Busting healthcare myths

Watching the healthcare reform debate grow increasingly rancorous, I am reminded of the oath taken by doctors and nurses when they begin practicing medicine: First, do no harm. As a former nurse, I know that this oath is the cornerstone of our work. Which is why, as this debate unfolds, I wish that the politicians were also bound by this important oath.

From scary warnings about death panels to missing facts about the insurance industry’s willingness to play its part in reforming the system, the past several weeks have demonstrated that it’s business as usual in Washington. This lack of information and misinformation — you might even call it myth-information — is harmful to American seniors, families, small-business owners, providers, hospitals and, especially, all patients, regardless of income level.

• Any plan that is signed by President Obama will not add “one dime to our deficits now or in the future. Period.” One bill House Democrats offered would add $220 billion to the deficit over 10 years, according to the Congressional Budget Office (CBO). Democrats and the administration have characterized the bill as deficit-neutral because they are not counting the estimated $245 billion cost of adjusting Medicare physician reimbursement rates. Further, CBO Director Elmendorf is on record as saying that none of the proposed pieces of legislation to date would create “the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.”

• The public option will reduce healthcare costs by creating more competition. Unfortunately just the opposite is true. By design, a nonprofit, government-run and subsidized plan would have an unfair competitive advantage. Public entities generally do not have to adhere to state pricing or regulatory guidelines. Today, nine times out of 10, the reason certain markets are dominated by one or two large insurance companies is that state regulations make it challenging or impossible for smaller, private insurers to compete. A public option will only make this situation worse. In such an anti-competitive environment, private insurers — entities that are facilitating access and choice for millions of Americans today — would be forced to reassess whether it is viable to offer coverage in markets across the country.

• If you like your current healthcare coverage, you can keep it. That will be hard to do if your employer changes your health plan options, switches to the public plan or drops insurance coverage altogether — all possibilities under the proposed plan. A CBO analysis of the healthcare bill written by House Democrats showed that an estimated 3 million people with employer-based care would lose that coverage by 2016 because their employers would stop offering it.

• A public option will keep private-sector insurance companies honest and force them to be more transparent. Perhaps the real question is how will a new public option work any better than Medicare, which is rife with fraud, abuse and inefficiency, and which continuously underpays providers — both hospitals and physicians — for medical services? Although it is not acknowledged, these underpayments by the government to providers are one of the primary reasons that the cost of healthcare is so out of control today. Unfortunately, to make hospitals and physicians whole, billions of dollars of medical costs are shifted annually to private insurers. In turn, employers and employees pay higher healthcare premiums to offset a portion of the underpayments not absorbed by private insurers. Yet, not once in this debate has this huge issue honestly been acknowledged.

• Medicare benefits will not be cut on the president’s watch. The vow sounds great, but conflicts with proponents’ desire to pay for health reform by reducing Medicare payments to providers by more than $500 billion during the next 10 years. Those cuts will impact hospitals and the Medicare Advantage (MA) beneficiaries, who are the elderly and who are ardent supporters of this program. There is no question that removing Medicare fraud and improving operational efficiencies can lead to significant cost savings. But does anyone really believe that reduced benefits to seniors, especially the 22 percent of Medicare beneficiaries enrolled in MA, will not occur?

There are plenty of other examples that are misleading the American public. Claiming that requiring insurers to cover preventive care will save money is questionable, as most experts agree that such measures actually cost money. Capping medical liability would significantly reduce the practice of defensive medicine by at least $30 billion annually and thus reduce the cost of healthcare, yet tort reform is not currently addressed in proposed legislation outside of a demonstration project.

I also take issue with those who suggest that those opposing reform proposals do so only to criticize without offering alternative solutions. In fact, so many of us in the insurance and provider communities have worked tirelessly to not only provide input into current proposed legislation but have also offered our own reform proposals.

Myth-information has no place in such an important debate. We all have too much at stake. Americans deserve better.

Greenrose, R.N., is president and CEO of the American Association of Preferred Provider Organizations. Her e-mail address is This e-mail address is being protected from spambots. You need JavaScript enabled to view it