It’s becoming clear that Rick Perry has never met a buzzword he doesn’t like. We’ve heard that Social Security is a Ponzi scheme and that Medicare isn’t working. Now he has added the words “socialized medicine” to his stump speech vocabulary, in reference to the Massachusetts health reform law, which is all about the state’s residents buying insurance from private insurance companies through a shopping service called The Connector. While the state operates the exchange, it sells nothing and underwrites no insurance. And it certainly doesn’t run the hospitals or doctors’ offices, leaving them to charge pretty much what they want to. That’s hardly socialized medicine. Yet that didn’t stop Candidate Perry from trotting out the bogeyman once again. Speaking at the Iowa Credit Union League Friday, he told his audience:
The model for socialized medicine has been tried before…whether it was in western Europe or in Massachusetts…The problem with state-sponsored health care is that you cannot contain it just within the borders of your state. When that plan took effect, it also increased Medicare/Medicaid costs.
The implicit translation: “state-sponsored health care,” no matter where it begins, will inevitably spread to other states or to other countries. The specter of Communism is haunting Europe—that sort of threat. During the last presidential campaign we heard a lot about socialized medicine from the Republican candidates. We urged the press not to use the misleading and inflammatory term, and after a while, it didn’t. In particular we noted that the AP actually clarified for its readers what socialized medicine was and was not.
In this crop of stories about Perry’s latest speech in Iowa, Politico chose to play the socialized medicine comment with the headline “Perry slams ‘socialized medicine.’” Its story gave no explanation or context for the remark, instead moving on to Perry’s new attack theme—Mitt Romney is a rich kid and Perry is not. The night before at a Republican dinner in Iowa’s Greene County, Perry had a different way to describe the Massachusetts health plan. Reuters and the Des Moines Register reported that Perry told the crowd “government mandated, government-run health care is part of what he put in place as the governor of Massachusetts.”
“Government-mandated?” Yes. In Massachusetts there is a mandate that all residents carry insurance. But government-run? Not really. Massachusetts does set the rules for state-subsidized coverage, which is provided by private insurance companies—Blue Cross Blue Shield, primarily—and also for the state’s shopping service. That’s no different from a state setting rules and regulations for other businesses. But the term government-run implies that the government has taken over selling health insurance and curing sick people–hardly the case. Like socialized medicine, these terms cry out for more explanation and discussion. If a news outlet can’t do that, perhaps it’s best not to pass them along, since misleading and sometimes downright deceitful campaign rhetoric fools the public.
Perry got some new talking points for his chat with assorted Iowans when a market-oriented think bank in Boston, the Beacon Hill Institute, released a report saying that the Massachusetts health law had driven up insurance costs by $4.3 billion and the state’s health care expenditures by $414 million. “Think about what ObamaCare is going to do to this country,” Perry said. The media jumped on this new information, but again did not provide any way to judge whether the think tank had a point, or whether it was providing only half the story. More money is spent on health care in the state because more people are insured and are using services. Total health expenditures equal the number of services times the price of those services, and the price of those services is the highest in the country. So insurance premiums haven’t decreased, especially for small businesses. Hospital costs, which account for the bulk of the state’s spending on medical care, have not gone down either. Since 1997, hospital costs in Massachusetts have been rising relative to the national average, and have continued to do so before and after the law passed in 2006, says Alan Sager, professor of health policy at Boston University’s School of Public Health. It would be good for the media to explain all this next time Perry throws out numbers.
It looks like the Massachusetts health plan is going to be a spark plug in the primaries and beyond. The public needs the straight scoop on health care in the Bay State.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.