 425 of Obama’s health care bill, the federal government will require EVERYONE who is on Social Security to undergo a counseling session every five years with the objective being that they will explain to them just how to end their own life earlier. Yes.… They are going to push SUICIDE to cut medicare spending!!!” FactCheck will respond: “In fact, [the part of the bill cited on p. 425] requires Medicare to cover counseling sessions for seniors who want to consider their end-of-life choices—including whether they want to refuse or, conversely, require certain types of care. The claim that the bill would ‘push suicide’ is a falsehood.” FactCheck will find that McCaughey “misrepresent[ed]” the bill in her claims, and she and other health care reform opponents are resorting to “scare tactics” to try to defeat the legislation. (Henig 7/29/2009)
President Obama holds a “town hall” meeting on health care reform, sponsored by the American Association of Retired Persons (AARP). The meeting is conducted by telephone at AARP’s Washington headquarters, where a small studio audience and approximately 180,000 callers from around the country listen and take part.
Rumor Control - In his introduction, AARP CEO A. Barry Rand tells the participants: “There’s a lot of misinformation about health care reform—even on what AARP stands for, and what AARP supports. This town hall is part of our ongoing effort to debunk myths and provide accurate information.… I want to make it clear that AARP has not endorsed any particular bill or any of the bills being debated in Congress today. We continue to work with members of Congress on both sides of the aisle and with the administration to achieve what is right for health care reform.” AARP president Jennie Chin Hansen notes some of the most prevalent myths and misinformation about health care reform as expressed in previous AARP-sponsored town halls: “Like, will the government tell my doctor how to practice medicine?” For his part, Obama says: “Nobody’s trying to change what does work in the system. We are trying to change what doesn’t work in the system.” He reassures the participants that “Nobody is talking about cutting Medicare benefits. I just want to make that absolutely clear.… [W]e do want to eliminate some of the waste that is being paid for out of the Medicare trust fund that could be used more effectively to cover more people and strengthen the system.”
Opposition Profiting from Status Quo - Of the anti-reform opposition, Obama says: “I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They’ll run all sorts of ads that will make people scared.… Back when President Kennedy and then President Johnson were trying to pass Medicare, opponents claimed it was socialized medicine. When you look at the Medicare debate, it is almost exactly the same as the debate we’re having right now. Everybody who was in favor of the status quo was trying to scare the American people saying that government is going to take over your health care, you won’t be able to choose your own doctor, they’re going to ration care.… You know what? Medicare has been extraordinarily popular. It has worked. It has made people a lot healthier, given them security. And we can do the same this time.” If nothing is done to change the status quo, Obama says, the cost of health care coverage will rise dramatically. “Health care costs are going up much faster than inflation,” he says, “and your premiums will probably double again over the next 10 years.… We’re already seeing 14,000 people lose their health insurance every day. So the costs of doing nothing are trillions of dollars over the next couple of decades—trillions, not billions… without anybody getting any better care.” Controlling health care inflation will allow the government to stabilize the Medicare trust fund: “[N]ot only can we stabilize the Medicare trust fund, not only can we help save families money on their premiums, but we can actually afford to provide coverage to the people who currently don’t have health care.”
End-of-Life Rumors - One caller is concerned about rumors surrounding end-of-life care. “I have been told there is a clause in there that everyone that’s Medicare age will be visited and told to decide how they wish to die,” she says. “This bothers me greatly, and I’d like for you to promise me that this is not in this bill.” The host elaborates: “As I read the bill, it’s saying that Medicare will, for the first time, cover consultation about end-of-life care, and that they will not pay for such a consultation more than once every five years. This is being read as saying every five years you’ll be told how you can die.” Obama replies, “Well, that would be kind of morbid,” and reassures the caller that the rumors are not true, adding, “Nobody is going to be knocking on your door.” He explains that one proposal would have Medicare pay for consultations between doctor and patients about living wills, hospice care, and other information critical to end-of-life decisions. “The intent here is to simply make sure that you’ve got more information, and that Medicare will pay for it,” he says. “The problem right now is that most of us don’t give direction to our family members, so when we get really badly sick… the [doctors] are making decisions in consultation with your kids or your grandkids and nobody knows what you would have preferred.” Obama is refuting rumors that claim under his reform proposal, elderly Americans would be encouraged to die sooner (see July 16, 2009 and July 23, 2009).
Pre-Existing Conditions - Insurers will no longer be able to deny care to people with so-called “pre-existing conditions.” Obama reflects on his mother, who died of cancer: “She had to spend weeks fighting with insurance companies while she’s in the hospital bed, writing letters back and forth just to get coverage for insurance she’d already paid premiums on. And that happens all across the country. We’re going to put a stop to that.… We’re going to reform the insurance system so that they can’t just drop you if you get too sick. They won’t be able to drop you if you change jobs or lose your job.… We want clear, easy-to-understand, straightforward insurance that people can purchase.”
Keeping Existing Coverage - Obama reassures another caller that she will not have to drop the coverage she has. “Here’s a guarantee that I’ve made: If you have insurance that you like, then you’ll be able to keep that insurance. If you’ve got a doctor that you like, you’ll be able to keep your doctor. Nobody is going to say you’ve got to change your health care plan. This is not like Canada where suddenly we are dismantling the system and everybody’s signed up under some government program. If you’ve already got health care, the only thing we’re going to do for you is, we’re going to reform the insurance companies so that they can’t cheat you.… If you don’t have health insurance, we’re going to make it a little bit easier for you to be able to obtain health care.” Those dissatisfied with their coverage, or who have no coverage at all, would have a wider array of choices, including, perhaps, a government-run plan (the “public option”).
Rationing Health Care? - One caller asks, “Even if I decide when I’m 80 that I want a hip replacement, am I going to be able to get that?” Obama responds: “My interest is not in getting between you and your doctor—although keep in mind that right now insurance companies are often getting between you and your doctor. [Decisions] are being made by private insurance companies without any guidance as to whether [they] are good decisions to make people healthier or not. So we just want to provide some guidelines to Medicare, and by extension the private sector, about what [treatments] work and what doesn’t.… We don’t want to ration by dictating to somebody [that] we don’t think this senior should get a hip replacement. We do want to provide information to [you and your doctor about what] is going to be most helpful to you in dealing with your condition.” He gives the following analogy: “If you figure out a way to reduce your heating bill by insulating your windows… you’re still warm inside. [But] you’re not wasting all that energy and sending it in the form of higher bills to the electric or gas company. And that’s then money you can use to save for your retirement or help your kid go to college. Well, it’s the same principle within the health system.” Obama is refuting claims by health care opponents that the government intends to ration health care and deny elderly patients needed treatment (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, and July 28, 2009).
Reform Not 'Socialized Medicine' - Obama assures the participants that his vision of health care reform is not socialism under any guise. “A lot of people have heard this phrase ‘socialized medicine,’” he says. “And they say, ‘We don’t want government-run health care. We don’t want a Canadian-style plan.’ Nobody is talking about that. We’re saying, let’s give you a choice.” He recalls: “I got a letter from a woman the other day. She said, ‘I don’t want government-run health care. I don’t want socialized medicine. And don’t touch my Medicare.‘… I wanted to say, ‘That’s what Medicare is. It’s a government-run health care plan that people are very happy with.’”
Conclusion - Obama says he doesn’t expect a perfect health care system. “But we could be doing a lot better than we’re doing right now,” he says. “We shouldn’t have people who are working really hard every day without health care or with $8,000 deductibles—which means basically they don’t have health insurance unless they get in an accident or they get really sick. That just doesn’t make sense. So we’ve got to have the courage to be willing to change things.” After the town hall ends, AARP board chair Bonnie Cramer says she believes Obama “really made it very clear that Medicare beneficiaries will not see cuts in Medicare services.” By speaking directly to older Americans, Cramer says, “He put to rest a lot of their concerns.” (Beam 7/28/2009; AARP Bulletin Today 7/29/2009; McKnights 7/29/2009)
Slate reporter and columnist Christopher Beam coins a new term, “deathers,” to label conservatives who are spreading the debunked rumors that President Barack Obama’s health care proposals would kill old people (see July 16, 2009 and July 23, 2009). Beam publishes his article on the same day that Representative Virginia Foxx (R-NC) claims that under Obama’s reforms, seniors would be “put to death” (see July 28, 2009), and that Obama holds a “town hall” meeting where he debunks this and other rumors surrounding his proposals (see July 28, 2009). The claim apparently originated with lobbyist and lawyer Betsy McCaughey (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 16, 2009, and July 23-24, 2009), who used similarly questionable claims to derail the 1994 reform proposals by the Clinton administration (see Mid-January - February 4, 1994). Others have made similar assertions; Representative Paul Broun (R-GA) recently warned that Obama’s reform proposals would “kill people” (see July 10, 2009), and conservative commentator and author Charlotte Allen says: “Obama’s not going to say, ‘Let’s kill them.’ But he seems to be perfectly comfortable with the idea that a lot more old people are going to die a lot sooner.”
End-of-Life Consultations - Beam shows that the language of the bill, as it stands in Congress at this time, provides for “end-of-life consultations” between patients and doctors, if the patients wish them. In those consultations, doctors would explain what kind of services are available to those patients—palliative care and hospices, in-home care, more intensive treatments in a hospital, etc.—but would not tell patients that they had to restrict themselves to less intensive treatments that would shorten their lives. Some “deathers” have also insisted that the bill provides for the withholding of “artificially administered nutrition and hydration.” McCaughey is a vocal proponent of this claim. However, such a choice would have to be made by the patient and/or the family, specifically not a doctor.
Shared Decision-Making - Opponents of health care reform such as McCaughey claim that the House bill would “coerce” seniors into taking part in a program that forces them into making decisions about “trade-offs among treatment options,” or takes the final decision-making power away from them and places it in the hands of doctors or government officials. In reality, the bill would provide an informational tool for patients and families to make informed decisions. No coercion could legally be applied.
Obama Staffers Cause Concern - Some of Obama’s staffers have said and written things that cause consternation among reform opponents (see July 23-24, 2009). One of Obama’s senior health care advisers, Ezekiel Emanuel, who serves as health policy adviser at the White House’s Office of Management and Budget (OMB), wrote in 2008 that doctors too often interpret the Hippocratic oath “as an imperative to do everything for the patient regardless of the cost or effects on others,” leading some to wonder if Emanuel would put cost concerns over patients’ needs; others have gone farther, comparing Emanuel to Nazi doctors and of advocating “eugenics.” In 1977, Obama’s “science czar,” John Holdren, joined two other authors in writing about possible methods of population control, including a speculative bit about sterilizing people by introducing chemicals into the water supply. (ABC News later reports that the controversial passage was from a textbook in which various methods of population control were considered and rejected. Holdren recently released a statement saying that population control is not the government’s job; his statements on the matter passed muster in the Senate Commerce Committee, whose Republican members joined Democrats in unanimously approving his nomination as the director of the White House’s Office of Science and Technology Policy.) And some worry that the proposed Independent Medicare Advisory Council, which would oversee cost containment for Medicare, would be staffed, in Allen’s words, with “a certain class of secularized intellectuals” who might put cost concerns over quality of life. (Beam 7/28/2009; Tapper 7/28/2009)
Representative Anthony Weiner (D-NY), a progressive Democrat who favors single-payer (government-provided) health care and is one of the strongest voices from the Democratic left in favor of the “public option” in health care reform, introduces an amendment to the pending health care reform legislation, HR 3200, that would eliminate Medicare. Weiner has no intention of actually trying to eliminate Medicare, instead he wants to get Republicans, who have repeatedly said they don’t want “government health care” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, and July 28, 2009) to go on record as supporting Medicare, a government-run health care provider. Weiner tells interviewer Rachel Maddow: “I guess Republicans don’t like publicly funded, publicly administered health plans except for Medicare, and, I guess, except for the Veterans Administration and except for the health care that our military gets from the Department of Defense. The fact of the matter is, what we’ve learned is that government administered health care works pretty darn well. It’s got lower overhead and people like it. So, when my Republican colleagues pound the drum and pound the podium about how they hate government-run health care, I guess they haven’t looked at what they get.” Weiner says he introduced the amendment in part to embarrass House Republicans whose rhetoric on public health care he thinks has become quite harsh. (MSNBC 7/31/2009)
Representative Earl Blumenauer (D-OR), who co-authored the provision in the House health care reform legislation mandating that Medicare would pay for periodic “end-of-life” counseling sessions between patients and doctors, releases a fact sheet called “Myth vs. Fact: Advance Planning Consultations in HR 3200” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, and July 31, 2009 - August 12, 2009). Blumenauer writes: “Few areas are more vital for honest discussion and careful consideration than end-of-life care for America’s seniors. Unfortunately, families often do not know their loved ones’ preferences for end-of-life care and are not confronted with these difficult decisions until an emergency arises. This leaves spouses, sons, daughters, and grandchildren unprepared; as a result families struggle to make decisions in the midst of turmoil. The House health care legislation includes a provision (Sec. 1233) that provides seniors with better care as they grapple with these hard questions. This provision extends Medicare coverage to cover the cost of patients voluntarily speaking with their doctors about their values and preferences regarding end-of-life care. These are deeply personal decisions that take thoughtful consideration, and it is only appropriate that doctors be compensated for their time.” He then corrects three “myths” surrounding the provision:
Myth: Patients will be forced to have this consultation once every five years. In reality, he writes, such advance planning consultations are entirely voluntary; the provision mandates that Medicare will pay for one such consultation every five years if the patient chooses. Under certain circumstances, Medicare will pay for more frequent consultations.
Myth: Patients will be forced to sign an advance care directive (or living will). Blumenauer writes that no such mandate exists in the legislation, or is being contemplated. Like the advance planning consultations, living wills are entirely voluntary.
Myth: Patients will have to see a health care professional chosen by the government. The government will not choose any health care professionals for anyone. If a patient chooses to have an advance planning consultation, it will be with a doctor of his or her choosing.
Blumenauer notes that the following organizations have endorsed his provision: the American Association of Retired Persons (AARP), the American Academy of Hospice and Palliative Medicine, the American College of Physicians, the American Hospice Foundation, the Center to Advance Palliative Care, Consumers Union, Gundersen Lutheran Health System, the Hospice and Palliative Nursing Association, Medicare Rights Center, the National Hospice and Palliative Care Organization, the National Palliative Care Research Center, Providence Health and Services, and the Supportive Care Coalition. (US House of Representatives 7/2009 ; Brown 7/28/2009)
Anti-health care reform protesters sound off at a health care forum in Hartford, Connecticut, featuring Senator Christopher Dodd (D-CT). Many of the protesters identify themselves as either belonging to a “tea party” protest organization or a related group calling itself “Dump Dodd.” One protester seems to suggest that Dodd, who has been diagnosed with early-stage prostate cancer, either commit suicide or be forced to die: “How come we don’t just give Chris Dodd painkillers? Like a handful of them at a time! He can wash it down with Ted Kennedy’s whiskey!” The protester is apparently referring to a claim by Rush Limbaugh that the reform proposal would deny senior citizens needed treatment, and would instead force them to rely on pain medications while waiting to die (see July 28, 2009). One reform advocate, who later posts his impressions of the event on the liberal blogs Daily Kos and My Left Nutmeg, writes that the “Dump Dodd” protesters rail about communism and socialism taking over American democracy, and notes, “Never mind that they were essentially calling Medicare, the VA, and the military’s Tricare communist and socialist.” (My Left Nutmeg 8/4/2009; Stephen Herron 8/5/2009; Rucker and Eggen 8/6/2009)
An organization called Conservatives for Patients’ Rights (CPR) publicly takes credit for orchestrating the disruptive and sometimes-violent protests against the White House’s health care reform proposals (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, and August 4, 2009). Washington Post reporter Greg Sargent says the admission “rais[es] questions about [the protests’] spontaneity.” CPR is headed by Rick Scott, a former health industry CEO who once ran Columbia/HCA before being ousted for malfeasance in 1997. (Columbia/HCA subsequently paid the US government $1.7 billion dollars in fines due to fraud that occured during Scott’s tenure.) Scott, who was once a part owner of the Texas Rangers with George W. Bush, now owns an investment firm that primarily traffics in health care, and owns a chain of Florida urgent care clinics called Solantic. (Eggen 5/10/2009; Sargent 8/4/2009) (Solantic also boasts former Bush administration official Thomas Scully as a member of its board. In 2004, Scully deliberately withheld information from Congress that the Bush administration’s Medicare reforms would cost $200 billion more than acknowledged.) (MSNBC 8/7/2009)
Contracting with 'Swift Boat' PR Firm - Scott is spending millions on CPR’s public relations effort, and has contracted with CRC Public Relations, the group that masterminded the “swift boat” attacks against 2004 Democratic presidential candidate John Kerry. He is also coordinating his efforts with Grover Norquist, the conservative advocate and influential Washington insider. CPR spokesman Brian Burgess confirms that CPR is e-mailing “town hall alert” flyers and schedules of town hall meetings to its mailing list. CPR is also actively recruiting members for the “tea party,” a loosely organized group of conservative protesters (see April 8, 2009). Scott says, “We have invested a lot of time, energy, and resources into educating Americans over the past several months about the dangers of government-run health care and I think we’re seeing some of the fruits of that campaign.” Doug Thornell, a House Democratic staff member, says: “The more you dig the more you learn that this is a carefully orchestrated effort by special interest lobbyists and the Republican Party, who are using fringe elements on the right to protect insurance company profits and defeat health care reform. The anger at these events looks very similar to what we saw at McCain/Palin rallies in the fall.” (Eggen 5/10/2009; Sargent 8/4/2009)
Group Interested in Protecting Industry Profits, Critics Say - Richard Kirsch of Health Care for America Now, a pro-reform group, says of Scott: “Those attacking reform are really looking to protect their own profits, and he’s a perfect messenger for that. His history of making a fortune by destroying quality in the health care system and ripping off the government is a great example of what’s really going on.” CPR plans on spending over $1 million a month in anti-reform television and radio ads. (Eggen 5/10/2009) White House press secretary Robert Gibbs, learning of CPR’s admission, says the organization is led by a “CEO that used to run a health care company that was fined by the federal government $1.7 billion for fraud. I think that’s a lot of what you need to know about the motives of that group.” Scott retorts, “It is a shame that Mr. Gibbs chooses to dismiss these Americans and their very real concerns, instead opting to level personal attacks.” (Garofoli 8/4/2009)
Representative Anthony Weiner (D-NY), who represents one of the more liberal districts in the nation, reflects on a much less contentious town hall meeting on health care reform he held the evening before at a Queens senior center. Weiner says the calmer crowd “shows you a little bit what’s different between the left and the right. You know, we have this notion that if we talk about issues and we discuss the challenges, we can reach conclusions. The other side just literally is yelling no. They do it on the floor of Congress and now, they’re doing around town. But for the most part, you know, people have legitimate questions. These are tough issues and I feel very strongly—for example, I said… you know, the single-payer plan like Medicare for everyone. [A “single-payer” system would eliminate private health care and centralize all health care provision through the federal government.] Yet, still, there were seniors there who were standing up, saying, ‘I want you to leave your hands off my plan and don’t touch it and by the way, I don’t want the government involved.’ And, you know, I had to remind them Medicare, like 40 percent.… Well, a lot of them were reading and hearing some of the things they hear on angry, shouting radio shows, and they were parroting them back.” Weiner notes that because inertia is such “a powerful force in Washington,” conservatives and Republicans feel they have an advantage in merely trying to stop health care reform instead of “try[ing] to do something” (see August 11, 2009). “So, I think the Republicans have made the analysis that if we can just stop the governing party, the Democrats, from getting anything done, then we’ll be OK. [T]his is tough sledding in large part because the Republicans and the conservative right have a much easier job. They literally just have to stand in front of us and yell at the top of their lungs, and they will have succeeded with their day’s event. And that’s going to be difficult for us.” (MSNBC 8/10/2009)
Senator Johnny Isakson (R-GA), one of the foremost advocates of expanding Medicare’s end-of-life planning coverage, responds sharply to suggestions by former Alaska Governor Sarah Palin (R-AK) and others that the Democrats’ health care reform proposal would create “death panels” for the forcible euthanasia of citizens deemed “less productive” or “undesirable” (see August 7, 2009). Isakson, who co-sponsored the 2007 Medicare End-of-Life Planning Act and has proposed a similar amendment to the House’s language in the Senate version of the health care bill, notes that the bill would lead to the funding of voluntary end-of-life counseling sessions between doctors and their patients, and would allow patients to choose the level of care they would receive as their lives come to a close (see July 23, 2009 and July 23, 2009). He calls Palin’s interpretation of the legislation “nuts.” Isakson says: “In the health care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that’s because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia ‘durable power of attorney,’ you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you’re unable to make those decisions. This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it’s to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It’s just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.… It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.” He says he has no idea how Palin and others have become “so mixed up” on the concept. (Klein 8/10/2009) Liberal news and advocacy Web site Think Progress notes that another Republican senator, Susan Collins (R-ME), supports a similar provision to Isakson’s amendment. (Carlile 8/11/2009) The Washington Monthly’s Steve Benen notes that Isakson is a “deep-dyed” conservative, and writes, “Assorted wingnuts and teabaggers may not believe the administration, Democrats, objective news sources, or the plain black-and-white text of the legislation, but they should at least be willing to consider reality from one of the Senate’s most conservative members.” (Benen 8/11/2009)
At a “town hall” meeting to discuss health care reform, Senator Ben Cardin (D-MD) is plagued with “almost non-stop” hecklers who “hoot and holler” at his every statement, according to the Baltimore Sun. Outside the town hall, an opponent of health care reform holds a small, handwritten sign that says: “Death to Obama. Death to Obama—Michelle and 2 stupid kids.” (The man is detained by Secret Service agents.) The event, held at Towson University, is packed with anti-reform protesters, who regularly outshout those who have come to support Cardin and health care reform. Cardin is a proponent of the Democrats’ health care reform efforts. “I know some of you don’t want me to mention the facts, but listen to the facts,” he says towards the beginning of the event, drawing screams and catcalls from the protesters. Cardin’s every statement is greeted with jeers and shouts, and protesters break “into raucous cheers” when their fellows yell dismissive or abusive remarks towards him. According to the Sun reporters in attendance, Cardin keeps calm throughout the event. His statements that illegal immigrants would not be given coverage under the plan receives some of the heaviest levels of profane jeering and booing; in contrast, one of the longest and loudest ovations comes when an audience member asks why tort reform is not part of the reform plan. When one audience member asks if Cardin will put himself under a public plan, he retorts: “I’m in a public plan. It’s called Medicare.” Cardin is protected throughout the event by a large number of uniformed university security officers. About 500 people make their way inside; hundreds more are turned away and conduct their own protests, arguments, disputes, and screaming matches outside the venue. One supporter tells a reporter: “I guess we’re going to rally and scream at each other. It’s ridiculous, but you can’t just have one side control the whole discussion.” One protester, carrying a sign reading “Obama Lies, Seniors Die” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, and August 11, 2009), tells reporters, “I’m not a mob.” Cardin addresses the “euthanasia” issue in the venue, assuring the audience, “There would be nothing in a health overhaul plan about terminating people’s care at the end of life.” He then adds, “And by the way, President Obama is also a citizen of the United States.” (West and Scharper 8/11/2009; MSNBC 8/13/2009; Dishneau 8/13/2009)
Representative Ginny Brown-Waite (R-FL), who a month ago said that the Obama administration’s ideas on health care reform would send a message to senior citizens to “drop dead,” says that the idea of “death panels” as touted by former Governor Sarah Palin (R-AK) and others (see July 16, 2009, August 7, 2009, and August 10, 2009), is untrue. Brown-Waite opposes the Democrats’ health care reform in the House because it would cut funds from the Medicare Advantage program, costing some senior citizens more money. Of the so-called “death panels” provision, Brown-Waite notes, “It doesn’t say that they’re going to receive counseling on euthanasia, that’s not what it says.” And, she adds, lawmakers are not considering “some of the gruesome options opponents are slinging around as scare tactics” (see July 24, 2009). “I do not believe that Americans would ever accept end-of-life care advice that included any form of ways to end one’s life.” Some conservative anti-reform protesters now consider Brown-Waite a “Democratic collaborator” for her comments, but she has won praise from the American Association of Retired Persons (AARP) for exposing Palin’s “death panel” rhetoric as a lie. “She put principle first and laid out the facts,” the AARP notes in a news release. (Thompson 8/11/2009)
The “60 Plus Association” (60+), a conservative anti-health care reform organization, sends out what Washington Post commentator Greg Sargent calls a “brutal” mailer to Nebraska residents, depicting photos of senior citizens apparently suffering from various untreated ailments and making the questionable claim that health care reform would be funded by $500 million in Medicare cuts. 60+ is leading a media push against the Democrats’ reform package by claiming that the government would institute so-called “death panels” (see Shortly Before August 10, 2009). Sargent writes: “This is kind of a new frontier in the scare campaign targeting old folks: It links the prediction of drastic Medicare cuts to the widely-debunked claim that health care reform will lead to mass government euthanasia of the elderly” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, and August 11, 2009). The mailer repeats the widely discredited claim that the government could deny you treatment even if “you and your doctor insist on them,” and quotes President Obama as saying during one “town hall” forum, “Maybe you’re better off not having the surgery, but taking the painkiller.” Sargent notes: “Taken out of context, the comment sounds like a callous declaration to a patient that he or she should suck it up and forget about getting needed care. In fact, Obama was actually discussing the difficulties inherent in helping the elderly make good medical decisions.” (Sargent 8/11/2009)
Senator Sherrod Brown (D-OH) tells progressive MSNBC host Rachel Maddow that, although he believes much of the dissent against health care reform is genuine and many of the protesters against reform are “legitimately angry,” he believes that much of that anger and concern “is based on the fear that—on the fears that people in Washington, that corporate lobbyists, the fears they play on to create fear among people. You know, frankly, Rachel, if we had had these kind of corporate groups in Washington, they were around—been around the country creating the fear that we just saw on television. If we had seen that 45 years ago, we probably never would have gotten Medicare (see 1962). That’s why it’s so important to patiently, one person at a time, explain what this health care bill is about. Be patient, even with the anger people show. Don’t let them show disrespect. But at least, stand your ground. Don’t get angry. Don’t fight back, but answer calmly and rationally, because we need to pass this health care bill the same way that some pretty gutsy people 44 years ago passed Medicare.” The people who are “screaming euthanasia, socialized medicine” are “the people that are the most fearful.” He recalls speaking with one elderly Ohio woman who told him: “I hate socialized medicine. I don’t want government in my health care.” Brown recalls: “I asked her if she’s on Medicare. She said, ‘Yes, and I’m really pleased with my Medicare.’ Those people need education instead of the fear-mongers playing up on their fears.” (MSNBC 8/12/2009)
President Obama holds a “town hall” meeting in Portsmouth, New Hampshire, to discuss health care. Although the audience is allowed to attend on a first-come first-served basis, it is comprised mostly of health care reform supporters. During the event, Obama repeatedly solicits questions from skeptics of his health care plan, telling the audience, “I don’t want people thinking I have a bunch of plants in here.” In his remarks, Obama addresses what he calls some of the “wild misrepresentations that bear no resemblance to what’s in the [reform] bill.” He says for years, patients have been “held hostage” by insurance companies, and adds that “for all the scare tactics out there, what is truly scary” and risky would be the status quo, such as projections that Medicare will be in the red within five years. (Tapper and Miller 8/11/2009; Think Progress 8/11/2009) Seventy percent of the participants in the town hall were chosen in a random, online lottery, without consideration of political affiliation. The questions Obama answers are not prescreened. (MSNBC 8/12/2009)
Debunking 'Death Panels' - Obama opens by saying: “I do hope that we will talk with each other and not over each other. Where we do disagree, let’s disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that’s actually been proposed.… Because the way politics works sometimes is that people who want to keep things the way they are will try to scare the heck out of folks. And they’ll create boogeymen out there that just aren’t real.” (MSNBC 8/12/2009) Obama notes the claim of so-called “death panels that will pull the plug on Grandma,” directly referring to former Governor Sarah Palin (R-AK)‘s recent claim that the Democrats intend to create “death panels” that would decide who lives and dies (see August 7, 2009). Obama responds: “[I]t turns out that this, I guess, rose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care,” as well as living wills, hospice care, and the like. The “intention” is to help patients prepare for “end of life on their own terms.” Ironically, Obama adds, one of the chief sponsors of this idea is a Republican, Senator Johnny Isakson (R-GA), who “sensibly thought this would expand people’s options.” (Isakson takes issue with being identified as a sponsor of “end-of-life” counseling—see August 11, 2009). Obama says that beneath the false claims of “death panels” exists a real concern: “if we are reforming the health system to make it more efficient that somehow that will mean rationing of care.” He gives an example of such a concern: “some bureaucrat” saying “You can’t have this test, you can’t have this procedure” because “some bean counter” says so. This will not be the case, Obama says. The reform package would ensure that doctors and patients, not bureaucrats, make such decisions. He notes that insurance company bureaucrats “right now are rationing care.… So why is it that people would prefer having insurance companies making those decisions rather than medical experts and doctors figuring out what are good deals for care?” Obama tells his listeners: “I want to be very clear” about the “underlying fear that people won’t get the care they need. You will have the care you need, but also care that is being denied to you right now—that is what we are fighting for.” (Tapper and Miller 8/11/2009; Think Progress 8/11/2009)
Countering Claims of 'Enemies List' - Obama also counters recent claims that the White House is attempting to compile a list of “enemies” in asking that emails containing “fishy” health care information be forwarded to it. “Can I just say this is another example of how the media just ends up completely distorting what’s taking place?” he says. “What we’ve said is that if somebody has—if you get an email from somebody that says, for example, ‘ObamaCare is creating a death panel,’ forward us the email and we will answer the question that is being raised in the email. Suddenly, on some of these news outlets, this is being portrayed as Obama collecting an enemies list. Now, come on guys, here I am trying to be responsive to questions that are being raised out there—and I just want to be clear that all we’re trying to do is answer questions.” In recent days, Senator John Cornyn (R-TX) claimed that the White House “want[s] information on opponents of its health care plan.” (Nill 8/11/2009)
Advocating Violence outside the Venue - Outside the venue, a man, William Kostric, stands in the crowd with a gun strapped to his leg. Under New Hampshire law, he is within his rights to openly carry a handgun. He carries a sign that reads, “It is time to water the tree of liberty.” MSNBC host Rachel Maddow notes: “It’s a reference, of course, to Thomas Jefferson’s famous words, ‘The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants.’ For perspective on the implication of Jefferson’s words in this context being quoted by the guy with the gun at the event as which the president was speaking, when Timothy McVeigh was arrested 90 minutes after the Oklahoma City bombing, he was wearing a t-shirt with that slogan and a picture of Abraham Lincoln on the front and a tree dripping with blood in the back” (see 9:03 a.m. -- 10:17 a.m. April 19, 1995). Maddow later notes that McVeigh’s shirt bore the words “Sic Semper Tyrannis”—“thus always to tyrants”—the words shouted by Lincoln’s assassin after firing the fatal shot. Another anti-reform protester, Richard Terry Young, is arrested by security officials after sneaking inside the building hours before Obama arrives. He is carrying a knife on his person and a .38 caliber semi-automatic pistol in his truck with a round in the chamber. A number of anti-reform protesters from the New Hampshire Republican Volunteer Coalition also stage a protest outside the event. One advocates murdering all undocumented immigrants: “Why are we bankrupting this country for 21 million illegals who should be sent on the first bus one way back from wherever they come from? We don’t need illegals. Send them home once. Send them home with a bullet in their head the second time. Read what Jefferson said about the Tree of Liberty—it’s coming, baby.” (Nill 8/11/2009; MSNBC 8/12/2009; MSNBC 8/13/2009)
Fox News legal analyst Peter Johnson, commenting on the Democrats’ health care reform legislation on the morning show Fox and Friends, claims “no one is saying” that the reform package would kill old people (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, and August 11, 2009). “The president’s reform plan is a redistribution of health care,” Johnson says. “And what he’s saying is, I want to reduce hospital costs by $220 billion from Medicare. I want to cut out Medicare Advantage that affects 10 million people. I want to reduce imaging studies. I want to reduce electric wheelchairs. I want to reduce advanced nursing care in facilities. So no one is saying that the president wants to kill old people.” Unfortunately, on the very same program, Johnson said two weeks before that the reform package would indeed kill old people: “Some people are saying, well, this is a health care reform, other people say—maybe me—that this is a subtle form of euthanasia. And when you start looking at the proposals, you say, ‘God, what’s happening?’” Johnson has made similar accusations in the recent past, and said that under the reform proposals, America would become a “kind of 2009 ‘Brave New World,’ ‘Soylent Green,’ ‘1984,’ Aldous Huxley kind of world” where doctors will advise you to end your life rather than continue your care. (Media Matters 7/28/2009; Media Matters 7/31/2009; Media Matters 8/3/2009; Jilani 8/12/2009)
Representative Judy Biggert (R-IL) denounces the raucous and polarizing debates surrounding health care reform that have led to what she calls “circus” town hall meetings around the nation (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, August 5, 2009, August 5, 2009, August 6, 2009, August 6, 2009, August 6-8, 2009, August 8, 2009, August 10, 2009, August 10, 2009, August 11, 2009, and August 11, 2009). At the same time, she hands out a flier warning that the Democrats’ health care reform proposal would “encourage” senior citizens to “give up,” rather than seek treatment for serious illnesses. Biggert’s flyer says that the reform legislation “requires end-of-life counseling for seniors that might encourage them to give up when facing a serious illness.” It also asserts that the plan would “force” 114 million citizens onto government health care, and remove “millions of seniors” from Medicare. She concedes that the flier is “a little inflammatory,” and explains, “I probably wrote it when I was mad.” Biggert denies knowing that her staff would place the flyers on the chairs of scores of attendees at a Naperville Chamber of Commerce panel on health care reform. The flier promotes Biggert’s own reform ideas and attacks the Democratic plan. Biggert’s assertions have been roundly debunked (see July 23, 2009 and July 23, 2009). Biggert, 71, says that she understands why seniors are frightened of reform. “I picture myself going out into the forest and sitting there like the tribes used to do or getting on an iceberg and floating away.” As for the admittedly inflammatory flier, she says: “I think that is something that is between me and whoever… whether it is my doctor or my conscience or whatever.… I’m not talking that there is euthanasia or anything, but it is a concern particularly for seniors and a lot of seniors are upset about that. I’m not trying to upset them. This is what I have heard from them.” She denies handing the fliers out in the senior centers she has visited recently. (Ryan 8/13/2009; Corley 8/13/2009)
Representative John Mica (R-FL) tells listeners of Florida’s WDBO-AM that the idea of “death counselors” actually exists in the Democrats’ health care reform package. “They create a whole new category,” Mica says. “There are death counselors. There is authorization for reimbursement for those counselors for Medicare. You have a whole new cottage industry.” Mica’s idea, apparently sparked by debunked claims by former Governor Sarah Palin (R-AK) and health care industry lobbyist Betsy McCaughey, among others (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, August 6, 2009, August 7, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, and August 12, 2009), actually refers to the legislation’s provision that Medicare would pay for “advanced care planning consultations” for elderly and seriously ill patients (see July 23, 2009, July 23, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 10, 2009, August 11, 2009, and August 11, 2009). (Hazen 8/12/2009; Jilani 8/12/2009)
Investigative journalists find that at least seven prominent Republicans who now denounce what they call “death panels” and claim that the Democrats’ health care legislation will lead to the untimely deaths of US senior citizens (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, August 11, 2009, August 12, 2009, August 12, 2009, August 12, 2009, and August 13, 2009) actually supported proposals similar to the legislation’s provision for government-funded “end-of-life counseling.”
Palin, Gingrich Supported 'Advance Directives' - In August 2008, Sarah Palin (R-AK), then the governor of Alaska, proclaimed “Healthcare Decisions Day.” She urged public health care facilities to provide more information about so-called “advance directives,” and said that seniors must be informed of all their options as the end of their lives draw near. The proclamation has recently been deleted from the Alaska governor’s Web site. Reporter Matt Taibbi notes that in late 2008 and early 2009, former House Speaker Newt Gingrich (R-GA) endorsed an aggressive “end of life” program from a Wisconsin health care provider, Gundersen Lutheran Health System, and wrote, “If Gundersen’s approach was used to care for the approximately 4.5 million Medicare beneficiaries who die every year, Medicare could save more than $33 billion a year.” Taibbi accuses Gingrich of “lying [about death panels] in order to scare a bunch of old people.” (Matt Taibbi 8/12/2009; Fang 8/13/2009)
Five Others Voted for End-of-Life Counseling - In 2003, five Republicans who now oppose the supposed “death panels” voted in favor of an almost-identical provision in that year’s Medicare reform legislation. Representatives John Boehner (R-OH), Thaddeus McCotter (R-MI), Johnny Isakson (R-GA), and John Mica (R-FL), and Senator Chuck Grassley (R-IA) all voted for the bill, which provided coverage for “counseling the beneficiary with respect to end-of-life issues and care options, and advising the beneficiary regarding advanced care planning.” Boehner, McCotter, and Mica have claimed that the current attempt at health care reform would lead to “government-encouraged euthanasia.” Isakson opposes the House legislation because it allows the “government to incentivize doctors by offering them money to conduct end-of-life counseling.” And Grassley told constituents that they are “right to fear” that government could “decide when to pull the plug on Grandma” (see August 12, 2009). (Sargent 8/14/2009)
Widespread Republican Support in 2003 - In all, 202 House Republicans and 42 Republican Senators voted for the Medicare bill. MSNBC host Rachel Maddow will say: “And there was not a peep about then-President Bush having a secret plan to kill old people. Bottom line? Either Republicans like Chuck Grassley and John Boehner and John Mica have totally changed their minds about whether living wills are really a secret plot to kill old people, or they voted for something just a few years ago that they actually thought was a secret plot to kill old people. Take your choice.” (MSNBC 8/17/2009)
After briefly backing away (see August 10, 2009) from her earlier claim that the Democrats’ health care reform legislation would mandate so-called “death panels” (see August 7, 2009), former Governor Sarah Palin (R-AK) reiterates her claim. In a post on her Facebook page, Palin writes: “Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care (see August 11, 2009); that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system, these ‘unproductive’ members of society could face the prospect of government bureaucrats determining whether they deserve health care. The provision that President Obama refers to is Section 1233 of HR 3200, entitled ‘Advance Care Planning Consultation.’ With all due respect, it’s misleading for the president to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients.… Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often ‘if there is a significant change in the health condition of the individual… or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program.‘… President Obama can try to gloss over the effects of government-authorized end-of-life consultations, but the views of one of his top health care advisers are clear enough (see July 23-24, 2009). It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.” Members of Palin’s own party have called her claims inaccurate (see August 11, 2009) and “nuts” (see August 10, 2009), White House press secretary Robert Gibbs has identified Palin as one of the persons responsible for spreading “wrong” information about health care reform, and the Democratic Congressional Campaign Committee (DCCC) is using her claims in a fundraising plea to supporters, calling her statement “disgusting” and “outrageous.” (Barr 8/13/2009)
In an op-ed for USA Today, House Minority Leader John Boehner (R-OH) takes the White House to task for “letting House Speaker Nancy Pelosi [D-CA] and Congress run health care reform into the ground,” and says that Republicans have always “stood ready to work with him to pass bipartisan health care reforms that reflect the priorities of struggling American families and small businesses.” Boehner says Pelosi and the Congressional Democrats have crafted a bill that “puts Washington in control of Americans’ health care—something most Americans staunchly oppose.” He then accuses President Obama of trying to “spin the American people” about what he calls the “hopelessly flawed bill.” He terms the bill “radical,” and claims, falsely, that Pelosi and House Majority Leader Steny Hoyer labeled opponents of the bill “un-American” (see August 10, 2009—Pelosi and Hoyer wrote that “[d]rowning out opposing views is simply un-American”). Boehner says that neither Republicans nor anyone else “condone… the actions of those who disrupt public events,” but decries those who claim the dissent against the bill is in any way “manufactured” (see April 14, 2009, April 15, 2009, May 29, 2009, July 27, 2009, August 4, 2009, August 5, 2009, Before August 6, 2009, August 6, 2009, August 6-7, 2009, August 10, 2009, and August 12, 2009). He says Obama is lying about the portion of the bill that would allow Americans to keep their present health care, and cites the debunked study by the Lewin Group (see July 27, 2009) as evidence. He says the bill would add $239 billion to the deficit over the next decade, says Obama is lying about not cutting Medicare benefits, and says Obama is lying when he says the bill would not lead to health care “rationing.” Boehner concludes by claiming that “Republicans are offering better solutions that would make quality health care more affordable and accessible for every American,” and calls on Obama to “scrap this costly plan, start over, and work with Republicans on reforms that reflect the priorities of the American people.” (Boehner 8/13/2009) Liberal news and advocacy Web site Think Progress notes that Boehner’s office has sent out messages promoting the town hall disruptions, and notes that Boehner’s claims of “rationing” are wrong. (Corley 8/13/2009)
Representative Michele Bachmann (R-MN) tells Fox News viewers that health care reform is unconstitutional. She says: “It is not within our power as members of Congress, it’s not within the enumerated powers of the Constitution, for us to design and create a national takeover of health care. Nor is it within our ability to be able to delegate that responsibility to the executive.” Ian Millhiser of the progressive news and advocacy Web site Think Progress takes issue with Bachmann’s statement, writing that she “is wrong about both the contents of the health care plan and the requirements of the Constitution.” None of the versions of health care legislation being considered in Congress make any provision for a “national takeover of health care.” Bachmann may be referring to the “public option,” which would create a government-run health care plan that citizens could choose to participate in. Millhiser notes that Article I of the Constitution gives Congress the power to “lay and collect taxes, duties, imposts, and excises,” and to “provide for… the general welfare of the United States.” Millhiser writes, “Rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the ‘general welfare.’” Millhiser writes that it is unclear what Bachmann means by “delegat[ing] that responsibility to the executive,” but notes that no one has proposed giving the White House anything approaching the authority to run or reconfigure the US health care system. He calls Bachmann’s view of the Constitution “radical,” and writes: “If Congress does not have the power to create a modest public option which competes with private health plans in the marketplace, then it certainly does not have the authority to create Medicare. Similarly, Congress’ power to spend money to benefit the general welfare is the basis for Social Security, federal education funding, Medicaid, and veterans’ benefits such as the VA health system and the GI Bill. All of these programs would cease to exist in Michele Bachmann’s America.” (Millhiser 8/19/2009)
An NBC/Wall Street Journal poll shows that the misinformation permeating the debate over health care reform is having an effect. Forty-five percent believe that the reform legislation pending in Congress includes “death panels” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, August 11, 2009, August 12, 2009, August 12, 2009, August 12, 2009, August 13, 2009, August 12-13, 2009, August 13, 2009, and August 15, 2009), and 55 percent believe that illegal immigrants will receive government-funded coverage. These numbers are disproportionately higher among Fox News viewers: 72 percent believe the government will fund coverage of illegal immigrants, 75 percent believe in “death panels,” and 79 percent believe the reform bill will lead to a government takeover of the US health care system. Large minorities of other network viewers believe these same examples of misinformation. MSNBC’s Domenico Montanaro writes: “This is about credible messengers using the media to get some of this misinformation out there, not as much about the filter itself. These numbers should worry Democratic operatives, as well as the news media that have been covering this story.” (Montanaro 8/19/2009; Corley 8/19/2009) Another poll, from Public Policy Polling, shows that 39 percent of Americans want the government to “stay out of Medicare,” apparently unaware that the government funds, administers, and operates Medicare. The same poll shows that 38 percent of respondents do not believe President Obama is a natural-born American citizen; six percent don’t believe that Hawaii, Obama’s birth state, is part of the United States. The poll does not differentiate between Fox viewers and others. (Jilani 8/19/2009)
In an interview with NPR, Michael Steele, the chairman of the Republican National Committee (RNC), finds it difficult to both support Medicare and attack government-run health care. Steele is interviewed by Steve Inskeep, and tells him that government-run health care is never a good option, but simultaneously demands that health care reformers protect Medicare and retain its funding.
Says Democrats Want to Cut Medicare, Then Advocates Cutting Medicare - Steele calls Medicare “a valuable program” that is “the last line of opportunity” for elderly Americans to receive health care. He accuses Democrats of wanting to “raid” the program to fund health care reform, and says accusations that he wants to cut Medicare spending is “a wonderful interpretation by the left” that he wants to reduce such funding. However, in response to the next question, Steele says he supports cutting Medicare spending; Inskeep asks, “[Y]ou would be in favor of certain Medicare cuts?” and Steele says: “Absolutely. You want to maximize the efficiencies of the program. I mean, anyone who’s in the program would want you to do that, and certainly those who manage it want you to that.”
Protecting and Attacking Medicare Simultaneously - Inskeep pins Steele down on the dichotomy by noting that he has previously written about the need to protect Medicare while attacking the idea of President Obama’s “plan for a government-run health care system.” Inskeep observes, “You’re aware that Medicare is a government-run health care program,” and Steele retorts: “Yeah, look how it’s run. And that’s my point. Take Medicare and make it writ large across the country, because here we’re now—how many times have we been to the precipice of bankruptcy for a government-run health care program?” In the following exchange, Steele, according to Think Progress reporter Amanda Terkel, “tie[s] himself into knots”:
Inskeep: “It sounds like you don’t like Medicare very much at all.”
Steele: “No, I’m not saying that. No, Medicare…”
Inskeep: “… But you write in this [Washington Post] op-ed that you want to protect Medicare because it’s politically popular. People like Medicare.”
Steele: “No, no, no, no, no. Please, don’t…”
Inskeep: “That’s why you’re writing to protect Medicare.”
Steele: “Well, people may like Medicare, and liking a program and having it run efficiently is sometimes two different things. And the reality of it is simply this: I’m not saying I like or dislike Medicare.… My only point is that, okay, Medicare is what it is. It’s not going anywhere. So let’s focus on fixing it so that we don’t every three, five, 10 years have discussions about bankruptcy and running out of money.”
'You're Doing a Wonderful Little Dance' - Inskeep continues to drill into Steele’s support for Medicare and his simultaneous opposition to government-run health care, leading Steele to note, “I want to protect something that’s already in place and make it run better and run efficiently for the senior citizens that are in that system does not mean that I want to automatically support, you know, nationalizing or creating a similar system for everybody else in the country who currently isn’t on Medicare.” When Steele says the government could regulate the private industry to make sure that private insurers don’t make decisions for citizens’ health care based on profit, Inskeep asks: “Wait a minute, wait, wait. You would trust the government to look into that?” After a brief, spluttering exchange, Steele says, “I’m talking about those who—well, who regulates the insurance markets?” Inskeep notes, “That would be the government, I believe.” Steele then accuses Inskeep of trying to manipulate the conversation: “Well, and so it—wait a minute, hold up. You know, you’re doing a wonderful little dance here and you’re trying to be cute, but the reality of this is very simple. I’m not saying the government doesn’t have a role to play. I’ve never said that. The government does have a role to play. The government has a very limited role to play.”
Insists that 'No One's Trying to Scare' Americans about Reform - Towards the end of the interview, Inskeep asks whether it is difficult to explain health care to Americans in a way that “doesn’t just kind of scare people with soundbites.” Steele replies: “No one’s trying to scare people with soundbites. I have not done that, and I don’t know any leaders in the House and the Senate that have done that.” (National Public Radio 8/27/2009; Terkel 8/27/2009) Steele has called the Democrats’ health care reform plan “socialism” and accused Congressional Democrats of being in a “cabal” to enact government-controlled health care over the objections of the American populace (see July 20, 2009). And his RNC has sent out a survey suggesting that the Democrats’ reform proposal would discriminate against Republicans (see August 27, 2009).
Newsweek publishes an extensive article detailing what it calls “the five biggest lies in the health care debate.” Despite the title, the article actually debunks seven.
The government will have electronic access to your bank accounts and steal citizens’ money (see (July 30, 2009) and After). The bill passed by the House Ways and Means Committee indeed calls for electronic fund transfers, but only from insurers to doctors and other providers. Patients are not involved in such transactions.
You’ll have no choice in what health benefits you receive. This story seems to originate from a blog, Flecks of Life, which features a picture of President Obama made up as the Joker from the Batman films. The House bill provides for a “health care exchange,” including a list of private insurers and a single government plan, allowing people without health insurance to choose from the list. The government will prevent insurers from refusing clients with “preexisting conditions,” and require them to offer at least minimum coverage. However, Newsweek observes, “The requirements will be floors, not ceilings, however, in that the feds will have no say in how generous private insurance can be.”
No chemo for older Medicare patients. Newsweek calls this a “vicious” rumor coming from the so-called “deather” camp (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, August 11, 2009, August 12, 2009, August 12, 2009, August 12, 2009, August 13, 2009, August 12-13, 2009, August 13, 2009, August 15, 2009, August 18, 2009, and August 23-24, 2009). The claim is that Medicare will refuse cancer patients over 70 years of age anything other than end-of-life counseling, including chemotherapy and other life-extending treatments. The claim, Newsweek says, “has zero basis in fact. It’s just a vicious form of the rationing scare.”
[H]ealth-care reform will be financed through $500 billion in Medicare cuts. Again, nothing in the House bill or anything being considered in the Senate exists to back this claim. There are proposed decreases to increases in future Medicare funding, essentially reducing Medicare expenditures from the forecast of $803 billion by 2019. $560 billion would be removed from future Medicare increases over the next 10 years, and would not come from funds slated to provide actual care to seniors. And the House bill proposes increasing Medicare funding by $340 billion over the next 10 years. According to Medicare expert Tricia Newman of the Kaiser Family Foundation, the money would pay for office visits, eliminate copays and deductibles, and close the so-called “donut hole” in Medicare drug benefits.
Illegal immigrants will get free health insurance. While a 1986 law allows illegal immigrants to receive free emergency care through emergency room clinics like everyone else in America, the House bill does not give anyone free health care. Illegal immigrants will not be eligible for subsidies to buy health insurance. In July, the House defeated a Republican-sponsored amendment to require anyone enrolling in a public plan or seeking subsidies to purchase health insurance to provide proof of citizenship. After the amemdment was defeated, Representative Steve King (R-IA) began spreading the false claims that since proof of citizenship would not be mandated, illegal immigrants would indeed be able to obtain government-funded health insurance. Newsweek writes: “Can we say that none of the estimated 11.9 million illegal immigrants will ever wangle insurance subsidies through identity fraud, pretending to be a citizen? You can’t prove a negative, but experts say that Medicare—the closest thing to the proposals in the House bill—has no such problem.”
Death panels will decide who lives. So-called “death panels” form the heart of the “deather” claims that the government would mandate “end of life counseling sessions” that would encourage elderly and seriously ill patients to allow themselves to die. Newsweek calls the claim a “lie” that “springs from a provision in the House bill to have Medicare cover optional counseling on end-of-life care for any senior who requests it. This means that any patient, terminally ill or not, can request a special consultation with his or her physician about ventilators, feeding tubes, and other measures. Thus the House bill expands Medicare coverage, but without forcing anyone into end-of-life counseling.”
The government will set doctors’ wages. This is another claim that seems to have originated on the Flecks of Life blog. Like the earlier claim, it is false. The House bill, according to Newsweek, “says that physicians who choose to accept patients in the public insurance plan would receive five percent more than Medicare pays for a given service, [but] doctors can refuse to accept such patients, and, even if they participate in a public plan, they are not salaried employees of it any more than your doctor today is an employee of, say, Aetna.” Amitabh Chandra of Harvard University says, “Nobody is saying we want the doctors working for the government; that’s completely false.” (Begley 8/29/2009)
Representative Anthony Weiner (D-NY), a vocal supporter of health care reform and an advocate of universal health care for all Americans (see July 30, 2009), engages in a contentious on-air debate on MSNBC with CNBC’s Maria Bartiromo. Weiner extolls the virtues of Medicare, a US-run health care system for all citizens 65 or older: “The United States of America, 40 percent of all tax dollars go through a public plan. Ask your parent or grandparent, ask your neighbor whether they’re satisfied with Medicare. Now, there’s a funding problem, but the quality of care is terrific. You get complete choice and go anywhere you want. Don’t look at—” Bartiromo interrupts Weiner by snapping: “How come you don’t use it? You don’t have it. How come you don’t have it?” Weiner replies: “Because I’m not 65. I would love it.” Bartiromo, seemingly unaware that Medicare is only for those aged 65 or older, and also that Weiner is 20 years too young for the system, retorts, “Yeah, come on.” Weiner says: “Medicare for someone age 45? I would take it in a heartbeat.” (Klein 9/1/2009; Pitney 9/1/2009)
The Pharmaceutical Research and Manufacturers of America (PhRMA) acknowledges it has funded a series of television advertisements in support of legislation primarily written by Max Baucus (D-MT), chairman of the Senate Finance Committee, to reform US health care. The television ads are part of an agreement between the Obama administration, Baucus, and PhRMA in June, where the organization agreed to various givebacks and discounts designed to reduce America’s pharmaceutical spending by $80 billion over 10 years. PhRMA then set aside $150 million for advertising to support health care legislation. More progressive House Democrats such as Henry Waxman (D-CA) are pushing for stiffer drug industry givebacks than covered in the deal. PhRMA is led by Billy Tauzin, a former Republican congressman. Until recently, the organization spent some $12 million on ads by an offshoot coalition called Americans for Stable Quality Care, and aired television ads such as “Eight Ways Reform Matters to You.” PhRMA’s new ads will specifically support the Baucus bill. Many are critical of the deal, with James Love of the progressive research group Knowledge Ecology charging, “Essentially what the US got was not $80 billion, but $150 million in Obama campaign contributions.” (Wilson 9/12/2009) Investigative reporter Matt Taibbi agrees with Love, accusing the White House of colluding with Baucus and Tauzin’s PhRMA to orchestrate a “big bribe” in exchange for the Democrats’ dropping of drug-pricing reform in the Baucus bill. Taibbi writes that in June, White House chief of staff Rahm Emanuel met with representatives from PhRMA and drug companies such as Abbott Laboratories, Merck, and Pfizer to cut their deal. Tauzer later told reporters that the White House had “blessed” a plan involving the $150 million in return for the White House’s agreement to no longer back government negotiations for bulk-rate pharmaceuticals for Medicare, and to no longer support the importation of inexpensive drugs from Canada. Taibbi writes that the White House worked with Baucus and PhRMA to undercut Waxman’s attempts to give the government the ability to negotiate lower rates for Medicare drugs. PhRMA’s ads are being aired primarily in the districts of freshmen Democrats who are expected to face tough re-election campaigns, and in the districts of conservative “Blue Dog” Democrats, who have sided with Baucus, Obama, and PhRMA to oppose the Waxman provision in favor of PhRMA’s own provision, which would ban the government from negotiating lower rates for Medicare recipients. (Taibbi 9/14/2009)
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