The Real Tragedy of the Komen/Planned Parenthood Flapdoodle
…is that it overshadowed news that the U.S. House of Representatives overwhelmingly voted to repeal one of two new entitlement programs created by Obamacare—the ironically named CLASS Act—with a bipartisan three-fifths majority. (With numbers like that, Congress could even repeal Obamacare’s death panel!)
But really, one private organization pulling funding for another private organization is way more important than Congress voting to repeal an entitlement program … isn’t it?
‘The Moment It Produces Useful CER, PCORI Is Toast.’
An excerpt from a Politico Pro article (paywall) on the “Patient-Centered Outcomes Research Institute,” President Obama’s comparative-effectiveness research agency:
The point of comparative effectiveness research is to compare two or more different ways of treating the same condition to see which one works best. The idea is that if definitive best practices can be established, they will be widely adopted by providers and may be preferentially reimbursed by payers. Cheaper treatments that are effective would be favored.
It may sound harmless — like common sense, even, to the uninitiated — but it’s a menacing prospect to some pharmaceutical companies and medical device-makers who are concerned that their products may wind up on the wrong side of the ledger.
For this reason, Michael Cannon, director of health care studies at the Cato Institute, says good comparative effectiveness research is almost suicidal.
“The whole point of [comparative effectiveness research] is to find out what doesn’t work,” Cannon said in an email. “Every time the government has tried to do CER, the guys who provide the stuff found not to work successfully lobby to have the offending agency defunded. I see no reason to think this time will be any different. The moment it produces useful CER, PCORI is toast.”
And that’s just one source of opposition.
Other sources of opposition include patients who don’t like restrictions on their health care subsidies, thank you very much.
(The “suicidal” bit is confusing, and wasn’t my language. So to clear up any misunderstandings: comparative-effectiveness research is good. Markets both produce and employ it. Government is so incompetent that it cannot reliably produce CER, much less make use of it. Markets are smart. Government is stupid.)
Strike Three for PolitiFact
The annual unveiling of its “Lie of the Year” award garners PolitiFact more attention than anything else. Hopefully, it will garner so much attention that people will recognize this award, which is supposed to improve political discourse, instead degrades it.
PolitiFact’s past three Lies of the Year have been about health care. Not one of them was a lie.
A lie is when a speaker says something that he knows or believes to be false, for the purpose of deceiving others. None of these supposed Lies of the Year even met the threshold test of being false. The first two (“death panels” and “ObamaCare is a government takeover”) were actually, demonstrably true.
The third and latest Lie of the Year—that “Republicans voted to end Medicare”—is arguably true: its veracity depends on what your definition of “Medicare” is. To seniors, Medicare means “the government helps me pay for health care.” The House Republicans’ budget (a.k.a., the Ryan plan) would not end such federal assistance, and would arguably improve access to quality health care. To the Left, “Medicare” means the particular way the federal government helps seniors access health care: a single-payer system. The Ryan plan would end that single-payer system. My leftist friends are right and PolitiFact is wrong: from a certain and valid perspective, this claim is true.
Moreover, even if these three statements were false, the speakers believed them to be true. Therefore, they cannot be lies. Every single Lie of the Year award has gotten that basic fact wrong.
In the process, this award degrades political discourse by implicitly launching—an encouraging others to launch—ad hominem assaults on people who hold legitimate differences of opinion. PolitiFact should find a better way to attract readers.
I have been writing about the flaws in PolitiFact’s business model for some time:
- Just Call Me Liar of the Year
- Why I’m Boycotting PolitiFact
- PolitiFact Just Asked Me to Be a Source, Again. I Declined, Again.
- PolitiFact Just Called, Again. I Declined to Help, Again.
I’m glad to see my friends on the Left have taken notice, though I regret the way it happened.
PolitiFact Just Asked Me to Be a Source, Again. I Declined, Again.
The last time this happened, I blogged that I “declined to help” PolitiFact. That’s actually not true. The whole purpose of my PolitiFact boycott is to help them.
Why I’m Boycotting PolitiFact
Reporters at PolitiFact.com have used me as a resource half a dozen times or so when fact-checking something someone said about health care reform. Sometimes we disagree about where the truth lies, but I’ve always been happy to help. That changed recently, and I should let PolitiFact’s reporters know why.
At the end of each year, PolitiFact sifts through the many claims its reporters have deemed untrue and selects one to be their Lie of the Year. The Lie of the Year award is easily PolitiFact’s biggest publicity-generator. In 2009, they picked Sarah Palin’s “death panels” claim. In 2010, they picked the claim that the new health care law is a “government takeover” of health care.
Looking at those two Lies of the Year together brought a couple of things home for me.
The first is not so much that each of those statements is actually factually true; it is rather that they are true for reasons that PolitiFact failed to consider. PolitiFact’s “death panels” fact-check never considered whether President Obama’s contemporaneous “IMAC” proposal would, under standard principles of administrative law, enable the federal government to ration care as Palin claimed. (In an August 2009 oped for the Detroit Free Press, I explain how the IMAC proposal would do just that.) PolitiFact’s “government takeover” fact-check hung its conclusion on the distinction between “public” vs. “private” health care, without considering whether that distinction might be illusory. (In a January 2011 column for Kaiser Health News, I cite well-respected, non-partisan sources – and even one of President Obama’s own health care advisors – to demonstrate that this distinction is illusory.) Aside from whether they arrived at the truth, each of these fact-checks was woefully incomplete.
Second, PolitiFact’s decision to go further by declaring those statements lies highlights a logical flaw in their Lie of the Year award. For a statement to be a lie, the speaker must know or believe it to be false. In neither the case of “death panels” nor “government takeover” has PolitiFact offered any evidence that the speakers knew or believed their statements to be false. Until PolitiFact offers such evidence, it has no factual basis for calling either statement a lie. Moreover, if PolitiFact’s reporters believe that Sarah Palin et alia believe that what they said was true – and I would be willing to bet good money that they do – then PolitiFact’s reporters know that their past two Lies of the Year aren’t really lies.
I have concluded that the errors in those two fact-checks, plus the fundamental (and rather ironic) error at the heart of PolitiFact’s Lie of the Year award, are serious enough that until PolitiFact addresses them I can no longer serve as a resource for PolitiFact in good conscience. Since January, I have declined maybe four requests for help from PolitiFact reporters, and will politely continue to do so until they address these errors.
Some conservatives think PolitiFact is a left-wing outfit. I don’t think that’s true, and I have defended PolitiFact against that charge. I believe that PolitiFact’s reporters are earnestly doing their best to get at the truth. But there’s a tension between that belief and these errors. Whether PolitiFact recognizes and addresses that tension will tell us a lot about PolitiFact.
Filed under: Cato Publications; General; Government and Politics; Health Care
Just Call Me ‘Liar of the Year’
It would appear that I am the Liar of the Year.
The fact-checking journalists at PolitiFact.com gave their 2010 Lie of the Year award to the notion that ObamaCare is “a government takeover of health care,” and in 2009 gave the same award to Sarah Palin’s “death panels” claim. But as I explain in my latest column for Kaiser Health News, the fact-checkers left out a few facts. Read the column to find out what PolitiFact missed. Here’s my conclusion:
From my vantage point, the evidence shows that ObamaCare is a government takeover of health care, and Sarah Palin’s “death panels” claim was essentially true. If that makes me Liar of the Year, so be it.
But another way to look at it is this: PolitiFact has now misappropriated this award for two years in a row. Not only is each of these “lies” factually true, but — and this is more important — the people who made those statements believe them to be true, which means they fall short of the dictionary definition of a lie: “An assertion of something known or believed by the speaker to be untrue with intent to deceive.“ There is simply no factual basis — and no excuse — for calling them lies.
PolitiFact’s Lie of the Year award has proven as conducive to civil discourse as Rep. Joe Wilson’s, R- S.C., dyspeptic “You lie!” outburst during one of President Obama’s previous addresses to Congress. Rather than continue to poison the well by dispensing another award this year, PolitiFact should just let it lie.
PolitiFact should also revisit its evaluations of those two claims.
The Real Problem with Those Non-Death Panels
Rich Lowry has the right take on the Obama administration’s decision to have Medicare cover end-of-life counseling despite Congress’ rejection of the idea.
USA Today Abets ObamaCare Supporters’ Misinformation Campaign
An article in today’s The USA Today titled, “With Many Still in Dark, Groups Shed Light on Health Care Law,” aims to correct misinformation about ObamaCare. Ironically, the article is itself a monument to misinformation.
It begins:
True or false: The new health care law will cut Medicare benefits for seniors. It will slash Medicare payments to doctors. It will ration health care.
In three polls conducted last month, large percentages of Americans answered “true” to each statement. All three are false.
In fact, two of the three statements are 100-percent true.
First, ObamaCare will cut payments to the private health insurance companies that provide coverage to the 20 percent of Medicare enrollees who participate in the Medicare Advantage program. That will eliminate many types of coverage for seniors in Medicare Advantage. That should be painfully obvious, but if you require confirmation, visit FactCheck.org. ObamaCare will also ratchet down the price controls that Medicare uses to pay hospitals and many other health care providers. It should likewise be obvious that that will reduce access to services that are ostensibly “guaranteed” to all enrollees. But again, if you need confirmation, check in with Medicare’s chief actuary, who works for President Obama. We can debate whether that’s good or bad. What’s not up for debate: ObamaCare in fact “will cut Medicare benefits for seniors.”
Second, it is also true — ipso facto – that ObamaCare “will ration health care.” To ration is to limit consumption. When ObamaCare reduces coverage for Medicare Advantage enrollees and reduces access to care for all Medicare enrollees, it limits seniors’ consumption of medical care. We can debate whether that’s good or bad. What’s not up for debate: that is rationing.
Finally, yes, it is technically false that ObamaCare “will slash Medicare payments to doctors.” But since current law will slash Medicare payments to doctors if Congress does nothing, and since an earlier version of ObamaCare would have eliminated those cuts, but ObamaCare’s architects dropped that provision so as to make ObamaCare appear deficit-neutral… well, perhaps the public can be forgiven if it confuses “eliminating a provision that would have prevented cuts in Medicare payments to doctors” with “slashing Medicare payments to doctors.”
What Do The Economist‘s Bloggers Think a Free Market Is, Anyway?
A correspondent for The Economist, whose initials are M.S., posts this on the Democracy in America blog:
[T]he new health-care-reform law passed in March is an entirely private-insurer, free-market-based reform. If someone were to refer to it as a “government takeover of the health-care sector”, that person would hold a factually incorrect ideological belief.
I wonder what convinced M.S. that the new health care law is an entirely free-market-based reform. Was it the expansion of the government’s Medicaid program to another 16 million Americans? Was it the 19-million-plus other Americans who will receive government subsidies to purchase private health insurance? Was it the new price controls that the law imposes on health insurance? Or the price and exchange controls that it will extend to even more of the market? Was it the dynamics those regulations set in motion, which will reduce variety and innovation in health insurance? Was it the mandates that require private actors to spend their resources according to the wishes of the state? Or the new federal regulations that will shape every health insurance plan in the United States, whether purchased through the employer-based market, the individual market, or the new health insurance “exchanges”? Was it the half-trillion dollars of (explicit) tax increases over the next 10 years?
I wonder what it is about this law that M.S. thinks is consonant with the principles of a free market. Perhaps we have a different idea of what “free” means.
M.S. lists other “factually incorrect beliefs,” including:
that the Clinton plan would deny patients their choice of doctor, and that the health-care-reform bills in Congress at the time involved government “death panels” that could decide to withhold care from elderly patients on a cost-benefit basis.
I won’t dredge up the Clinton health plan. But I have previously demonstrated that, when Sarah Palin claimed that President Obama wanted to give a government panel the power to deny medical care to the elderly and disabled based on cost-effectiveness criteria, the president had in fact proposed a panel with the power to do exactly that.
I agree with M.S. about this much: “once people are exposed to false information, it’s extremely difficult to convince them it’s false.”
Medicare Fraud: 1, Anti-Fraud Measures: 0
As the nation contemplates the new health care entitlements that Congress and President Obama just created, it is worth noting an article in today’s Washington Post, which reports on the performance of past efforts to eliminate fraud in another health care entitlement:
More than a decade ago, Congress set out to squeeze the fraud out of Medicare billing at nursing homes, requiring more precise justifications for costs. It created new “ultra-high” billing categories intended to be used for only 5 percent of the patients needing highly specialized care and rehabilitation.
But within a few years, nursing homes flooded the ultra-high categories with patients, contributing to $542 million a year in potential overpayments, federal analysts found.
Since then, the numbers in the ultra-high categories have quadrupled, and the amount of waste and abuse could reach billions of dollars a year…
The article ends with the ominous implication that eliminating fraud in entitlement programs like Medicare will ultimately require government agencies to decide whether certain services are medically necessary.
Death panels, anyone?
Sorry Boys, Sarah Palin Is (Partly) Right
Don’t believe everything you read at The Plank — including the part about Sarah Palin’s “death panel” claim being a “lie.”
Palin’s claim was a tad hyperbolic, but that does not change the fact that — as I explain in the Detroit Free Press — President Obama has proposed a new government panel that would enhance Medicare’s ability to deny care to the elderly and disabled based on government bureaucrats’ arbitrary valuations of those patients’ lives.
Give Me Liberty or Give Me Death Panels
“Death panels” are a dominant motif in the debate over health care regulation, a fact that spins off political flares like a roman candle.
Extremists on both sides have taken their extreme positions: Some literally fear President Obama and his health regulation plans; others are outraged that anyone could possibly feel that way.
Charges of special-interest organizing meet counter-charges of unfairness and false accusation. Good video from town hall meetings and volleys of “Nazi” and “socialist” give cable news networks another short reprieve from their long slow decline. It’s all manna for the writers at Comedy Central.
But let’s talk substance: Health care is a scarce good, so it will always be rationed. The core question is whether government should take the dominant role in health care rationing over from insurance companies, or whether reform should restore rationing decisions to patients advised by doctors.
Though they would never have the name or the form, the “death panel” label roughly (and unfairly) describes what would happen if health decisions were turned over to government bureaucrats under the leading proposals today. The bureaucracy would do exactly what “reform” asks it to do(!): prioritize cost savings and efficiency over the unique, individual interests of patients and their families.
The bureaucracy would serve its own interests too. Bureaucracies are subject to capture by special interests, of course, and they can be corrupted. These things are easier when the people who might die look like statistics.
Many people feel very strongly that problems with health care today indicate the need for President Obama’s and Congress’ health care plans. But what’s wrong with health care doesn’t mean that these proposals would make things better. Because they would move control of health care in the wrong direction, they would make things worse.
Everyone has a personal story about health care, and I have one too. On the day my mother passed away, my family and I were called to the hospital and met by a social worker. He showed us to a small anteroom at the entrance to the intensive care unit, where he guided us through a lengthy conversation about my mother’s wishes and the family’s circumstances. He then called in the doctors to offer their prognosis and advice, which we took.
It was a death panel. It was our death panel — because my parents had fully prepared for this eventuality by buying insurance.
Just like health care will always be rationed, there will always be death panels. The question is who runs them. To the extent our public policy drives people away from financial responsibility for their own health care, it sets them up for death panels that are administered by government bureaucrats, not by loved ones and doctors.
Political debate is rollicking and unfair and full of inaccuracy. And in the terms of today’s health care debate, we don’t want “rationing” — meaning we don’t want government rationing. And we don’t want death panels — meaning we don’t want government death panels, because government death panels will deny people and their families an essential dignity of life: choosing how it ends.
In that sense I say with apologies to Patrick Henry: Give me liberty or give me death panels.
Cato on Facebook
Cato on Twitter
Cato on Google+
Cato on YouTube
