http://news.yahoo.com/s/ap/20090910/ap_on_go_pr_wh/us_health_care_fact_check


FACT CHECK: Obama uses iffy math on deficit pledge

By CALVIN WOODWARD and ERICA WERNER, Associated Press Writers Calvin Woodward And Erica Werner, Associated Press Writers – 21 mins ago

WASHINGTON – President Barack Obama used only-in-Washington accounting Wednesday when he promised to overhaul the nation's health care system without adding "one dime" to the deficit. By conventional arithmetic, Democratic plans would drive up the deficit by billions of dollars.

The president's speech to Congress contained a variety of oversimplifications and omissions in laying out what he wants to do about health insurance.

A look at some of Obama's claims and how they square with the facts or the fuller story:

OBAMA: "I will not sign a plan that adds one dime to our deficits either now or in the future. Period."

THE FACTS: Though there's no final plan yet, the White House and congressional Democrats already have shown they're ready to skirt the no-new-deficits pledge.

House Democrats offered a bill that the Congressional Budget Office said would add $220 billion to the deficit over 10 years. But Democrats and Obama administration officials claimed the bill actually was deficit-neutral. They said they simply didn't have to count $245 billion of it — the cost of adjusting Medicare reimbursement rates so physicians don't face big annual pay cuts.

Their reasoning was that they already had decided to exempt this "doc fix" from congressional rules that require new programs to be paid for. In other words, it doesn't have to be paid for because they decided it doesn't have to be paid for.

The administration also said that since Obama already had included the doctor payment in his 10-year budget proposal, it didn't have to be counted again.

That aside, the long-term prognosis for costs of the health care legislation has not been good.

CBO Director Douglas Elmendorf had this to say in July: "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."

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OBAMA: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have."

THE FACTS: That's correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage. Employers sponsor coverage for most families, and they'd be free to change their health plans in ways that workers may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it.

In the past Obama repeatedly said, "If you like your health care plan, you'll be able to keep your health care plan, period." Now he's stopping short of that unconditional guarantee by saying nothing in the plan "requires" any change.

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OBAMA: "The reforms I'm proposing would not apply to those who are here illegally." One congressman, South Carolina Republican Joe Wilson, shouted "You lie!" from his seat in the House chamber when Obama made this assertion.

THE FACTS: The facts back up Obama. The House version of the health care bill explicitly prohibits spending any federal money to help illegal immigrants get health care coverage. Illegal immigrants could buy private health insurance, as many do now, but wouldn't get tax subsidies to help them. Still, Republicans say there are not sufficient citizenship verification requirements to ensure illegal immigrants are excluded from benefits they are not due.

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OBAMA: "Don't pay attention to those scary stories about how your benefits will be cut. ... That will never happen on my watch. I will protect Medicare."

THE FACTS: Obama and congressional Democrats want to pay for their health care plans in part by reducing Medicare payments to providers by more than $500 billion over 10 years. The cuts would largely hit hospitals and Medicare Advantage, the part of the Medicare program operated through private insurance companies.

Although wasteful spending in Medicare is widely acknowledged, many experts believe some seniors almost certainly would see reduced benefits from the cuts. That's particularly true for the 25 percent of Medicare users covered through Medicare Advantage.

Supporters contend that providers could absorb the cuts by improving how they operate and wouldn't have to reduce benefits or pass along costs. But there's certainly no guarantee they wouldn't.

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OBAMA: Requiring insurance companies to cover preventive care like mammograms and colonoscopies "makes sense, it saves money, and it saves lives."

THE FACTS: Studies have shown that much preventive care — particularly tests like the ones Obama mentions — actually costs money instead of saving it. That's because detecting acute diseases like breast cancer in their early stages involves testing many people who would never end up developing the disease. The costs of a large number of tests, even if they're relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing.

The Congressional Budget Office wrote in August: "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."

That doesn't mean preventive care doesn't make sense or save lives. It just doesn't save money.

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OBAMA: "If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage."

THE FACTS: It's not just a matter of being able to get coverage. Most people would have to get coverage under the law, if his plan is adopted.

In his speech, Obama endorsed mandatory coverage for individuals, an approach he did not embrace as a candidate.

He proposed during the campaign — as he does now — that larger businesses be required to offer insurance to workers or else pay into a fund. But he rejected the idea of requiring individuals to obtain insurance. He said people would get insurance without being forced to do so by the law, if coverage were made affordable. And he repeatedly criticized his Democratic primary rival, Hillary Rodham Clinton, for proposing to mandate coverage.

"To force people to get health insurance, you've got to have a very harsh penalty," he said in a February 2008 debate.

Now, he says, "individuals will be required to carry basic health insurance — just as most states require you to carry auto insurance."

He proposes a hardship waiver, exempting from the requirement those who cannot afford coverage despite increased federal aid.

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OBAMA: "There are now more than 30 million American citizens who cannot get coverage."

THE FACTS: Obama time and again has referred to the number of uninsured as 46 million, a figure based on year-old Census data. The new number is based on an analysis by the Kaiser Commission on Medicaid and the Uninsured, which concluded that about two-thirds of Americans without insurance are poor or near poor. "These individuals are less likely to be offered employer-sponsored coverage or to be able to afford to purchase their own coverage," the report said. By using the new figure, Obama avoids criticism that he is including individuals, particularly healthy young people, who choose not to obtain health insurance.

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His speech was general and not specific enough for me. Still too many questions for this viewer.

i got a crush on obama

Well when I read through it I have to wonder who the authors are because they are not correct or accurate on a quite a few things.

Not adding one dime to the deficit can and probably does mean that the bill will offset itself. The final bill is not even on the table yet so how could they know it not to be true?

Obama cannot help if your employer changes insurance or whatever just like he cannot help it right now if they choose to. He cannot force employers to keep insurance or not change it. That one is just fearmongering and stupid.



I too am concerned with the cuts to Medicare. I understand it needs to be cleaned up but I would hate to see elderly loose what little coverage they do have from medicare.



Preventative care especially for breast cancer and prostate cancer are really really important regardless to cost. In the end they will cost less in coverage of the cancer patient because their bout with the cancer will be less costly to everyone if found early enough.

I guess then you will always have questions because I don't know what more he can say to people. How frustrating. oh well.

He gave a good speech. But 20 minutes will not explain how a thousand pages of legislation will be paid for. Or how many loopholes will be discovered and abused by people. Fix the current health care, don't take it over. Government is for oversight, not management. Look at the Walter Reed debacle. Our vets were treated like crap..oh well. I will not argue the point, just not seeing how it will work. Many people have no insurance because of their lifestyle. I will not pay for the drunk sitting in the bar, the cigarette smoker, the daredevil, the prostitute etc.

You already do pay for them.

People that need health insurance:

http://www.youtube.com/watch?v=8GoFj8Fc9iM

Good summary of the address, thanks for posting it.

Geezuz you didn't hear a word he said. Unbelievable.. oh well not going to waste my time.

Yeah, it sucked when Bush cut the funds to the VA Medical Centers.

The program will not be paid for / our government does not have a very good track record of paying for programs and keeping them revenue neutral. More wishful thinking!!!

And turn this around like this / no one knows exactly what employers will do to compete with the government option. Interesting angle isn't it.

Obama is lying to America.

As the proposal is currently worded..I know EXACTLY what employers will do.

According to the proposal...employers who don't offer insurance will be penalized up to $750 per uninsured worker in their employ.

A company pays, on average, somewhere between $5000-$10,000 dollars per year for each employee they offer insurance to.

Do the math.

What do YOU think companies will see as a better option. It'll be a whole lot cheaper to just not bother offering insurance at all.

" If you have a plan, you can keep your plan. " What didn't get added to that was " But only if your plan isn't something your employer provides. "

You can read his mind?

Not his mind, but I hear all the forgotten words from his campaign - especially the ones about transparency and ethics and all the words that surrounded his "change we can believe in" comments. All lies.

Obama supporters are "Still in Denial"

"And what I've said is, I'm going to have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies — they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process."

What a joke but it got him votes.

Quit whining, geezuz. I support him and believe me I am not in denial. He is slowly keeping his promises and it's going to take more what little time he has been in already. But feel free to try to convince us that he's a joke. Good luck with that.

As a Canadian living in the States, I am absolutely baffled by the controversy over this healthcare reform that exists in this country.

The obvious fact is that much of this is troll-baiting by the media: 'left' and 'right' media sources alike are rolling on the wave of disagreement as coverage of this 'hot' issue guarantees ratings, thus bringing in ad revenue, while simultaneously allowing them to downplay any truly meaningful stories from around the globe, and perpetuating their own dominance over public opinion. Just think about how much any US-based news-source plays up the opposition between supposed democratic and conservative 'values', polarizing the public and minimizing the diversity of socio-political opinion.

And though it's a separate point, tangential at best to the healthcare issue, it needs to be driven home - given the typically formulaic approach to the 'discussion' of two-party state politics, the capacity of an issue to break down along the lines of simple opposition can be linked directly to how much coverage it gets in mainstream media.

On to the subject at hand - healthcare reform - there really are two basic issues, which are intrinsically at odds with each other. The first can be broadly described as 'coverage' and the second as 'affordability'. Seemingly EVERYONE who speaks up is either optimistic or worried about both human lives and money. And this is where my train of thought crashes. How can anyone sane claim to care about both to the same extent?

Raising the quality of life in the country, which is essentially what extending healthcare coverage will do, can only be done at cost (but will pay for itself in the long run, as more people are able to access medical services).

On the other hand, bashing the idea of a 'public option' as ideological socialism because it relies on taxation and the redistribution of budget (in other words for 'taking' money instead of 'making' it) is a form of narrow-minded support for an abstract notion of profit, which is tied to the well-being of private enterprises (such as insurance companies, which are at best bureaucratic entities that exist with virtual independence of the people employed by them).

So, you either prefer to support the idea that people deserve to receive medical attention (the cost of such services being a secondary concern), or you prefer to support the idea that medical attention is a service to be capitalized upon (that its a potential source of revenue).

SIMPLY PUT: extending healthcare coverage aims to provide for the well-being of all the country's citizens; balancing the budget by relying on private enterprises to cover healthcare aims to provide for the well-being of said enterprises (read: a very small percentage of the country's citizens).

Since this is already too long to read for the select group of readers that will surely attack this uninvolved bystander's opinion, the conclusion will have to be hasty: it is inane to assume that a non-profit-motivated entity such as the government will withhold medical services from those that need it for budgeting reasons, while believing that profit-motivated companies will assure coverage for the reasons of 'good business' and 'competition'.

JUST WHAT IS SO WRONG about letting the government take the $500 billion over 10 years from one medicare provider and reallocate it to another one? All it means is that more medicare providers will have better equipment, better ability to provide said medicare (this is built on an assumption that the money will be taken from the budgets of well-established service points and moved toward establishing new ones and/or bettering the less-established ones).

And can anyone explain to me why this 'discussion' is so freaking clouded with jargon? What is a Medicare provider? is it a hospital? is it a doctor? is it both? and if so isn't it just a bit silly to lump an individual in the same category as an institution?

p.s. if I get seriously sick, I'm getting my *** across the border to Canada, where I, along with millions other citizens, have paid a relatively small tax to get a plastic card in my wallet that assures I will get treatment, no matter what the nature and severity of my illness. Did I mention that Canadian government-run health insurance actually is NOT mutually exclusive with employer-based private health benefits? In fact everybody has health coverage from their province (Canadian equivalent of a state), and most people have employer-provided benefits IN ADDITION to that. But what do we know, we're crazy socialists, though I'm sure the Europeans are even crazier and even more socialistic

That still doesn't mean you can't go and get coverage from the government. That's why their calling it the 'public option', isn't it? And if that is true, then can you please explain to me EXACTLY why you would prefer to be covered by an employer who would rather pay a penalty than provide for your health as opposed to the government, which is trying to provide for the health of as many citizens as it can get away with?

Good post Molot.