Republicans Propagating Falsehoods in Attacks on Health-Care Reform
By Steven Pearlstein
As a columnist who regularly dishes out sharp criticism, I try not to
question the motives of people with whom I don't agree. Today, I'm
going to step over that line.
The recent attacks by Republican leaders and their ideological
fellow-travelers on the effort to reform the health-care system have
been so misleading, so disingenuous, that they could only spring from
a cynical effort to gain partisan political advantage. By poisoning
the political well, they've given up any pretense of being the loyal
opposition. They've become political terrorists, willing to say or do
anything to prevent the country from reaching a consensus on one of
its most serious domestic problems.
There are lots of valid criticisms that can be made against the health
reform plans moving through Congress -- I've made a few myself. But
there is no credible way to look at what has been proposed by the
president or any congressional committee and conclude that these will
result in a government takeover of the health-care system. That is a
flat-out lie whose only purpose is to scare the public and stop
Under any plan likely to emerge from Congress, the vast majority of
Americans who are not old or poor will continue to buy health
insurance from private companies, continue to get their health care
from doctors in private practice and continue to be treated at
privately owned hospitals.
The centerpiece of all the plans is a new health insurance exchange
set up by the government where individuals, small businesses and
eventually larger businesses will be able to purchase insurance from
private insurers at lower rates than are now generally available under
rules that require insurers to offer coverage to anyone regardless of
health condition. Low-income workers buying insurance through the
exchange -- along with their employers -- would be eligible for
government subsidies. While the government will take a more active
role in regulating the insurance market and increase its spending for
health care, that hardly amounts to the kind of government-run system
that critics conjure up when they trot out that oh-so-clever line
about the Department of Motor Vehicles being in charge of your
There is still a vigorous debate as to whether one of the insurance
options offered through those exchanges would be a government-run
insurance company of some sort. There are now less-than-even odds that
such a public option will survive in the Senate, while even House
leaders have agreed that the public plan won't be able to piggy-back
on Medicare. So the probability that a public-run insurance plan is
about to drive every private insurer out of business -- the Republican
nightmare scenario -- is approximately zero.
By now, you've probably also heard that health reform will cost
taxpayers at least a trillion dollars. Another lie.
First of all, that's not a trillion every year, as most people assume
-- it's a trillion over 10 years, which is the silly way that people
in Washington talk about federal budgets. On an annual basis, that
translates to about $140 billion, when things are up and running.
Even that, however, grossly overstates the net cost to the government
of providing universal coverage. Other parts of the reform plan would
result in offsetting savings for Medicare: reductions in unnecessary
subsidies to private insurers, in annual increases in payments rates
for doctors and in payments to hospitals for providing free care to
the uninsured. The net increase in government spending for health care
would likely be about $100 billion a year, a one-time increase equal
to less than 1 percent of a national income that grows at an average
rate of 2.5 percent every year.
The Republican lies about the economics of health reform are also
heavily laced with hypocrisy.
While holding themselves out as paragons of fiscal rectitude,
Republicans grandstand against just about every idea to reduce the
amount of health care people consume or the prices paid to health-care
providers -- the only two ways I can think of to credibly bring health
spending under control.
When Democrats, for example, propose to fund research to give doctors,
patients and health plans better information on what works and what
doesn't, Republicans sense a sinister plot to have the government
decide what treatments you will get. By the same wacko-logic, a
proposal that Medicare pay for counseling on end-of-life care is
transformed into a secret plan for mass euthanasia of the elderly.
Government negotiation on drug prices? The end of medical innovation
as we know it, according to the GOP's Dr. No. Reduce Medicare payments
to overpriced specialists and inefficient hospitals? The first step on
the slippery slope toward rationing.
Can there be anyone more two-faced than the Republican leaders who in
one breath rail against the evils of government-run health care and in
another propose a government-subsidized high-risk pool for people with
chronic illness, government-subsidized community health centers for
the uninsured, and opening up Medicare to people at age 55?
Health reform is a test of whether this country can function once
again as a civil society -- whether we can trust ourselves to embrace
the big, important changes that require everyone to give up something
in order to make everyone better off. Republican leaders are eager to
see us fail that test. We need to show them that no matter how many
lies they tell or how many scare tactics they concoct, Americans will
come together and get this done.
If health reform is to be anyone's Waterloo, let it be theirs.
Steven Pearlstein can be reached at email@example.com.