Top 10 health care reform myths
Myth 1: Your health care will be rationed when the bill becomes law.
Fact: Your health care already is being rationed by the health insurance companies every day. Many days all you need to do is pick up a newspaper to find another story about a family battling an insurance company to get coverage for a treatment that was denied, or a story about a family kicked out of an insurance policy because someone in the family got sick. Those are actually the strategies used regularly by insurance companies to reduce their costs and increase profits. In fact, Wendell Potter, a former senior executive at CIGNA health insurance company, gave details about how the industry rations coverage on June 24, 2009, before the Senate Committee on Commerce, Science, and Transportation. He testified that "insurers routinely dump policyholders who are less profitable or who get sick" and "also dump small businesses whose employees' medical claims exceed what insurance underwriters expected."
Health and Human Services Secretary Karen Sebelius said during her confirmation hearings about rationing, "I, frankly, as insurance commissioner, where I served for eight years, saw it on a regular basis by private insurers, who often made decisions overruling suggestions that doctors would make for their patients, that they weren't going to be covered. And a lot of what we did in the office of the Kansas Insurance Department was go to bat on behalf of those patients to make sure that the benefits that they had actually paid for were, in fact, ones that were delivered."
The health care reform bill actually will help prevent rationing by making it illegal for a company to kick you out of your insurance policy because you get sick. The only way you can get kicked out of a policy when the new law takes effect in six months will be if the insurance company can prove fraud. Beginning in 2014, the insurance company will not be able to deny you coverage because of pre-existing conditions. Beginning in 90 days, those with pre-existing conditions will be able to get health insurance through temporary insurance pools.
Myth 2: The health care bill provides for "euthanasia" or death panels.
Fact: At no time in the process were death panels or "euthanasia" mandated by the House or the Senate. In fact, Sarah Palin won an award for "Lie of the Year" for her claim about "death panels." At one point the House bill did include an amendment to the Social Security Act to provide coverage for advance care planning on an optional basis if requested by the patient. These were special consultations with a physician or other qualified care provider about ventilators, feeding tubes and other measures to sustain life. This provision was taken out to avoid political problems.
Myth 3: Health care reform will raise your taxes.
Fact: Most people will not see a tax increase. Those earning more than $200,000 individually ($250,000 as a married couple) and those with high-premium insurance plans will see tax increases. High earners need to pay 0.9% more in Medicare taxes. The total Medicare payroll tax rate will be 2.35%. The current rate is 1.45%. The tax rate will apply to unearned income, such as dividends and capital gains. Taxpayers who get high-premium insurance plans from their employers, which some think are a luxury, will need to pay a "Cadillac Tax." If your employer plan exceeds $8,500 for a single person or $23,000 for a family in premiums per year, you could be stuck with that tax.
Myth 4: Health care reform will create nationalized heath care.
Fact: The idea of a single-payer system like we see in Canada or the U.K. was rejected by both the Administration and Congress early in the debate about health care reform. Instead of a single-payer system, the bill calls for creating the state-based American Health Benefit Exchanges and Small Business Health Options Program Exchanges. These exchanges will include private insurance options. They will be administered by a governmental agency or non-profit organization. Individuals and small businesses up to 100 people will be able to purchase insurance through these exchanges. Insurance companies will compete on these exchanges for your business.
Myth 5: Health care reform will be the start of socialized medicine.
Fact: At no time in the discussion did anyone suggest a system of socialized medicine as can be found in countries like Russia or China. With socialized medicine, the government finances and provides health care services. Similar myths were spread about Medicare when that program was passed in 1965. Clearly you can see that doctors in private practice continue to provide medical care to seniors under the provisions of Medicare. Under health care reform, not only will you get your care from private doctors, you'll get your insurance from a private insurance company. Even the possibility of a competing government option insurance was removed from the legislation.
Myth 6: The government can't run a health program.
Fact: All you need to do is talk with seniors about their medical care under Medicare or veterans about their care under the Veterans Administration to find out whether or not they are satisfied with their coverage. In fact, the Commonwealth Fund concluded in a May 2009 survey: "elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans."
In 2005, Washington Monthly declared the VA care, "The Best Care Anywhere."
Myth 7: You won't have any choices under health care reform.
Fact: While your choices won't be limitless, you will likely have more comprehensive coverage than you do now if you are under an individual plan. Your employer plan choices will likely remain the same or your employer may switch insurance companies, but that will still be the choice your employer can make. The law actually provides for four benefit tiers:
- Bronze plan: Covers 60% of the benefit costs of the plan with an out-of-pocket limit equal to the Health Savings Account (HSA) current law limit of $5,950 for individuals and $11,900 for families.
- Silver plan: Covers 70% of the benefit costs of the plan with the HSA out-of-pocket limits.
- Gold plan: Covers 80% of the benefit costs of the plan with the HSA out-of-pocket limits.
- Platinum plan: Covers 90% of the benefit costs of the plan with the HSA out-of-pocket limits.
Myth 8: Doctors wages will be set by the government.
Fact: Your doctors will still be in private practice and they will determine their own wages. That's true today even for most people who receive their coverage through Medicare or Medicaid. Some Medicare or Medicaid patients do receive services through community health clinics that are funded by their states. In those clinics, doctors may be paid by state government. You can read more about the direct impacts on doctors at the American Medical Association Web site.
Myth 9: Medicare coverage will be cut.
Fact: The Commonwealth Fund found the opposite is true. In its issue brief, the Fund found that health care reform "would strengthen the program by reducing costs for prescription drugs, expanding coverage for preventive care, providing more help for low-income beneficiaries, and supporting accessible, coordinated, and comprehensive care that effectively responds to patients' needs. The legislation also would help to extend the program's fiscal solvency for nine years, under the Senate bill. This issue brief examines the provisions in the pending legislation and how each one would work to improve benefits, extend the fiscal solvency of the Medicare Hospital Insurance Trust Fund, reduce pressure on the federal budget, and contribute to moving the health care system toward better access to care, improved quality, and greater efficiency."
Myth 10: You'll lose your private insurance.
Fact: At no time throughout the legislative process was health care reform designed to replace existing private insurance. The House of Representatives did propose a government insurer that would compete with private insurers for your business, but that provision is not in the final bill that passed both houses of Congress.
The bill instead will improve your health care coverage by limiting your out-of-pocket exposure because of a major illness, by not allowing companies to deny you coverage because of pre-existing conditions, and by not allowing companies to kick you out of your insurance because you get sick. You will not lose your private insurance, but your private insurer may need to make changes to your policy by 2014 to come into compliance with the new insurance regulations. If you don't like what your private insurer does with its changes, you can make the choice to change insurers by choosing one of those competing on the national exchanges.
Lita Epstein has written more than 25 books including The Complete idiot's Guide to Social Security and Medicare and The Pocket Idiot's Guide to Medicare Part D.