• Government encouraged euthanasia. The essence of this fable is that somehow healthcare reform is going to ration medicine so much that the government is going to decide who should die. The US House Republican Leadership encouraged this piece of folklore . Some Republicans are restating the myth on the floor of Congress. Typical of politicians, they take a small kernel of truth and create a story surrounding it–Jenny McCarthy would be proud. The facts are these: the healthcare plan will allow Medicare to pay for counseling between physicians and patients for end-of-life decisions. This is a very important issue in healthcare, because of the physical pain, emotional loneliness, and economic expense to the patient and their family. This is not just an issue for seniors, but for anyone with a terminal disease or for anyone caring for someone with a terminal disease. The counseling isn’t mandatory, but now Medicare will pay for it. They will help a family and the patient understand the decisions in front of them. They can help them set up hospice care, a dignified way to treat patients with end-stage disease. They can counsel them on the costs and treatments. And they can assist individuals with their end-of-life advanced directives, which are always specified by the patients themselves, their guardians, or their families. It’s never a government decision, and if I thought that the healthcare plan insisted that the government set the directives, then I’d be opposed too. The proposed plan is just paying for counseling. That’s a wonderful idea, just when patients and families are undergoing incredible emotional stresses. This myth is simply a scare tactic, and it has no logic.
• The government can’t run the healthcare system. One of the more amusing arguments I’ve heard is that if they can’t run the Department of Motor Vehicles or the US Post Office, how can they run health care. First of all, the US government doesn’t run the DMV, and here in California, I can do almost anything online. And the US Post Office technically isn’t government run, and once again, it’s pretty efficient in delivering a few billion pieces of mail. Of course, the government successfully manages two critical healthcare plans, Medicaid and Medicare, and two healthcare systems, the Veteran’s Administration and US Military system. Are they perfect? No, but they work, and work well. Consider this point: no one, Republican or Democrat, would ever suggest eliminating Medicaid or Medicare, because they would be thrown out of office at the next election.
• The government is going to make your healthcare decisions. This nice piece of mythology is one of the most irrational (amongst a long list of irrational myths that I’ve heard), because private healthcare insurance does it all the time. Unless you are incredibly wealthy or have a generous healthcare plan, your medical choices are made by a faceless bureaucrat at an insurance company. A related comment is that you will lack choices in your medical care. I hate to be the one to break the news to you, but your choices are limited, arbitrarily at times, by those insurance companies. Do you think you’ll will get to be included in a new therapy at the Mayo Clinic? No, you’re not. Will the government make you choose a different doctor? Most HMO’s do that already. The fact is Obama’s healthcare reform proposal is all about paying, not about actually controlling.
• The American Public doesn’t want to give up their private insurance plan. Sorry, but no. According to a recent CBS/New York Times poll, 66% of Americans want a government funded choice.
• Obama wants a Canadian-style healthcare system. This is a strawman argument on two different levels. First, Obama does not want a single payer system and has excluded those from his own party who are pushing for it. Secondly, the Canadian healthcare system is very effective, by some indicators more effective than the current US system. For example, healthcare costs are far lower in Canada, who spends about 10.1% of their GDP on healthcare while the US spends 16.0%. Yet, life expectancy in Canada is 80.1 years, while the US is 78.1. And infant mortality, a key measure of the quality of healthcare, is substantially lower in Canada, 5.0 per 1000 live births vs. the US 6.7. Maybe we should be trumpeting the effectiveness of the Canadian healthcare system.
• The US has the best health care system in the world. It is the most expensive, as I’ve discussed previously, and which is reviewed in a recent article about the US healthcare system. But is it the best? That same article states that 42.6 million Americans lack health insurance. The only other developed country that does not provide healthcare for all of its citizens is South Africa. Some will state that we provide free health care through emergency departments and other facilities. The problem is that ER’s aren’t staffed to manage individual’s healthcare effectively. Moreover, by using the ER as a clinic, it reduces its ability to focus on its primary goal, to treat emergencies and traumas. Furthermore, the defining characteristic of a quality healthcare system is to improve the health of its citizens. Yet, the US ranks near the bottom of developed countries. And if you examine the racial and economic groups, the disparity in healthcare outcomes is large. For example, the infant mortality rate for white children is 6.0 deaths per 1000 live births, which still ranks near the bottom, while the rate for black children is 14.3. That is not a sign of a civilized healthcare system, it indicates that there are weaknesses in our system

Tags: Healthcare policy, Healthcare reform, Obama, Health insurance, Managed care