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Separating Fact from Fiction in Health Reform Debate

August 27, 2009 at 4:02 PM EDT
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With five different versions of a health care bill in Congress, Ray Suarez examines the effort to separate fact from fiction in the national debate over a reform plan.

JEFFREY BROWN: Health care reform continued to be a hot topic at congressional town meetings this week. An exchange between Senator John McCain and a constituent in Sun City, Arizona, help explains why.

TOWN HALL ATTENDEE: I came here for a reason, and that’s to learn, and I support this. I’ve got a couple questions. When I was in school, Jack and Jill ran up the hill. I could understand that.

This stuff that comes out of Washington now that’s in legislation bills, they don’t even know what’s in it. How can we expect to know what’s in it?

Why can’t we just have a simple — first, simple statement saying, “This is this, this is this.” No, they got in the there, it will be in there, and not right now, but it will be, we hope to get in the there, yes, it’s in there, no, it isn’t in there. We don’t understand nothing.

SEN. JOHN MCCAIN, R-Ariz.: Wait a minute. Sir, sir, come here a second, would you? Would you come back? Here’s the bill. Six hundred pages, and it doesn’t have a major portion of the reform that they’re contemplating. The one in the House was 1,000 pages.

JEFFREY BROWN: Well, there are actually five different versions of health reform bills in Congress right now. Ray Suarez tries to separate fact from fiction about their contents.

RAY SUAREZ: As the health care debate rages on across the country, much of the back-and-forth has centered on controversial provisions that may or may not actually be in any of the proposals currently working their way through Congress.

In his weekly address on Saturday, President Obama sought to debunk what he called “some of the more outrageous myths circulating on the Internet, on cable TV, and repeated at town halls across the country.”

U.S. PRESIDENT BARACK OBAMA: Let’s start with the false claim that illegal immigrants will get health insurance under reform. That’s not true. Illegal immigrants would not be covered. That idea has never even been on the table.

Some are also saying that coverage for abortions would be mandated under reform. Also false. When it comes to the current ban on using tax dollars for abortions, nothing will change under reform.

And as every credible person who has looked into it has said, there are no so-called death panels, an offensive notion to me and to the American people.

These are phony claims meant to divide us. And we’ve all heard the charge that reform will somehow bring about a government takeover of health care. I know that sounds scary to many folks; it sounds scary to me, too. But here’s the thing: It’s not true.

RAY SUAREZ: But despite the efforts of the president and other supporters of the Democratic proposals, a recent NBC News poll found that many Americans believe just the opposite when it comes to such claims.

On whether the plans put forward by congressional Democrats would give coverage to illegal immigrants, 55 percent said they believed that was likely to happen.

Meanwhile, 54 percent said they thought the plans would lead to a government takeover of the health care system. Half of the respondents said they believed taxpayer money would be used to pay for women to have abortions. And 45 percent said that Democratic reforms would allow the government to make some decisions about when to stop providing medical care to the elderly.

To help us sort out fact from fiction, we sat down with two individuals who’ve been monitoring the health care debate closely. One is Bill Adair, editor of the nonpartisan fact-checking Web site “PolitiFact” and Washington bureau chief of the St. Petersburg Times.

The other is Julie Rovner, health policy correspondent for National Public Radio.

Fact or fiction: The Democratic plans will give health insurance coverage to illegal immigrants.

Julie, is there anything in these proposals that would allow someone who’s working in the country, living in the country illegally to get health care coverage?

Coverage for illegal immigrants

JULIE ROVNER, National Public Radio: There's no coverage in any of these proposals for people who are in the country illegally. Now, under current law, if you were in the country illegally, there are provisions for you to get care in an emergency room. That's considered a public health issue.

You don't want people who are in the country running around with perhaps contagious diseases. And, again, you know, pregnant women in labor, no matter where they're from, there's certainly a humanitarian issue. You know, people who have dire emergency needs ought to get treatment.

RAY SUAREZ: So, just to recap, under current law, illegal immigrants can receive emergency treatment, but they would not be allowed to sign up for any of the plans being debated. In fact, the language in the House bill says, "Nothing in this subtitle shall allow federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

Fact or fiction: The Democratic plans will result in a government takeover of the health care system.

Opposition to Democratic reforms has also come from those who say such plans amount to or could lead to a government takeover of health care. This has especially been true of protestors at town hall events this month.

WILLIAM COSTRICK: It's dressed-down socialism. It's redistribution of wealth. They're robbing from one person to redistribute it to someone who they feel is more worthy.

DONNA SMITH: The biggest concern is that the government will absolutely take over and make every decision for you, from birth until death.

RAY SUAREZ: Such concern arises out of the much-discussed idea of a public option, a government-run plan that would compete with private insurers. But PolitiFact's Bill Adair says the government option is just a small part of the overall plan.

BILL ADAIR, PolitiFact: The president has not proposed government-run health care. The president has proposed that three-fourths of the people roughly would keep their employer-provided private health care, the other quarter would go into a health care exchange, and one of the options in that health care exchange would be a public option, a publicly run health plan.

Controversy over abortion

RAY SUAREZ: Under the Democratic House bill, those who would qualify for the exchange include the self-employed and employees of small businesses.

Fact or fiction: The Democratic plans will use taxpayer money to pay for women to have abortions. In a July 23rd op-ed in the National Review, House Minority Leader John Boehner wrote the Democratic health care plan would "require Americans to subsidize abortions with their hard-earned tax dollars."

Adair says the issue is not as simple as either side makes it seem.

BILL ADAIR: The goal of the Democrats is to have an abortion-neutral bill. The plans in the health care exchange could still provide abortions. It's just that, in the case of taxpayer money that was used for the public option to -- that would be used to pay for the public option, that its share could not be used to pay for abortion coverage.

But that plan might still cover abortions. Theoretically, the abortion coverage in it would be paid for by the share that the patient paid for under this one version of the bill.

So when Congressman Boehner said the president's plan subsidizes abortions, we rated that one false, because, as we read that bill, there are efforts to sort of separate it out.

Debunking the 'death panel'

RAY SUAREZ: Fact or fiction: The Democratic plans will allow the government to make decisions about when to stop providing medical care to the elderly.

The idea that the government would make decisions about end-of-life care caught fire earlier this month after former Alaska Governor Sarah Palin wrote on her Facebook page that seniors and the disabled "will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment, of their 'level of productivity in society,' whether they're worthy of health care."

The health bill pending in the House includes language that would authorize Medicare to pay for a beneficiary to consult with their doctor about whether to pursue aggressive and potentially life-saving treatments later in life.

JULIE ROVNER: What's in the proposal says that there will be Medicare reimbursement for doctors to have conversations with seniors about end-of-life directives. Now, those end-of-life directives could be to say, "Do everything possible to keep me alive." It's certainly not about euthanasia. It really could be just exactly the opposite.

And, in fact, in many cases, you end up with seniors or other people who are, frankly, not elderly being incapacitated, unable to communicate, unable to express their wishes, and having it fall on family members who honestly don't know what those people's wishes are. So you end up, perhaps, with plugs being pulled on people wrongly. So this really is just really the antithesis of death panels.

Counting the uninsured

RAY SUAREZ: Fact or fiction: There are 46 million Americans who do not have health insurance.

Another point of contention that is not as hotly debated is the actual number of uninsured Americans. President Obama often cites the Census Bureau's statistic, 46 million. But one projection from the conservative think-tank Pacific Research Institute puts the number as low as 8 million, after subtracting illegal immigrants, those who can afford insurance, but choose not to buy it, and those who qualify for a government plan, but aren't currently enrolled.

BILL ADAIR: I don't think it's as low as 8 million. I mean, from what we've seen, the experts we've talked to, the surveys that we've looked at from the Census Bureau, you know, it's probably -- the Census Bureau's number is, I think, the one that we have put the most stock in. That seems to be the most reliable. And when you back out the number of non-citizens, it's probably accurate to say that about 36 million Americans are uninsured.

RAY SUAREZ: NPR's Rovner says arriving at an accurate count is not as clear cut as the president or his critics would like it to be.

JULIE ROVNER: Yes and no. Well, the first thing you can't do is simply subtract people who are in the country illegally, because a number of those people, it turns out, do have health insurance. A lot of them have Social Security numbers that they've obtained illegally, and therefore they have their own health insurance, so you can't just subtract 12 million people who are here illegally.

A lot of people don't have employer-provided health insurance. They may not work enough hours to get it or they may not be able to afford it on the wages that they make, even if they are eligible for it.

A lot of people may be eligible for public insurance, but they may not know it or they may be afraid to sign up for it. They may be here -- they may be immigrants who are here legally but they may be frightened of the system. So it's not quite as simple as it seems.

RAY SUAREZ: And with public opinion seemingly opposed to the facts in a lot of cases, one thing is certain: When it comes to debunking health care myths, it's easier said than done.

JEFFREY BROWN: Bill Adair and Julie Rovner will answer your questions about health care reform at our Web site,