Fight the smears

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Five right-wing myths about healthcare reform, and the facts

By Mike Madden


Aug. 6, 2009 * WASHINGTON -- Turning America socialist apparently wasn't enough for him -- now President Obama is trying to make old people kill themselves, callously deny important medical procedures, funnel tax dollars to abortion clinics and wiggle the government's way into every doctor's office in America.

At least, that's the sense you might have about the healthcare reform proposals Congress is considering from listening to opponents describe them. Already, conservative activists have erupted against the plan, with protesters hanging Democratic lawmakers in effigy and disrupting town hall meetings.

As both the House and the Senate clear out of the Capitol for the month, expect the viral buzz -- and the TV battle -- about what's in the bills to grow louder and louder. The White House finally seems to have realized that the administration can't win the policy debate without addressing some of the attacks from the right. Aides recently released a video rebutting some of the claims about what healthcare reform would and wouldn't do. An administration official told Salon Wednesday that the White House will soon launch a Web site modeled on the "Fight the Smears" site Obama's campaign ran last fall, where voters can find -- and debunk -- some of the rumors about the reform proposals, and the White House is already collecting chain e-mails at "flag@whitehouse.gov," an address Obama aides set up to receive them.

But the administration might already be behind the curve. Over the last few weeks, opponents have managed to get out their spin on the bill through talk radio, blogs, chain e-mails and other channels. And their talking points depend on a notably elastic approach to the truth. Here's a fact check of some of the more alarming claims that the right is making about healthcare reform, claims that are already hardening into myth.

Myth 1: Democrats want to kill your grandmother.

This claim seems too outlandish on its face to get much traction, but Republicans actually made some headway on it recently. Two House GOP leaders put out a statement warning that the healthcare reform bill "may start us down a treacherous path toward government-encouraged euthanasia." To hear opponents of reform talk about it, the legislation would force seniors to go in for sessions once every five years -- and more frequently if they're sick -- where doctors will encourage them to end their lives. Rep. Virginia Foxx, R-N.C., summarized the scare tactic pretty well on the House floor last week, when she said the bill would "put seniors in a position of being put to death by their government," and therefore, wouldn't be pro-life. The GOP has pushed this line especially hard with some of the conservative groups behind the government's intervention in the Terri Schiavo case a few years ago, hoping to get antiabortion allies on board fighting reform. "Can you imagine the response of the American people when they find this out?" one-time GOP presidential candidate Fred Thompson asked about the alleged euthanasia scheme on his radio show last month. "They're going to counsel you on preparing you to die," Rush Limbaugh pronounced a few weeks ago. Proof of how far this attack has spread came last week, when a caller to an AARP forum asked Obama about it directly. (Probably unwisely, the president tried to make light of the question, saying there weren't enough government employees to go meet with old people to talk about end-of-life care.)

There is a kernel of truth at the root of this attack: The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover. But the consultations wouldn't be mandatory; if your grandmother doesn't want to go talk to her doctor about end-of-life care, she won't have to. Because Medicare doesn't pay for this kind of planning now, only 40 percent of seniors who depend on the government insurance say they have an advance directive that tells healthcare providers what measures they do and don't want used to prolong their life, even though 75 percent say they think it's important. The lack of planning actually costs a lot of money. Medicare spends billions and billions of dollars annually on expensive treatment during the last year of a dying patient's life. Without allowing Medicare to pay for end-of-life consultations, it's hard to know whether patients even want to go to such expensive lengths.

Myth 2: The government -- i.e., you -- will have to pay for abortions.

This is another way the GOP is stirring up antiabortion activists against healthcare reform -- by warning that your tax dollars will be used to pay for someone else's abortion. An ad by the Family Research Council dramatizes the issue about as creepily as possible. "To think that Planned Parenthood is included in the government-run healthcare plan and spending tax dollars on abortions," a distraught older man tells his wife, sitting at their kitchen table after opening a letter from the government. "They won't pay for my surgery, but we're forced to pay abortions." The narrator lays out what's going on: "Our greatest generation denied care, our future generations denied life." A House Republican aide says the GOP thinks this could be the most potent type of viral attack against reform, since antiabortion Democrats will have trouble voting for the legislation if it includes taxpayer funding for the procedure.

But only the most extreme antiabortion reading of the legislation would say it does that. The words "Planned Parenthood" and "abortion" don't appear anywhere in the text, despite conservative buzz that it would funnel millions of dollars to killing babies. (A proposal in the Senate version of the reform legislation would require insurance plans to cover preventive care and screening visits to community health providers, which could include Planned Parenthood.) Even an AP story that Matt Drudge was hyping on Wednesday as proof that the government would be funding abortions didn't go quite that far -- instead, the story detailed a fight over whether women who buy government-subsidized private insurance through a proposed exchange system should be able to have abortions covered by their plans. Pro-choice lawmakers are trying to craft a compromise that would require insurance companies to pay for abortions out of premiums paid by patients, not out of tax dollars. Pro-choice Rep. Lois Capps, D-Calif., amended the House version of the legislation to state that abortion is not part of an "essential benefits package" that all insurance plans must provide -- meaning someone could offer a special "pro-life health insurance" plan that doesn't cover abortions, even under the reforms.

Myth 3: Obama will ban all private health insurance.

Allegedly, the House proposal for healthcare reform bans private insurance. This rumor comes complete with a citation: "Right there on Page 16 is a provision making individual private medical insurance illegal," the unflaggingly pro-business paper Investors Business Daily wrote in an editorial last month. Other right-wing blogs and news outlets picked up on the idea, as well. It fits in with a broader message Republicans have been using: The reform will lead to a total government takeover of healthcare.

The IBD line is literally true -- Section 102 of the House bill says insurance companies can't independently issue any new individual policies after the legislation takes effect (though existing policies are grandfathered in). But it misses the point. Private plans aren't banned, but rather shifted into the new health insurance exchange the legislation would set up. You can still get a private policy, but the way in which you buy it changes. If you wanted to buy your own insurance, you have to do it through the government-run insurance exchange. Your policy becomes part of broader risk pools, which makes the premiums cheaper and keeps insurance companies from dumping them once they get sick. PolitiFact looked into the claim and rated the IBD editorial "pants on fire," its lowest rating -- as in, "Liar, liar, pants on fire."

Myth 4: The government can't possibly run a healthcare program.

Opponents of reform trot out comparisons to government services frequently when they try to argue against a public, government-funded healthcare plan. Republicans drew up a chart that purports to show how convoluted the bureaucracy involved in any government plan would be. This message doesn't make Obama the enemy, it makes government inefficiency the enemy. "If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid and healthcare done by the government," conservative economist Arthur Laffer told CNN this week.

If that doesn't quite make sense, there's a reason -- Medicare and Medicaid are, of course, government-run healthcare programs. Medicare in particular is quite popular; polling shows some seniors are anxious that the reform will affect the care they already get from the government. (In fact, Democratic pollster Celinda Lake says she frequently encounters voters who say they want to keep the government out of their Medicare.) The Department of Veterans Administration also runs a healthcare system that experts praise for its well-developed health information technology network, which lets doctors see results of tests and procedures any patient has had anywhere in the network -- eliminating the wasteful duplication that Obama says he wants to cut out of the larger healthcare world, as well.


Myth 5: Unlike private insurance, government bureaucrats will ration care.

This line also makes government the enemy. "You may want healthcare that your doctor has prescribed for you," Peter Ferrara, of the anti-tax, anti-government Institute for Policy Innovation, wrote on the National Review last month. "But the rationing bureaucracy in Washington that doesn’t even know you, or your doctor, may decide that your doctor doesn’t know what he’s talking about, or that you are too old for the government to pay for your hip replacement to stop the pain, or to get an expensive triple bypass or a pacemaker operation to save your life." Since the Obama administration keeps talking about encouraging doctors to shift to outcome-based pay scales and evidence-based guidelines for what treatments or procedures to use, opponents don't have much trouble painting a troubling picture of faceless government hacks denying the care you -- or your loved ones -- need.

Of course, there are already plenty of faceless hacks denying people care right now; they just work for private insurance companies, not the government, and they're denying care because that helps keep the insurers' profit margins up. At a recent House hearing, just three insurance companies testified that they had "rescinded" -- or dropped -- coverage for nearly 20,000 patients between 2003 and 2007, often after patients had submitted claims they thought would be covered. Even Republicans seem to know the insurance companies can be bad. "I would always rather the devil I know than the devil I don't know," House GOP boss John Boehner said last week, explaining why going after the government works even though private insurance companies would seem to be just as much of a villain.

http://www.salon.com/news/feature/2009/08/06/healthcare/


http://www.whitehouse.gov/blog/Facts-Are-Stubborn-Things/
 
Five right-wing myths about healthcare reform, and the facts

By Mike Madden


Aug. 6, 2009 * WASHINGTON -- Turning America socialist apparently wasn't enough for him -- now President Obama is trying to make old people kill themselves, callously deny important medical procedures, funnel tax dollars to abortion clinics and wiggle the government's way into every doctor's office in America.

At least, that's the sense you might have about the healthcare reform proposals Congress is considering from listening to opponents describe them. Already, conservative activists have erupted against the plan, with protesters hanging Democratic lawmakers in effigy and disrupting town hall meetings.

As both the House and the Senate clear out of the Capitol for the month, expect the viral buzz -- and the TV battle -- about what's in the bills to grow louder and louder. The White House finally seems to have realized that the administration can't win the policy debate without addressing some of the attacks from the right. Aides recently released a video rebutting some of the claims about what healthcare reform would and wouldn't do. An administration official told Salon Wednesday that the White House will soon launch a Web site modeled on the "Fight the Smears" site Obama's campaign ran last fall, where voters can find -- and debunk -- some of the rumors about the reform proposals, and the White House is already collecting chain e-mails at "flag@whitehouse.gov," an address Obama aides set up to receive them.

But the administration might already be behind the curve. Over the last few weeks, opponents have managed to get out their spin on the bill through talk radio, blogs, chain e-mails and other channels. And their talking points depend on a notably elastic approach to the truth. Here's a fact check of some of the more alarming claims that the right is making about healthcare reform, claims that are already hardening into myth.

Myth 1: Democrats want to kill your grandmother.

This claim seems too outlandish on its face to get much traction, but Republicans actually made some headway on it recently. Two House GOP leaders put out a statement warning that the healthcare reform bill "may start us down a treacherous path toward government-encouraged euthanasia." To hear opponents of reform talk about it, the legislation would force seniors to go in for sessions once every five years -- and more frequently if they're sick -- where doctors will encourage them to end their lives. Rep. Virginia Foxx, R-N.C., summarized the scare tactic pretty well on the House floor last week, when she said the bill would "put seniors in a position of being put to death by their government," and therefore, wouldn't be pro-life. The GOP has pushed this line especially hard with some of the conservative groups behind the government's intervention in the Terri Schiavo case a few years ago, hoping to get antiabortion allies on board fighting reform. "Can you imagine the response of the American people when they find this out?" one-time GOP presidential candidate Fred Thompson asked about the alleged euthanasia scheme on his radio show last month. "They're going to counsel you on preparing you to die," Rush Limbaugh pronounced a few weeks ago. Proof of how far this attack has spread came last week, when a caller to an AARP forum asked Obama about it directly. (Probably unwisely, the president tried to make light of the question, saying there weren't enough government employees to go meet with old people to talk about end-of-life care.)

There is a kernel of truth at the root of this attack: The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover. But the consultations wouldn't be mandatory; if your grandmother doesn't want to go talk to her doctor about end-of-life care, she won't have to. Because Medicare doesn't pay for this kind of planning now, only 40 percent of seniors who depend on the government insurance say they have an advance directive that tells healthcare providers what measures they do and don't want used to prolong their life, even though 75 percent say they think it's important. The lack of planning actually costs a lot of money. Medicare spends billions and billions of dollars annually on expensive treatment during the last year of a dying patient's life. Without allowing Medicare to pay for end-of-life consultations, it's hard to know whether patients even want to go to such expensive lengths.

Myth 2: The government -- i.e., you -- will have to pay for abortions.

This is another way the GOP is stirring up antiabortion activists against healthcare reform -- by warning that your tax dollars will be used to pay for someone else's abortion. An ad by the Family Research Council dramatizes the issue about as creepily as possible. "To think that Planned Parenthood is included in the government-run healthcare plan and spending tax dollars on abortions," a distraught older man tells his wife, sitting at their kitchen table after opening a letter from the government. "They won't pay for my surgery, but we're forced to pay abortions." The narrator lays out what's going on: "Our greatest generation denied care, our future generations denied life." A House Republican aide says the GOP thinks this could be the most potent type of viral attack against reform, since antiabortion Democrats will have trouble voting for the legislation if it includes taxpayer funding for the procedure.

But only the most extreme antiabortion reading of the legislation would say it does that. The words "Planned Parenthood" and "abortion" don't appear anywhere in the text, despite conservative buzz that it would funnel millions of dollars to killing babies. (A proposal in the Senate version of the reform legislation would require insurance plans to cover preventive care and screening visits to community health providers, which could include Planned Parenthood.) Even an AP story that Matt Drudge was hyping on Wednesday as proof that the government would be funding abortions didn't go quite that far -- instead, the story detailed a fight over whether women who buy government-subsidized private insurance through a proposed exchange system should be able to have abortions covered by their plans. Pro-choice lawmakers are trying to craft a compromise that would require insurance companies to pay for abortions out of premiums paid by patients, not out of tax dollars. Pro-choice Rep. Lois Capps, D-Calif., amended the House version of the legislation to state that abortion is not part of an "essential benefits package" that all insurance plans must provide -- meaning someone could offer a special "pro-life health insurance" plan that doesn't cover abortions, even under the reforms.

Myth 3: Obama will ban all private health insurance.

Allegedly, the House proposal for healthcare reform bans private insurance. This rumor comes complete with a citation: "Right there on Page 16 is a provision making individual private medical insurance illegal," the unflaggingly pro-business paper Investors Business Daily wrote in an editorial last month. Other right-wing blogs and news outlets picked up on the idea, as well. It fits in with a broader message Republicans have been using: The reform will lead to a total government takeover of healthcare.

The IBD line is literally true -- Section 102 of the House bill says insurance companies can't independently issue any new individual policies after the legislation takes effect (though existing policies are grandfathered in). But it misses the point. Private plans aren't banned, but rather shifted into the new health insurance exchange the legislation would set up. You can still get a private policy, but the way in which you buy it changes. If you wanted to buy your own insurance, you have to do it through the government-run insurance exchange. Your policy becomes part of broader risk pools, which makes the premiums cheaper and keeps insurance companies from dumping them once they get sick. PolitiFact looked into the claim and rated the IBD editorial "pants on fire," its lowest rating -- as in, "Liar, liar, pants on fire."

Myth 4: The government can't possibly run a healthcare program.

Opponents of reform trot out comparisons to government services frequently when they try to argue against a public, government-funded healthcare plan. Republicans drew up a chart that purports to show how convoluted the bureaucracy involved in any government plan would be. This message doesn't make Obama the enemy, it makes government inefficiency the enemy. "If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid and healthcare done by the government," conservative economist Arthur Laffer told CNN this week.

If that doesn't quite make sense, there's a reason -- Medicare and Medicaid are, of course, government-run healthcare programs. Medicare in particular is quite popular; polling shows some seniors are anxious that the reform will affect the care they already get from the government. (In fact, Democratic pollster Celinda Lake says she frequently encounters voters who say they want to keep the government out of their Medicare.) The Department of Veterans Administration also runs a healthcare system that experts praise for its well-developed health information technology network, which lets doctors see results of tests and procedures any patient has had anywhere in the network -- eliminating the wasteful duplication that Obama says he wants to cut out of the larger healthcare world, as well.


Myth 5: Unlike private insurance, government bureaucrats will ration care.

This line also makes government the enemy. "You may want healthcare that your doctor has prescribed for you," Peter Ferrara, of the anti-tax, anti-government Institute for Policy Innovation, wrote on the National Review last month. "But the rationing bureaucracy in Washington that doesn’t even know you, or your doctor, may decide that your doctor doesn’t know what he’s talking about, or that you are too old for the government to pay for your hip replacement to stop the pain, or to get an expensive triple bypass or a pacemaker operation to save your life." Since the Obama administration keeps talking about encouraging doctors to shift to outcome-based pay scales and evidence-based guidelines for what treatments or procedures to use, opponents don't have much trouble painting a troubling picture of faceless government hacks denying the care you -- or your loved ones -- need.

Of course, there are already plenty of faceless hacks denying people care right now; they just work for private insurance companies, not the government, and they're denying care because that helps keep the insurers' profit margins up. At a recent House hearing, just three insurance companies testified that they had "rescinded" -- or dropped -- coverage for nearly 20,000 patients between 2003 and 2007, often after patients had submitted claims they thought would be covered. Even Republicans seem to know the insurance companies can be bad. "I would always rather the devil I know than the devil I don't know," House GOP boss John Boehner said last week, explaining why going after the government works even though private insurance companies would seem to be just as much of a villain.

http://www.salon.com/news/feature/2009/08/06/healthcare/


http://www.whitehouse.gov/blog/Facts-Are-Stubborn-Things/

About the original 'fight the smears' aka astro turfing:

http://www.americanthinker.com/blog/2008/09/astroturfing_the_new_propagand.html

So many links at site, many of which have to do with the election at that time, yet many are relevant today, with the spins going on from both sides:

eptember 17, 2008
Astroturfing, the new propaganda plague

Clarice Feldman
If you're reading this article online, you probably do know about astroturfing, but your friends who are less computer savvy do not: Astroturfing is the attempt to create the feeling of a grassroots movement by planting stories around the web through the use of paid or volunteer spammers.

The consequences of astroturfing will reach far more people than know the meaning of the term, and I ask you to bring this propaganda technique to their attention.

Jim Treacher has led the way in documenting the Obama astroturf effort.

One of the people most involved in astroturf activities is Obama's chief campaign adviser, David Axelrod. Of him, Treacher observes:

[A]fter about 20 seconds with Google, I found this interesting tidbit from the March '08 issue of Business Week. It's about how Axelrod juggles his work for AKP&D Message & Media, his Chicago-based political consultancy business, with his work for another PR company he runs:

From the same River North address, Axelrod operates a second business, ASK Public Strategies, that discreetly plots strategy and advertising campaigns for corporate clients to tilt public opinion their way. He and his partners consider virtually everything about ASK to be top secret, from its client roster and revenue to even the number of its employees. But customers and public records confirm that it has quarterbacked campaigns for the Chicago Children's Museum, ComEd, Cablevision, and AT&T.

ASK's predilection for operating in the shadows shows up in its work. On behalf of ComEd and Comcast, the firm helped set up front organizations that were listed as sponsors of public-issue ads. Industry insiders call such practices "Astroturfing," a reference to manufacturing grassroots support. Alderman Brendan Reilly of the 42nd Ward, who has been battling the Children's Museum's relocation plans, describes ASK as "the gold standard in Astroturf organizing. This is an emerging industry, and ASK has made a name for itself in shaping public opinion and manufacturing public support."

On August 30, Little Green Footballs noticed what appeared to be a pro-Palin web site but, in fact, was one clearly designed to turn off her socially conservative supporters:

Suddenly appearing among the Google search results for "sarah palin gay," a web site titled: Sarah Palin Supports Gay Rights.

Sarah Palin (GOV-Alaska-Republican), supports gay rights, says Anchorage Daily News.

Quote "Gov. Sarah Palin vetoed a bill Thursday that sought to block the state from giving public employee benefits such as health insurance to same-sex couples."

Quote ""It is the Governor's intention to work with the legislature and to give the people of Alaska an opportunity to express their wishes and intentions whether these benefits should continue," the statement from Palin's administration said."

Coghill said he's interested in a new plan that would allow state employees to designate one person - maybe a same-sex partner, but also possibly a family member or roommate - who would be eligible for state-paid benefits. But the employee would have to pay to add that person to his or her benefits."

Sarah Palin's veto gave gays the same rights as married couples in Alaska.

A vote for McCain/Palin is a vote for gay marriage.

Interesting. There's nothing else on the page. This sure looks like the work of the dastardly right-wing anti-gay attack machine, doesn't it?
Tracing the source of the post, LGF found:

Why, you're redirected to none other than FightTheSmears.com, the official Barack Obama site that's supposed to be defending him against smears.

Looks like they may have a second purpose: to generate a few smears of their own.

Jim Treacher also noted the viral spread from an anonymous post on Kos of the meme Jesus was a community organizer:

If you Google "Jesus was a community organizer" "Pilate was a governor", suddenly that moronic non sequitur is all over the place. Hundreds of results, and I'll give you a cookie made of dreams if you can find one dated before Sept. 4. Purely spontaneous, right?

Way to get rid of the "He thinks he's the Messiah" meme, geniuses. Astroturfing sucks, but if it helps turn even more people away from a witless crybaby like Obama, who wants to be president because otherwise it's not fair, that works for me. We are the spam we've been waiting for.

And you'll never guess where this wonderful, poetic grassroots slogan "originated". It's attributed only to "a reader." Kos is such an idiot that he couldn't even come up with a fake name to put it under. How about "Sparack Spobama"? "Spavid Spaxelrod"? (I wonder if this Kos page will be deleted, just like the one that launched the utterly deranged conspiracy theory about Palin's youngest son? Get the disinfo out there, and then remove the source. Orwell was an amateur.)

It is increasingly obvious that Kos is at the center of this scam


I figure the process goes something like this:

Kos posts the initial meme -- in this case, "Jesus was a community organizer and Pontius Pilate was a governor" -- attributing it to "a reader."
The astroturfing team blasts that meme across dozens (hundreds?) of blogs, like so, in an attempt to make it look like a spontaneous response to Kos's post.
Morons fall for it.

But that, of course is not the only way astroturfing works. Sometimes, as we noted in the first example, the scam posts appear on a website which seems support the candidate or a particular issue.

I haven't seen so much airtime given clearly astroturfed sod since the Democrats' great Foley scam in the 2006 election, but I expect it will only increase until election day. Help me fight it. Please.
 
History is clear. Every time we come close to passing health-insurance reform, the special interests fight back with everything they've got. They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do.

We can't let them do it again. Not this time. Not now.
 
5 freedoms you'd lose in health care reform

In the interest of fairness...

Let's explore the five freedoms that Americans would lose under Obamacare:

1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.

2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.

5 freedoms you'd lose in health care reform
 
History is clear. Every time we come close to passing health-insurance reform, the special interests fight back with everything they've got. They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do.

We can't let them do it again. Not this time. Not now.

It's actually much simpler....when somebody offers you something free on tv, you smile.....when you see how much the shipping and handling fees come to, you frown....
 
If the Republicans actively refuse to participate in a reasonable way with reasonable proposals, isn't it time to just say, "We're going to pass what the American people need and what they want without the Republicans"?
 
If the Republicans actively refuse to participate in a reasonable way with reasonable proposals, isn't it time to just say, "We're going to pass what the American people need and what they want without the Republicans"?
When "reasonable" means you must agree then reason is not what you will get. Actual reason says we should pay attention to what is happening, do it right and without a centralized government database tracking your private information. (I can't believe that Ds cannot see a time when the opposition may be in power and take advantage of such information. It's all good because it is the altruistic government handling all your private data.)

Slow it down and do it right, that's pretty much what everybody is asking, not just Rs.
 
If the Republicans actively refuse to participate in a reasonable way with reasonable proposals, isn't it time to just say, "We're going to pass what the American people need and what they want without the Republicans"?

yes, it is.....the Democrats don't need Republican support to pass what Democrats demand Americans have....just do the deed and let the votes fall where they may......stop pretending you care what the consequences are....
 
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