Health Care: The 10 Most Constructive Insights, Suggestions and Questions of 2009

By Naomi Freundlich and Maggie Mahar TCF

This year the rhetoric around health care reform reached historic levels. Barely a week went by without pundits dissecting some new fact, policy detail or wording change implicit in the various reform plans emerging from Congress. The result was a barrage of media reports, often conflicting, that heralded the demise or success of reform on a regular basis. Twisted facts, reactionary politics and just plain scare tactics have been pervasive.
Below, “The 10 Most Destructive Lies about Health Care Reform in 2009” and “ The Ten Most Constructive Insights, Suggestions and Questions.”


Heath Care Reform: The 10 Most Destructive Lies of 2009
1.)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 are worthy of health care."
Sarah Palin made these comments on her Facebook page, responding to a provision in the House health care bill that would provide compensation to doctors who consult with patients about end-of-life care. The lie quickly spread—repeated at town hall meetings, tea parties, on Fox TV and throughout the Conservative blogosphere.

2) “You lie!” Joe Wilson’s angry shout-out to President Obama in the middle of his speech before the joint session of Congress made headlines this fall. Wilson was responding to Obama’s promise that health reform will not include coverage for illegal immigrants.

3) “Despite public statements by Pres. Barack Obama that ‘no federal dollars will be used to fund abortion,’ all of the major bills under consideration would put the federal government into the business of subsidizing elective abortion on a massive scale.” Minnesota Citizens Concerned for Life

“The Kennedy bill would result in the greatest expansion of abortion since Roe v. Wade.” according to National Right to Life Legislative Director Douglas Johnson

This charge, made by Conservative groups like the Family Research Council (which ran an ad with a distraught older man telling his wife that Medicare won’t pay for his back surgery because the government is spending too much on abortions) helped fuel opposition to reform.


4) “I have a message for you--You’re gonna die sooner!”

Dec. 1 2009 Senator Tom Coburn (R-OK) on the floor of the Senate warning senior citizens. Coburn was speaking about proposed Medicare cuts that could total billions of dollars. In fact, savings would come from removing the waste and over-treatment that plague the program.


5) “Health care reform will mean women won’t be able to get mammograms…”

Carly Fiorina, candidate for U.S. Senate from California made this statement during a weekly Republican address. She exploits her experience as a breast cancer survivor to make her case against health reform:

“Will a bureaucrat determine that my life isn’t worth saving?,” she asked before suggesting that the Senate health care bill would allow the Task Force to ration cancer treatments.

6) The Department of Veterans Affairs has "a manual out there telling our veterans stuff like, 'Are you really of value to your community?' You know, encouraging them to commit suicide." (Michael Steele)


7) "Take your AARP card, cut it in half and send it back. They've betrayed you," McCain told seniors after the group endorsed Medicare cuts. The Senator proposed an amendment that would “strip” the cuts from legislation—even though he had no intention of voting for the bill anyway.

8) "President Obama . . . wants to mandate circumcision." (Rush Limbaugh)

9) “Obamacare Could Kill You”. , writing in The Spectator, warns that, a Federal Health Board will be used to make life and death decisions based on cost-effectiveness -- deciding, for example when a drug’s expense has become too high to justify giving it to dying cancer patients.


10) A data-storing microchip "would be implanted in the majority of people who opt to become covered by the public health care option." (chain e-mail that found its way into the blogosphere)

Health Care: The 10 Most Constructive Insights, Suggestions and Questions of 2009
1) Maybe Washington Post columnists should have term-limits? Jamison Foser, County Fair, November 22, 2009, Jamison Foser.

2 ) The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

3) “Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation.” Christopher, Hayes, writing in the Nation,” commenting on Rick Scott, the founder of Conservatives for Patients Rights who is best known as the former CEO of Columbia/HCA, the for-profit hospital chain that was forced to pay $1.7 billion to settle the largest health care fraud lawsuit in history.

4) “Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina—all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved. The difficulty is how to go about it.” Dr. Atul Gawnde

5) “If No Republicans Will Join, Why Should the Democrats Negotiate with . . . . Nobody?” asked Chris Matthews after grilling Republican Orrin Hatch on what it would take to get him to vote for health care reform.

“Would you sign on to any health reform bill this year?” Matthews queried. “Assume they dropped the public option and put in tort reform would you sign on? . . . or is this just a stupid negotiation? Are the Democrats just negotiating with themselves?”


6) “Name any stakeholder – hospital, physician, nurse, insurer, pharmaceutical manufacturer, supplier, even patients’ groups – every single one of them says, 'Oh, we need change! We need change!'But, when it comes to specifics, every single one of them demands to be kept whole or made better off.

“We are stuck in ‘the Tragedy of the Commons. The smart strategy for each person separately is not the best strategy for all people together. What is good for ‘me’ is not good for ‘us.’ Just like the villagers, health care stakeholders are eroding a common good by doing what makes sense for each of them, separately. In the short run, everyone wins. In the long term, everyone loses.” Dr. Donald Berwick, delivering the keynote address at Institute for Health Care I mprovement’s (IHI) 21st Annual National Forum on Quality and Improvement in Health Care,

7) Here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community has come to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.” Dr. Atul Gawande, commenting on over-treatment in McAllen, Texas in “The Cost Conundrum.”

8) Over the past year, “the profit margin for health insurance companies was a modest 3.4 percent. Among the large, for-profit health insurers, profit margins line up with the industry as a whole: UnitedHealthGroup, the biggest health insurer, had a 4.1 percent profit margin over the past 12 months. WellPoint, the next biggest, had a 4 percent profit margin. Aetna, Cigna, and Humana came in below that.”

By contrast, “Pharmaceutical companies have a profit margin of 16.4 percent,” seventh highest of the 215 industries that Morningstar tracks. . . The big money isn’t in the insurance industry.”(Rick Newman, writing in U.S. News & World Report)

9) “An Independent Medicare advisory commission of doctors and medical experts charged with identifying waste can help encourage the adoption of common-sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.” President Obama, in a speech to Congress just after Labor Day

10) “Health Bill Alone Won't Stem Costs: White House” Reuters, reporting on White House Budget Director Peter Orszag’s comments on health care legislation. Orszag “indicated that other actions outside of Congress would still be needed to improve how medical care is delivered, including the Senate's proposed independent commission to oversee parts of Medicare.”