Claims about a government takeover, rationing largely unfounded

In her Vital Signs column for Marketwatch, Kristen Gerencher writes:

“As the clock ticks toward what could be final congressional approval of the most sweeping health-reform legislation in more than 40 years, a little perspective is in order.”

“The health-care system is complex, yet Americans’ experiences with it are deeply personal, making it a prime candidate for distortions and emotional manipulation. While people hold different views about what the nation should do about its coverage, cost and quality problems, facts and nuance often get lost in the political rhetoric of the debate.”

You can read the whole article here. The excerpts below summarize the five myths as she and her panel see them:

Assertion: It would lead to a government takeover of health care

The bottom line: “More care is going to be financed by government, but more care is not going to be provided by government,” Zuckerman said.

Assertion: An overhaul would lead to rationing, where more people face denials or delays in health care

Americans don’t support what he called hard rationing, when a person has the money to be treated but is prevented from getting care.

“The American public is quite accepting of rationing in the softer sense, that if you can’t afford it you can’t have it,” he said. “Pushing back that frontier is part of the objective of [the legislation.] The main thrust is to reduce rationing in terms of price rationing.”

Assertion: The bills do nothing to address out-of-control cost growth

“In the short run, cost-containment elements are not strong, but there are pieces in the legislation that could play out over time to contain costs,” he said. “It doesn’t look like the cost containment [elements] of the bill are as strong as they could be, but to say they’re nonexistent is an overstatement.”

Assertion: If you like your health insurance you can keep it

Many experts speculate that it would work out that way but caution that it’s not guaranteed, especially since the two bills assess the potential problem differently. While people wouldn’t be forced to change what they have, employers may decide for them if they wager they’d be better served to drop coverage and let their workers shop for policies in the new insurance marketplaces the bills envision.

Assertion: The bills are too big, and changes should be tackled one by one instead of all at the same time

It’s been 15 years since the U.S. came even remotely close to passing comprehensive health reform. While this year’s attempt is ambitious, people who decry the scope of the bills underestimate how many moving parts need to work in unison to achieve the desired results, Nichols said.

“It’s got to be done as a package,” he said.

For example, health insurers would be newly required to accept all comers regardless of their preexisting conditions in exchange for a new requirement that individuals have coverage or face financial penalties.

Addressing cost control without extending health insurance at the same time wouldn’t work either, Nichols said. “You cannot get to serious cost containment without the salve of coverage.”

“The status quo is not sustainable,” he added. “The people who argue that having somebody pay a dollar more or lose their extra glasses in their Medicare Advantage plan is somehow equivalent to leaving 50 million uninsured and doing nothing to contain the cost growth that’s eating our economy alive, that’s just folly. That’s what opponents are trying to get Americans to accept yet one more time.”