Now it’s my turn to weigh in on the “Lie of the Year,” the gimmick PolitiFact uses to highlight the most egregious misstatements of the past year. This time, though, the fact-checking service stumbled into a fusillade of criticism from such unlikely bedfellows as New York Times liberal columnist Paul Krugman and the conservative Wall Street Journal’s online opinion page. The lie, according to PolitiFact, was the Democrats’ assertion that Republicans voted to end Medicare when the House voted last spring to embrace a voucher plan pushed by Wisconsin congressman Paul Ryan. PolitiFact also argued Democrats overreached by failing to tell the public Ryan’s plan would not force people over fifty-five to leave the traditional Medicare program, using words like “end” and “kill” even though the program would continue to exist in a privatized form, and showing videos of old people who would not be affected by the change.
I am not going to comment on PolitiFact’s own politics (as the Wall Street Journal did), the notion of fact-checking balance that interested other commentators, or the notion that PolitiFact’s time has come and gone. The fact is Republicans by supporting Ryan’s voucher plan did essentially vote to end Medicare. The Dems who didn’t like that idea should have been more precise in their statements, saying instead “Republicans voted to end Medicare as we know it” or “voted to end Medicare as a social insurance program”—a point that Norman Ornstein, a resident scholar at the American Enterprise Institute, made in PolitiFact’s critique.
PolitiFact and others should have left it there and devoted space to the larger issue. Medicare may be wildly popular, but it is not well understood by most people—be they beneficiaries, politicians, or journalists. Deconstructing how this complicated and misunderstood program works and the historical context for proposed changes would go a long way to helping the public evaluate the arguments from both Democrats and Republicans. For more than a year, Campaign Desk has urged journalists to fill that void.
PolitiFact got into a bit of historical context, but its presentation was one-sided, saying that, “historically, attacks about Medicare have come from Democrats.” But the site did not trace the origins of the conservative/Republican efforts to transform Medicare into a voucher plan, a la Paul Ryan. A decade ago, in my book Slanting the Story: The Forces that Shape the News, I showed that conservative think tanks and their benefactors had long sought such a change as a way to transfer the increasing costs of seniors’ health care from the federal government to seniors themselves, thus saving money for the federal treasury. Deficit hawks like this approach. During that period, the Heritage Foundation and others decided to educate the press on the virtues of using vouchers for Medicare and modeling the program after the insurance arrangements for federal employees.
There’s no doubt that the voucher plan contemplated by Ryan—and now his new sidekick, Oregon senator Ron Wyden—will eventually change Medicare from a social insurance scheme, where everyone who paid into the program is entitled to a benefit, into private insurance, where the sellers must bow to the profit incentive. Because all people over sixty-five are included in Medicare’s gigantic pool, and risks are spread over more than 40 million seniors, Medicare is able to insure lots of very old and very sick people at reasonable costs. Private insurers cannot do that.
Trudy gets it exactly right. This is not a close question to anyone who understands the crucial social insurance nature of Medicare (and Social Security). The voucher proposals would unravel Medicare as the universal coverage/social insurance program we know, with insidious long-term results for tens of millions of Americans (as Brookings' Henry Aaron and others have pointed out in detail). My only quibble with Trudy's piece is that the blog posts from many of the progressives cited in Greg Marx's CJR piece yesterday, like Jonathan Chait's and the American Prospect pieces, were dead-on about the substance of the Medicare/social insurance issue and were not snarky. So Trudy engages in a bit of false equivalence there.
#1 Posted by Harris Meyer, CJR on Fri 6 Jan 2012 at 02:14 PM
Excellent piece. Thanks, as always, for your outstanding coverage of health care reform, and bringing us back to what was important about Politifact's latest misstep.
I do agree with Mr. Meyer that the great majority of the blog posts on the issues -- Politifact's dishonesty and the facts about the Medicare Program -- were anything but snarky on the liberal and mainstream side. In fact, most of them were if anything too earnest, but the ones I have read were fact-based and not snarky at all. So, unless you can point us to some number of snarky posts on the liberal side, I think you are guilty of false equivalence as well, Ms. Lieberman.
#2 Posted by James, CJR on Fri 6 Jan 2012 at 03:11 PM
Last year Politifact's "lie of the year" was Republican charges that Obamacare was a socialist government takeover of health care. Lieberman wants to have it both ways - slippery slope (which the Democrats used for this year's 'lie', and which the Republicans used last year) are OK if used by the left, not OK if used by the right. Just politics.
Last year the GOP protested the designation of their argument as a 'lie'. It still didn't rise to the level of a flat-out factual lie such as Pres. Obama's State of the Union charge that the 'Citizens United' ruling now permitted 'foreign entities' to 'bankroll' American elections, in my opinion, and of course the lamestream media concentrated on Justice Alito's 'no' response from the audience rather than calling out the President, whom even robo-leftists like Dahlia Lithwick knew to be wrong in the service of demagoguery. But never mind. Politifact is probably compensating this year - on exactly the same grounds. CJR had its chance to express skepticism about qualitative judgements being passed off as 'facts' last year - and, of course, chickened out rather than offend its co-religionsists in the urban bourgeoisie. No principle here, just whose ox is being gored.
#3 Posted by Mark Richard, CJR on Fri 6 Jan 2012 at 04:57 PM
Except that the fact that Obamacare is not "socialist government takeover of health care" is not even a debatable argument. Obamacare is based upon competitive health insurance programs in the private sector, so that refutes the false "socialist" right there. And Obamacare is not "government" takeover of health care -- health care is and will be by providers in the private sector, not government employees.
You might get away with calling Medicare a "socialist" type program and that would be a debatable point -- health care coverage is provided for every eligible person over 65 years of age regardless of ability to pay, and funded exclusively by taxes on working people. And you could probably say that the VA provides government-based health care -- a lot of the medical professionals in the VA system are government employees, providing health care in government-owned facilities, although many of the MDs are not government employees but contract with the VA to provide care. Most of those are private practitioners associated with teaching hospitals, which is one reason why the VA provides superb care -- superb government health care -- to our veterans.
Obamacare resembles neither of those systems. Your comparison just doesn't hold water. Not even close.
#4 Posted by James, CJR on Fri 6 Jan 2012 at 09:20 PM
What else should we expect from a lady who had made plain her belief that the best care for patients isn't best for the "system".
Anyone with such a leftist blind faith in the "system" isn't going to like Politifact's acknowledgement of Reality.
#5 Posted by padikiller, CJR on Sun 8 Jan 2012 at 02:29 PM
James, I happen to agree with you in the sense that government programs and management often have more to do with old-fashioned dirigisme of the Bourbon monarchist-model than with 'socialism'. People on both right and left make the mistake of thinking that any expansion of the state is 'leftist' and/or 'progressive', forgetting that Louis XIV was a 'big govenment' man, too.
That said, I think both charges were of the 'slippery slope' variety - characterizations of what the proponents really want, their long-term agendas, than of the actual text of what they say. There is no doubt that Obamacare has been hailed by the left as a step toward a more 'socialized' system. (The avowed socialist Sanders voted for it.) Beyond that, the current arguments by the Obama administration admit no restraints on the power of the federal government in economic matters under the commerce clause. (This should be neither a 'right' or 'left' matter, but has been mopst enthusiastically supported by the left.)
Most European socialists now have abandoned their faith in nationalized industries, once an article of socialist faith. Their preferred tools are now heavier taxes, heavier regulation, and mandates on individuals & business. So how exactly do American Democrats, most of them, differ in their policy aims from European Socialists? Obamacare has not directly nationalized medical care, but then the Republicans didn't vote to repeal Medicare, either.
The principal protester of the POLITIFACT 'lie' was Paul Krugman, who has not had the courage to apologize for another lie he peddled in the aftermath of the Giffords shooting a year ago, his suggestion that the psyhopath Lougher was motivated by Republican political rhetoric. The one year anniversary of the shooting would have been a good occasion for this person to have shown that kind of character - an admission of emotional excess. But Krugman, thin-skinned as liberal activists stereotypically are, can dish it out, but can't take it, and the mainstream media has long since gotten into the habit of consigning liberal excesses to the memory hole, while keeping conservative hysteria-mongering fresh in its collective mind. The double-standard would be a good source of investigation by CJR, if CJR ever worked up the nerve to challenge its mostly robo-left readers.
#6 Posted by Mark Richard, CJR on Mon 9 Jan 2012 at 12:45 PM
Yup, okay! A regulated market for private insurers to compete for customers represents exactly the kind of policies Louis XIV pursued. Or, more likely, someone is dressing up silly ideas in pretentious jargon.
#7 Posted by steveh46, CJR on Thu 12 Jan 2012 at 01:07 PM
The author correctly says that no one understands Medicare but then furthers the misunderstanding by falling into the typical private/public trap when comparing Original Medicare to Part D. Here's how it works:
-- The taxes taken out of our pay for 40 years goes to what is known as Medicare Part A, which is mostly for IN-PATIENT hospitalization and skilled nursing (it's "free" as long as you've worked enough "SS quarters," which almost everyone has).
-- Medicare Part B is mostly for doctors and OUT-PATIENT hospitalization (the distinction between IN-PATIENT and OUT-PATIENT is important); Part B costs beneficiaries $100 a month in 2012 (which is 25% of the cost; taxpayer money from general revenues cover the rest)
-- BUT, and here's the bad news, Parts A and B together (called Original Medicare) is lousy insurance with lifetime limits, $1150 dedutibles for each Part A hospital ADMISSION, 20% co-pays for every Part B incident (if you're not admitted but observed in a hospital for five days, that's OUT-PATIENT), no drug/vision/dental/annual-physical coverage, and no good outside the U.S. (not only no good in Windsor UK but no good in Windsor, ON)
-- So when we retire, we buy supplemental insurance (about half of us already retired can buy supplemental from our former employer but fewer and fewer employers offer it and it is getting more and more expensive) to make up for the gaps in A and B and we also add what is known as Part D for drug coverage. Depending on where you live, the combination of supplemental and drug coverage can add another $150-$300 a month to the $100 a month you pay for Part B
-- Depending on where you live, Medicare also offers what it calls Part C. It is almost always less expensive than the $350-$400 a month for supplemental/B but it is usually an HMO and you have to live with the doctor network
-- Recipients below the poverty level pay nothing; recipients below 150% of the poverty level are highly subsidized (some states better than others); those making more than $85,000 pay more for B and D as described above and this pot will grow under PPACA
-- Parts A, B, C and D are both private and public; run by private insurers but paid for by the government using our tax dollars and/or our premium dollars
Oh, in general this is not family plan (but some employer retiree insurance is) so double these numbers for your spouse.
#8 Posted by dennis byron, CJR on Thu 19 Jan 2012 at 05:11 PM
About this:
"The drug law began to change that by introducing means testing, a concept more associated with welfare programs than social insurance. It called for wealthier seniors to pay higher premiums for their medical coverage beginning in 2007. The health reform law took means testing a few steps further, requiring those seniors to pay more for their drug benefit as well. The law also reduced the subsidy Medicare will provide wealthier people for their medicines and changed the rules for determining who is wealthy, so that more people will pay the higher premiums."
It seems that "health reform" has actually been in the works for many years even though most would identify 2009-2010 as the official game with time on the clock and players on the field. But if including the legislation that enabled consumer-driven health plans with health savings accounts that downgraded the quality of employer-based coverage for many workers, much more significant (radical?) reforms have been subtly introduced for a long time but without fanfare or Hitler protest signs. It's as if the American public has long been fed policy changes with little awareness despite its high impacts. So another need is for the public to have greater understanding of the game as its played in the off season. At least with pro sports there's a lot of coverage about the off-season game and it's expected to occur. But with healthcare, it's like an event that happens every 15 or 20 years and then wow what a surprise next time you have to interact with health care or health insurance.
Another thing about comprehending Medicare is that most Americans have no interaction with it until nearing retirement. So unless you're close to parents or grandparents and learn about the program though their experiences, an average young to mid-life American would have no reason to understand how Medicare works.
If health reform was a sport, would it be cricket? Would we understand it better if it was basketball?
#9 Posted by MB, CJR on Sat 28 Jan 2012 at 02:55 PM