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Seven Deadly Myths of Health Care Reform

It’s not always easy to get people who have health insurance to see any value in health care reform. To dispel the negative myths that always rear their heads when the topic comes up, AARP Executive Vice President of Policy and Strategy John Rother offers this perspective on the facts and myths of health care reform.

 

“I use the term ‘myths’ because there’s a great deal of misunderstanding, both about the health care system, and about the proposals to change it. I use the term “deadly” because some kind of reform is coming and the stakes are really quite high ... for individual patients, for families, for the entire country.

As the debate heats up, you’re likely to hear all kinds of things about health care reform. A lot of the criticisms will be way off the mark and only distract us from the real issues. I call these criticisms the Seven Deadly Myths of Health Care Reform.

Myth 1: It will lead us down the road to socialized medicine.

The concern is that government will take control of the health care system ... that bureaucrats will call all the shots, and people will lose their freedom to choose doctors and hospitals and treatments.

This is a scare tactic. Powerful financial interests have profits dependent on the money flow of the current system. They want no change. Let’s be clear: The leading proposals in Washington would not give government control of the health care system. What we’re really talking about is a mixed public-private system—much like the federal employee system, or Medicare.

Another fear about federal power is that the government would put limits on the care you qualify for – rationing. It’s another scare tactic. There’s nothing in the proposals that would give the government the power to override the judgment of your doctor.

President Obama would create a new public insurance option for millions of people. But we believe this would enhance the system, by adding competition to the marketplace and giving more choice – not less – to the public.

We can’t afford not to. The cost of doing nothing is too high ... for patients, for families, for the U.S. economy.

Health care spending already takes up 16% of the U.S. economy. And that is projected to grow and grow and grow. There are upfront costs to health care reform ... [but] the benefits go beyond the federal budget. Containing costs will not only help working families pay their bills, but will help business compete internationally. And health costs are the key to controlling federal deficits over time.

The research actually shows that the ever-rising cost of health care – not the size of the boomer generation – is the real threat. So if you buy into the boomer myth, you’re misdiagnosing the problem.

The problem is that health care costs continue to rise two to three times faster than overall inflation, and take up a growing share of the economy. We need strategies to increase efficiency and value.

Cutting back on Medicare and Medicaid benefits may strike some as the answer. But it won’t get to the root of the problems – not as long as health care costs continue to rise. 

AARP believes in shared responsibility. Individuals should pay a fair share. But it’s a myth that this can be the whole answer. The problem is that when we shift too much cost to patients, they stop buying the care they do need.

People refrain from important treatments or don’t buy prescriptions or don’t keep up with them, in order to save money. And this really backfires if their untreated conditions get worse.

Nothing in health care reform should force you to pay more. Over time, the proposals should help us get a handle on costs, and lower everyone’s costs.

Depending where you live, there’s a tremendous variation in the ordering of medical services. Extensive research tells us that areas with greater use of services do not get better health results. ... We also need to pursue strategies to wring out waste and inefficiency. Better management, of chronic conditions in particular, could help add value – not add cost.

Proposals for change will spark resistance. One proposed reform is that we collect more scientific evidence on the effectiveness of medical therapies, so we have a better idea of what works best. It's called “comparative effectiveness.”

But a lot of business interests—like pharmaceuticals and medical devices—don’t want their products to be compared objectively. We think that basing decisions on sound evidence will lead to smarter spending.

We’re already paying money for the uninsured, through higher premiums and out-of-pocket charges, and higher hospital bills to make up for the uncompensated care that happens now. One way we can look at broader coverage is that it gives people a way into the system. It gives people a chance to take responsibility for themselves.

Another way we're all affected by the uninsured is that they rely so heavily on emergency rooms for care that could be given in physician offices. [That makes the wait longer for everyone.] We're all affected by strains on the system.

We have the most advanced technology, state-of-the-art research, and in some “Centers of Excellence” around the nation, the best care. But the quality of your care depends a lot on where you live. And your opinion of the system depends a great deal on where you sit – politically. So this may or may not be a myth, depending on many factors.

Where we all can agree is that the U.S. is No. 1 by far, when it comes to spending the most money on health care. And that’s not something to be proud of.

Those are my Seven Deadly Myths of Health Care Reform. I think they get to the heart of the debate. They also underscore the challenge we face in addressing the problems in the system, because so much of the political rhetoric is riddled with misunderstanding. Health care reform is a great opportunity. We should not allow myths to sidetrack this important debate."