US and the World

Friday debate preview: The big health care lie

FactCheck.org Bush Mischaracterizes Kerry's Health Plan

Once again, Bush is promoting the big lie - this time about Kerry's health care plan. The independent FactCheck.org does an excellent job of taking it apart. Their thoughts are better read in the Web version linked above, but here are the essetnials of what they say.

The ad claims Kerry's health care plan puts "Washington bureaucrats in control. . . Big government in charge. Not you. Not your doctor."

That's grossly misleading. In fact, 97% of Americans who now have health insurance will simply keep the plan they have now, according toprojections by the independent, politically neutral health-care research firmThe Lewin Group .

And The Lewin Group's vice president, John Sheils,disputes the Bush ad's claim:

Sheils: I dont see how, in Kerrys plan, decisions on medical procedures would be made in Washington under any circumstances, under any proposal.

Another health-care financing expert, economist Jeff Lemieux ofCentrists.org , calls the claims in the Bush ad"way out of bounds."

Lemieux: There is an increased government involvement in providing health insurance through the expansion of Medicaid. But interfering between doctors and patients? There is nothing in (Kerry's) reforms that would come close to making that happen - It is just way out of bounds.

In an earlierassessmentof the Kerry plan, the nonpartisan Centrists.org found Kerrys health proposalto be"similar in many ways to a blueprint offered in July by Senate Republican leader Bill Frist," and concluded that Kerrys proposal tries to achieve liberal goals" mostly through "conservative means.

And in fact, a conservative health-care expert,Robert E. Moffitof the Heritage Foundation, calls the claim in the Bush ad oversimplified "bumper-sticker health policy." Moffitt notes thatKerry's planwould expand existing government programs, mainlyMedicaid, tocover more children and low-income workers than at present. He said, "In those government programs, as with private managed care programs, your doctor will be under the same restrictions he is under today. In that respect, Kerry is making no changes in the doctor-patient relationship." He added:

Moffitt: The Kerry plan amounts to an expansion of existing public and private third party payment system; it is not so much a change in policy direction, as a dramatically more expensive version of the status quo; and with its cost, it's the status quo on steroids. In other words, it's weirdly "conservative," in the worst sense of that word.

Moffitt did predict that Kerry's plan would lead to "much higher levels of federal regulation," butchiefly on employers and insurance providers rather than doctors or patients. Kerry's plan envisions reducing the cost to workers of existing private health coverage by having the federal government pick up 75% of the cost of "catastrophic" medical bills exceeding $30,000 per year. That would require federal oversight to audit claims and define what medical procedures can be counted toward that $30,000 threshold, Moffitt said. But that's not the same thing as putting "big government in charge" of decisions now made by doctors and patients, as the Bush ad claims.

We also went to Kenneth Thorpe for his assessment. Thorpe was Deputy Assistant Secretary for Health Policy during the Clinton administration, and is now a professor at Emory University in Atlanta, where he has studied both the Kerry and Bush health plans. He says Bush is just making up the claim in the ad:

Thorpe: This is just a fabrication.. . . . Kerrys plan simply builds on what people are enrolling in today. The (Bush) big-government claims are just the same old scare tactics.

Thorpe says Kerry's plan includes providing private health insurance for small businesses and their workers through a program modeled on the Federal Employees Benefits Health Plan, theprogram that currently provides a wide choice ofcoverage for federal workers and members of Congress. "You can choose whatever you want," Thorpesays. "Its the consumers choice."

Bush's Backup

When asked to back up their ad, Bush campaign officials point to two editorial articles written by conservative advocates for Medical Savings Accounts, the approach Bush favors.

Onearticle is by John C. Goodmanof theNational Center for Policy Analysis, which describes itself as an organizationdeveloped to "promote private alternatives to government regulation and control." Goodman's article states that under Kerry's plan, "Most people would be forced from the private health plans they have today,"a statement thatis contradicted by the politically neutral Lewin Group's study we cited earlier.

Lewin's vice president John Sheils told FactCheck.org that his computer model projects that only 8.2 million (of the 243 million who currently have private or government health insurance) would change their insurance plans under Kerry's plan. And even those who would change would be covered either by Medicaid, in which 70% still have fee-for-service coverage that leaves them free to choose their own doctor, or subsidized private insurance coverage.

We asked Goodman to explain how he could predict that "most" would change insurance when the Lewin computer projection showed that 97% wouldn't change. "Well you know, I havent carefully read the Lewin study," Goodman said. "Im surprised that they said that."

Thesecondarticle cited by the Bush campaign isby David Gratzer of the conservative Manhattan Institute , buthis article mainly urges Republicans to make the politicalargument that Kerry's plan involves more government control:

Gratzer:Kerry's proposal would nationalize catastrophic coverage. Couple this with his endorsement of drug reimportation, and it becomes clear that a Kerry administration would end up running and setting the price of much of American health care.

Republicans, thus, are presented with a short-term opportunity. Kerry has painted a trillion dollar target on his back.. . .If Washington is in the business of covering catastrophic health expenses, how long before it manages all expenses?

That's not a fact, of course, it'sGratzer's opinion. And it'snot shared by the experts we quoted earlier.

A 1.5 trillion price tag?

The Bush ad gives Kerry's plan a "1.5 trillion dollar price tag" and the figure is shown twice on screenduring the ad. What the ad doesn't say is that the figure covers a full 10 years, and that it's the highest of three independent estimates issued so far. The figure comes from a study by the American Enterprise Institute, a conservative,pro-business think tank in Washington.

But aswe'vepreviously reported, the Bush campaign originally quoted a study byKen Thorpe ofEmory University, whoestimates the total cost of Kerry's plan to be $653 billion over 10 years.A thirdstudy released later byThe Lewin Group concluded that Kerry's plan would cost about $1.25 trillion over 10 years.

The estimates all agree that Kerry's ambitious and expensive plan would provide health coverage for a large portion of the 45 million who currently lack it. The American Enterprise Institute put the figure of those who would gain insurance at 24 million, the Lewin Group put it at 25 million and Thorpe is estimating 27 million.