True or false: The new health care law will cut Medicare benefits for seniors. It will slash Medicare payments to doctors. It will ration health care.
In three polls conducted last month, large percentages of Americans answered "true" to each statement. All three are false.
Sorry, no. As Cato's Michael Cannon points out, two out of those three statements are, in fact, very much true—and the third is potentially confusing enough that you could forgive a non-wonk for misunderstanding:
First, ObamaCare will cut p
ayments to the private health insurance companies that provide coverage to the 20 percent of Medicare enrollees who participate in the Medicare Advantage program. That will eliminate many types of coverage for seniors in Medicare Advantage. That should be painfully obvious, but if you require confirmation, visit FactCheck.org. ObamaCare will also ratchet down the price controls that Medicare uses to pay hospitals and many other health care providers. It should likewise be obvious that that will reduce access to services that are ostensibly "guaranteed" to all enrollees. But again, if you need confirmation, check in with Medicare's chief actuary, who works for President Obama. We can debate whether that's good or bad. What's not up for debate: ObamaCare in fact "will cut Medicare benefits for seniors."
Second, it is also true—ipso facto—that ObamaCare "will ration health care." To ration is to limit consumption. When ObamaCare reduces coverage for Medicare Advantage enrollees and reduces access to care for all Medicare enrollees, it limits seniors' consumption of medical care. We can debate whether that's good or bad. What's not up for debate: that is rationing.
Finally, yes, it is technically false that ObamaCare "will slash Medicare payments to doctors." But since current law will slash Medicare payments to doctors if Congress does nothing, and since an earlier version of ObamaCare would have eliminated those cuts, but ObamaCare's architects dropped that provision so as to make ObamaCare appear deficit-neutral… well, perhaps the public can be forgiven if it confuses "eliminating a provision that would have prevented cuts in Medicare payments to doctors" with "slashing Medicare payments to doctors."
The administration and its supporters have hitched themselves to the idea that the law's lack of popularity stems from the fact that the public just doesn't know what's in the law—and, in particular, that the public is ignorant of the law's many benefits. And sure, with any law as complex as the PPACA, there's bound to be some confusion. But as I argued in February, we've had reasonably good evidence for a while that, at least in comparison to the usual level of public knowledge about government affairs, the public actually has a pretty good idea of what provisions are in the law—even the benefits. And yet most (though not all) polls continue to show that the law's unpopularity remains higher than its popularity. Maybe they know what they're getting themselves into—even if USA Today doesn't.
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But if you use the law to unnaturally create a situation where subsidy is practically necessary to acquire something, cutting off that subsidy is tantamount to rationing.
"Look, the first thing for all of us to understand that is we actually have some -- some choices to make about how we want to deal with our own end-of-life care," Mr. Obama replied. After discussing ways "we as a culture and as a society [can start] to make better decisions within our own families and for ourselves," he continued that in general "at least we can let doctors know and your mom know that, you know what? Maybe this isn't going to help. Maybe you're better off not having the surgery, but taking the painkiller."
What Mr. Obama is describing is his preferred health-care future. If or when the Administration's speculative cost-cutting measures under universal health care fail to produce savings, government will start explicitly limiting patient access to treatments and services regarded as too expensive. Democrats deny this eventuality, but health planners will have no choice, given that the current entitlement system is already barreling toward insolvency without adding millions of new people to the federal balance sheet.
Earlier, a physician asked Mr. Obama if he would subject his own family to the restrictions of a national health plan, even if specialists recommended treatments that weren't covered. The President was noncommittal: "And you're absolutely right that, if it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."
In a 1998 paper by bioethicist Ezekiel Emanuel and Margaret Batten titled "What Are The Potential Cost Savings From Legalizing Physician-Assisted Suicide?" the authors found that "the savings can be predicted to be very small - less than 0.1 percent of both total health care spending in the United States and an individual managed-care plan's budget." They state that "The estimated cost savings from permitting physician-assisted suicide are lower than many people expect. One reason for this is the frequent overestimation of how much is spent on medical care at the end of life. One commentator claimed that 'some 70 to 90% of our health care dollar is spent on he last few months of life.' Others have suggested that the costs of care for dying patients account for almost 30 percent of all health care expenditures. In fact, each year about 10 percent of expenditures for medical care involves patients who die."
I don't know if there are more recent estimates of the cost of end-of-life care.
Amazing how the lazy would rather just say "stop trying to save old people" than look at the data and try to find strategies that will actually lead to reducing costs.
Another paper I came across, published in the British Medical Journal in 2010: "Are patients receiving enough information about healthcare rationing? A qualitative study." By Smith, Coast, and Donovan. Results: "Nearly all patients wanted to know about healthcare rationing and had high expectations of their clinical professionals to provide all relevant information about treatment options. However, professionals did not always understand these information requirements, and cases of implicit rationing were common." Discussion: "Clinical professionals need to understand patients' need for detailed information when it comes to rationing, and to understand that they are the main gateway for this to be provided. However, disclosure could be distressing for both patients and professionals, and thus the most sensitive and acceptable ways to make this information available requires further investigation."
"And you're absolutely right that, if it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."
That's how it works: MY family deserve the very best care possible. YOUR family, on the other hand....
Why do you insult McDonald's so? McDonald's has decent fish sandwiches and drinkable coffee. Sometimes they even have cute children's toys. USA Today has nothing of value.
I love it when wonks attack Obama's proposal because it "rations" healthcare. I challenge anyone to show me ANY system under which rationing does not occur.
To even believe that there is such a thing as a healthcare "system" is a mistake. It's long past time when we should all just admit that governments don't run economies, no matter what their press releases say.
Aw, you just don't see the brilliance of the Big Game Plan.
See, Uncle Sam has this problem coming on: too many old people needing pensions. Well duh, if Uncle Sam takes over health care, then he can Retire some retired people and that way he can keep his costs in line.
Nah. They wouldn't do that. Not in a million years.
Rationing does not mean the same as not subsidizing.
But if you use the law to unnaturally create a situation where subsidy is practically necessary to acquire something, cutting off that subsidy is tantamount to rationing.
Anyone who relies upon USA Today as a news source deserves what they get, really.
There will be rationing for everybody, not just oldsters.
"Look, the first thing for all of us to understand that is we actually have some -- some choices to make about how we want to deal with our own end-of-life care," Mr. Obama replied. After discussing ways "we as a culture and as a society [can start] to make better decisions within our own families and for ourselves," he continued that in general "at least we can let doctors know and your mom know that, you know what? Maybe this isn't going to help. Maybe you're better off not having the surgery, but taking the painkiller."
What Mr. Obama is describing is his preferred health-care future. If or when the Administration's speculative cost-cutting measures under universal health care fail to produce savings, government will start explicitly limiting patient access to treatments and services regarded as too expensive. Democrats deny this eventuality, but health planners will have no choice, given that the current entitlement system is already barreling toward insolvency without adding millions of new people to the federal balance sheet.
Earlier, a physician asked Mr. Obama if he would subject his own family to the restrictions of a national health plan, even if specialists recommended treatments that weren't covered. The President was noncommittal: "And you're absolutely right that, if it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."
He is just scum.
This things gonna be a shot in the arm for medical tourism!
(Trying to look on the bright side.)
Seriously, though. I've asked this before:
Is it possible to buy some kind of international catastrophic health insurance that pays for major treatment in, say, a hospital in Singapore?
In a 1998 paper by bioethicist Ezekiel Emanuel and Margaret Batten titled "What Are The Potential Cost Savings From Legalizing Physician-Assisted Suicide?" the authors found that "the savings can be predicted to be very small - less than 0.1 percent of both total health care spending in the United States and an individual managed-care plan's budget." They state that "The estimated cost savings from permitting physician-assisted suicide are lower than many people expect. One reason for this is the frequent overestimation of how much is spent on medical care at the end of life. One commentator claimed that 'some 70 to 90% of our health care dollar is spent on he last few months of life.' Others have suggested that the costs of care for dying patients account for almost 30 percent of all health care expenditures. In fact, each year about 10 percent of expenditures for medical care involves patients who die."
I don't know if there are more recent estimates of the cost of end-of-life care.
Amazing how the lazy would rather just say "stop trying to save old people" than look at the data and try to find strategies that will actually lead to reducing costs.
Another paper I came across, published in the British Medical Journal in 2010: "Are patients receiving enough information about healthcare rationing? A qualitative study." By Smith, Coast, and Donovan. Results: "Nearly all patients wanted to know about healthcare rationing and had high expectations of their clinical professionals to provide all relevant information about treatment options. However, professionals did not always understand these information requirements, and cases of implicit rationing were common." Discussion: "Clinical professionals need to understand patients' need for detailed information when it comes to rationing, and to understand that they are the main gateway for this to be provided. However, disclosure could be distressing for both patients and professionals, and thus the most sensitive and acceptable ways to make this information available requires further investigation."
If it's not covered, pay for it yourself. What's so unfair about that?
Why should the old, who already won the longevity lottery, be the only ones with unlimited access to "free care"?
By the way, I love that poster.
Go to thepeoplescube.com. I think they started it, and they got a BUNCH more awesome ones...
Me too!
"And you're absolutely right that, if it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."
That's how it works: MY family deserve the very best care possible. YOUR family, on the other hand....
Exactly. He is special and you are not. I really hate the mother fucker. I really hate him.
Remember the part in Atlas Shrugged with the hobo on the train? And his tale of the Century Motor Company?
I still say that Public Employee Pensions are relevant cost/benefit data when considering end of life issues too. I like things in context.
You mean... you mean.... USA Today... dare I say . . . LIED?!?!?
Who could've seen it coming!!
Great.
Now all we have to worry about is the massive discrepancy of numbers between those who read USA Today and those who read Cato/Reason.
Your refutation can't have reached more than .01% of those who have been "misinformed" by USA Today.
USA Today = the McDonald's of newspapers.
Why do you insult McDonald's so? McDonald's has decent fish sandwiches and drinkable coffee. Sometimes they even have cute children's toys. USA Today has nothing of value.
You can line the birdcage floor with it . . .
USA Today is mmm mmm good. You'll like it, once you find out what's in it
The multi colored fish wrap has some good box scores covering a lot of sports and minor leagues. This I like, the other shit no so much.
I love it when wonks attack Obama's proposal because it "rations" healthcare. I challenge anyone to show me ANY system under which rationing does not occur.
ummmm... a system where there's no rationing?
To even believe that there is such a thing as a healthcare "system" is a mistake. It's long past time when we should all just admit that governments don't run economies, no matter what their press releases say.
Aw, you just don't see the brilliance of the Big Game Plan.
See, Uncle Sam has this problem coming on: too many old people needing pensions. Well duh, if Uncle Sam takes over health care, then he can Retire some retired people and that way he can keep his costs in line.
Nah. They wouldn't do that. Not in a million years.
Soylent Green is people!!
click on my name,you can find cheap watches