Health Reform Without Apologies

Have you ever seen a fair, unbiased, evenhanded explanation of the Patient Protection and Affordable Care Act? Have you ever seen anything that even appeared to be objective? I haven’t.

So to fill the gap, my colleagues and I have produced “What Does Health Care Reform Mean To You? A Consumer’s Guide,” which explains how the new health care overhaul works, in a question-and-answer format. You can also get a pamphlet version— ideal for doctors’ offices, clinics, work places and everywhere else that people meet and socialize.

That it’s the first effort anyone has made to even try to be objective is in itself rather amazing. See if you agree on whether we succeeded and give us your comments.

During the nine-month period leading up to the passage of the Patient Protection and Affordable Care Act (PPACA), Americans were subjected to more than $200 million worth of TV, radio, newsprint and Internet ads. Almost all of these — pro and con — were pure propaganda.

Even today, the White House and leaders of both political parties offer us little more than sound bites crafted for the evening news. A taxpayer-funded mailing to Medicare enrollees has been accused of selling more than informing. The government’s own Web site, while containing much valuable information, touts only the benefits of reform and ignores the costs. A 24-page PowerPoint presentation, prepared for members of Congress who voted for PPACA, advises on words to use and words to avoid. It’s all about spinning, not about informing. And, according to the LA Times, both sides are gearing up for another massive dose of TV ads as we move closer to the fall elections.

Most of the mainstream media has published “talking points” lists of the benefits, prepared by the White House. We don’t know of any regular news source that has reported in a similar way on the costs. Even health policy journals have largely ignored the costs of reform and who will bear them. On the other side, Internet screeds warning of “death panels” have exaggerated from the opposite direction.

Many people are rightly confused about what to expect and why. We hope this publication will clear the air. Our goal is a balanced overview, with all important content sourced from government reports and other reputable documents.

John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis.  He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-drivenhealth care system. Dr. Goodman’s Health Policy Blog is considered among the top conservative health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.

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23 replies »

  1. I guess if you really like HCR for philosophical reasons, you wouldn’t like the curtain pulled back on the murkier aspects of whether PPACA can actually accomplish what people want: quality care that won’t bankrupt them. I scanned this and thought it was the first thing I’ve read that really tells it like it is. Not one single thing about the system will remain untouched, and we have no idea yet the extent to which that will be for better or for worse. This documents points out both. Guess that’s what bothers most of these posters.

  2. Nov. 2, the political hacks who created this unbelievable mess will be OweBama-unemployed. Example:
    “Facing a nationwide backlash, Democratic congressional candidates have a new message for voters: We know you don’t like ObamaCare, so we’ll fix it.
    “This was the line offered by Democrat Mark Critz, who won a special election in Pennsylvania’s 12th congressional district after expressing opposition to the law and promising to mend it—but not to repeal it. As a doctor I know something about unexpected recoveries, and this latest attempt to rescue ObamaCare from repeal needs to be taken seriously ..”
    Can’t wait for Nov. 2, and unemploy a lot of incompetent, political deadwood.

  3. How about we issue a one page pamphlet that says this:
    In order to have a rational health care system, it is decreed that healthier wealthier people have to transfer money to poorer, sicker ones, and the organization of health insurance has to be changed so that it’s sustainable under those circumstances–which includes the healthier & wealthier transferring money.
    And let’s acknowledge that if you run an extreme right wing think-tank that’s based on the notion (and funded by unbelievably rich people who believe) that taxation is theft and government regulation is fascism, you’re not going to like a policy that takes the only politically available path to that rational health care system. So any unbiased pamphlet is going to highlight the negatives and not say much about the positives.
    Then we can move along….

  4. Excellent analysis. Sarah Palin would be proud. Now, where is the fair and unbalanced pamphlet readers were promised?

  5. “Isn’t this more objective than anything else out there?”
    “Under the law, Medicare fees paid to doctors are required to drop by 30% in the next three years.
    • Medicare fees paid to doctors and hospitals will fall below Medicaid levels by 2019 and going forward will fall increasingly behind the rates paid by other patients.
    • By 2050, Medicare fees are projected to be only one-half of what the private sector pays.
    • By 2080, they will be only one-third.”
    From Dr. Goodman’s piece. Bullet point one is correct. That is the law, as the bullet point itself states. So what?
    The SGR mechanism was put into place to save Congresses from themselves, but the mechanism has not worked that way far. It should. The only force preventing the mechanism from working is pressure from physicians groups on Congresses, primarily the AMA. Let the law work as intended.
    Bullet points beyond the first are meaningless. Many changes will occur in the intervening years.
    My prediction is that a single payer/insurer scheme will evolve through one means or another well before 2019, nine years hence. The economics are simply too compelling. Eventually one or more influential Republican legislators will see the political advantages of promoting such a scheme because it relieves such a substantial level of cost imposed on business by current legislation.
    Private insurers cost business in toto a substantial amount of money. The cost could be easily obviated through a simple, effective single payer/insurer scheme.
    The exclusion of the so-called public option was the price that the Congressional backers of the ACA had to pay to avoid protracted opposition from private insurers which well knew that a public option would eventually expand sufficiently in size to marginalize to extinction private insurance. All to the good of the public however.
    If Dr. Goodman wants, I would be happy to discuss every assertion or fact from the Center’s paper under this posting.
    Personally, I do not find the comments above particularly nit-picking. They are not specific in their criticism, so that is a legitimate complaint from Dr. Goodman, but it also does not mean that the criticism itself is founded.

  6. Seems like there is a lot of petty nit-picking here by a lot of sour pusses. People in the photos look worried? What’s wrong with that? Aren’t there good reasons to worry? Do you want to see photos of seniors with “what, me worry?” Alfred E. Newman smiles?
    Question: Isn’t this more objective than anything else out there?
    More Questions: Is there any major benefit we have omitted? Any major cost we have suggested? Any factual errors?
    By the way, almost all the references are to the government documents.

  7. I will say that the first part of the pamphlet about likely difficuly in scheduling appts with doctors is very apt and appropriate. Just wish the rest of the pamphlet had stuck to more feasible criticisms of the Act instead of resorting to fearmongering among Seniors to run on this in the fall and duplicate what happened with the 1988 Medicare Catatrophic Coverage Act.

  8. 2/3 of the NCPA pamphlet is about the budget cuts to the dubious Medicare Advantage subsidies?
    My favorite scaremongering line though is that ‘1/7 of hospitals may close.’ Now that’s a real stretch and would love to see what crazy analysis this is based on.
    This is typical ‘conservative’ progranda. Only to happy to run rough shod over the Constitution and Bill of Rights when it supports their positions and more than happy to spend money on issues/causes they support.
    Goodman isn’t a ‘conservative’ in the classic sense but is really a corporatist shill wrapped in liberterian clothing which is what a majority of ‘conservatives’ are today.

  9. You people have no shame. This “objective” pamphlet reads like a Sarah Palin speech with the grammar cleaned up.
    Why do you feel the need to go through the whole scholarly pantomime? Wouldn’t it be easier to just make some mailers or leave flyers on cars or something?

  10. Although, I agree with your discussion. I still feel that as professionals instead of focusing on the ‘business’ aspect of healthcare, we should direct our efforts in making our clinical skills more sound. Below is a nice website, where you can start.
    1. Central searchable repository of a pharmacists ‘curb-side’ notes.
    2. Transition between hospital and retail settings, your notes can transition with you, not your job!
    3. For access from anywhere, when I do not have direct access to my references/websites.
    4. For the Pharmacist, BY the Pharmacist.

  11. I was disappointed to find that the pamphlet clearly had an ideological bias against the health plan, when it was advertised as an objective evaluation.

  12. Baucus never read the complete Law. Sad and pathetic. Most who voted had no idea about what they voted fore.
    One thing is clear, hospitals ar desperately seeking merger partners and patients are grist for their cash registers.

  13. I’M PROUD OF YOU LABOR!. Keep standing up. The lives and health of all the American people and the World are in serious jeopardy.
    Further, unemployment healthcare benefits are critically needed. But they should be provided through the Medicare program at cost, less the 65% government premium subsidy provided now to private for profit health insurance.
    Congress should stop wasting hundreds of millions of dollars of taxpayer money on private for profit health insurance subsidies. Subsidies that cost the taxpayer 10x as much or more than Medicare does. Private for profit health insurance plans cost more. But provide dangerous and poorer quality patient care.
    It’s over. Tell congress to get the healthcare Merchants of death and injury out of the American peoples lives for good. 2010 is about THE PUBLIC OPTION!
    And that CORRUPT! UNDEMOCRATIC! filibuster must GO! NOW!
    Alan Grayson Honors The Dead http://www.youtube.com/watch?v=TV9TRoYMtjs&feature=player_embedded
    Alan Grayson on Healthcare http://www.youtube.com/watch?v=oPpQ2MNaSDo&feature=player_embedded
    Ron Sparks HealthCareReform http://youtu.be/kqlBFRJh4Cw
    John Garamendi – The Public Option http://www.youtube.com/watch?v=EyBTEke68aQ&feature=player_embedded
    I want to commend all of you for working so hard and being so strong at helping the whitehouse and congress begin to address our U.S. and Global healthcare crisis. You have been AWESOME! my fellow Americans and peoples of the World. America and the World is better and safer for it. My greatest pride is the knowledge that I am one of you. And that you really get it. You really understand the importance of it all.
    There are some potentially very good things in the healthcare legislation. Especially with the reconciliation fix’s. The Democrats, Bernie Sanders and the Whitehouse did a GREAT! job of fighting to produce the best healthcare legislation that they could. They have earned all our strong support. And we should give it to them.
    But it was your relentless pressure and hard work that made the difference. Whatever good comes from this healthcare legislation, America and the peoples of the World will have each of you to thank. You were smart, creative, courageous and relentless. You fought together for the best legislation possible. And when you had to, you fought alone. No matter who stumbled and fell you continued to push and forge ahead. Fighting for the lives and health of the American people and the World. YOU SHOULD BE PROUD OF YOUR-SELVES 🙂
    It may come to pass that future generations will look back on us and say that we were ALL Americas Greatest Generations. And that healthcare reform was our finest hour. You should be proud of our leaders President Obama, Speaker Pelosi, Majority Leader Reid and the many other Democratic and independent fighters for the people in congress. They proved them-self worthy of the leadership of a GREAT! PEOPLE.
    But we are not done yet. This was just the beginning of healthcare reform, not the end. WE THE PEOPLE OF THE UNITED STATES, ARE NOT! divided on healthcare legislation. The vast majority of you have been consistently crystal clear that this legislation does not go far enough. You want a strong Government-run Public Option CHOICE!! available to everyone on day one. And you want it NOW!
    WE THE PEOPLE have been crystal clear that we want an end to dependence on for-profit healthcare and the for-profit proxies called private for non-profit healthcare. The American people want the CHOICE! of a strong Government-run Public Option to replace their need or dependence on healthcare providers whose primary motivation is profit. Rather than providing the highest quality, easiest accessible and most affordable medically necessary healthcare possible. This is what the rest of the developed World has. And the American people want it too. They want healthcare ASSURANCE! Not, for-profit health insurance. And they want it NOW!
    Now is the time to continue the push for a strong Government-run Public Option CHOICE! available to everyone that wants it on day one. Rationally it’s clear what we have to do to get this done. SUPPORT THE DEMOCRATS that supported you with a Public Option choice, and REMOVE as many republicans as you can. Not one republican in congress was willing to step across the isle to support a strong Government-run Public Option CHOICE!! available to everyone on day one. NOT ONE! Let no candidate prevail this November that does not support a Strong Government-run Public Option.
    47,000 AMERICANS die each year from lack of healthcare. 120,000 die from treatable illness that don’t die in other developed countries. Hundreds of thousands of you are dieing from medical accidents in a rush to profit. And Millions of you are injured. Millions more are driven into bankruptcy. All for the privilege of paying two to three times as much as any other people in the developed world for healthcare. HOGWASH!
    Additionally, tens of thousands of you and your children were killed and millions sickened and injured from a terror attack with H1N1 (swine flu). Released on the American people and the World by the for-profit healthcare industry. All in an attempt to panic and frighten you into accepting the oxymoronic criminal enterprise of private for-profit healthcare (The most costly, deadly, dangerous, and disgraceful product sold in America). H1N1 is still sickening people and killing them. Especially children, the young and the middle aged. And there will be a third wave. These are the terrorist you need to worry about the most. Even the so-called international terrorist would not do something so INSANE! But greed driven medical profiteers would and did.
    Apparently as far as republicans in GOVERNMENT are concerned, YOU! my fellow Americans – CAN JUST DROP DEAD! Including their own family members. Fools!… Hundreds of thousands of you, and possibly millions of you will die from the long-term effects of your infection and poisoning with H1N1.
    So my fellow Human Beings. Rest-up, Take good care of the basics (Balanced nutrition, hydration, exercise, rest and POSITIVE emotional supports). Then wade back into the FIGHT! for a strong Government-run Public Option CHOICE! available to everyone on day one. Drug re-importation, Abolishment or strong restrictions on patents for biologic and prescription drugs. And government controlled and negotiated drug and medical cost. You must take back control of your healthcare system from the Medical Industrial Complex. You MUST do it NOW! This is a matter of National and Global security. There can be NO MORE EXCUSES.
    God Bless You My Fellow Human Beings. I’m glad to know of you. And proud to be one of you.
    See you on the battle field.
    jacksmith – WorkingClass 🙂

  14. “Have you ever seen a fair, unbiased, evenhanded explanation of the Patient Protection and Affordable Care Act?”
    Have you ever seen a “fair, unbiased, evenhanded” EOB?

  15. Why am I not surprised by the “Fair and Balanced” part of it all?
    This is a compilation of facts, rounded off with opinionated statements and research quotes from known opponents of the reform.

  16. Nothing wrong with Dr. Goodman asserting his perspective – with or without facts to back that perspective up – but I can only guess that the repeated counterfactual postings here – epitomized by the summary of this pamphlet – are needed to help him make a living through his Center and to garner paying grants such as the Fellowship mentioned.
    I am certainly aware of the fact that everyone has to eke out a living, i.e. generate income, to pay for life’s necessities or more, but I have never been keen on those who knowingly – perhaps I presume more knowledge on Dr. Goodman’s part than warranted – provide distorted (i.e. non-factually based) analysis on behalf of private interests which benefit from the distortion of reality.
    That is glaringly and overwhelmingly the case with a politician/pundit such as Newt Gingrich, but is also true, it appears to me, of individuals such as Dr. Goodman.

  17. Is this a joke? Fine if you want to produce a pamphlet criticizing the legislation, but don’t call it an unbiased account.

  18. “Have you ever seen a fair, unbiased, evenhanded explanation of the Patient Protection and Affordable Care Act? Have you ever seen anything that even appeared to be objective? I haven’t.”
    I haven’t either, and I just read the pamphlet.
    It’s good. Very good. I particularly liked the distraught, almost panicky, look of the folks on the front cover. Who said you can’t judge a pamphlet by its cover?

  19. Fair and balanced… just like Fox news.
    Why not just come out and say that you have an ax to grind?

  20. 0/10 on the “fair, unbiased, evenhanded explanation” scale. You ascribe many problems in the health care system to the reform bill, yet these are issues that have existed for a long time. One example: “Can I Keep My Doctor?
    You may not be able to. For example, you may end up in a plan that restricts your choice of doctors. Or your doctor may end up in a plan that restricts her choice of patients. Also, the demand for doctor services will greatly exceed supply — creating new rationing problems.”
    These were all true before reform, and will be true after reform takes effect.