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You have to be taught to hate...

The views expressed on Progress Notes are those of our dedicated bloggers, and are not necessarily the position of Doctors for America


That, of course, is a memorable line from South Pacific, decrying racism and prejudice. I bring it up here because of the over-the-top rhetoric I hear from people who "hate Obamacare." It turns out, they have reason to hate it. The reasons are factually incorrect, but, hey, that has sustained racism from time immemorial, so why not the Affordable Care Act?


Several interesting developments have occurred that have led to this post. One, influential Congressional leaders are beginning to realize, as we already knew, that when people learn what is actually in the ACA, they like it. Two, the bad things that they really hate, are either not really there, or are some hysterical fantasy projections of the more extreme members of the conservative fringe. Three, some of the bad things that they don't like that are in there, like spreading the tax burden more fairly, are considered features, not bugs, to most of the population.


In recent days, House Congressional leadership have begun signaling that this whole "Repeal and Replace" thingmay not be as popular as they once thought.


If the Supreme Court overturns part or all of President Obama’s health care law, House Republicans will find themselves on the horns of a dilemma. They will be implicitly responsible not just for the demise of the individual insurance mandate and other unpopular parts of the Affordable Care Act, but also its popular provisions and the return of some of the insurance industry’s harshest practices, like discriminating against people with pre-existing medical conditions.


As one strategist put it, “I do think some Republicans are finally starting to realize they could be the dog that caught the car.” This includes two physician members of Congress, Tom Price and Phil Roe, leaders in health policy in the Republican Caucus:


In a shift unimaginable just a few weeks ago, some Republicans are publicly expressing support for the law’s ban on insurers turning away sick patients, for permitting young adults to remain on a parent’s policy until 26 and for closing the Medicare “doughnut hole.”


Regarding the things conservatives really hate about the ACA, PolitiFact Ohio is warning about the upcoming onslaught of negative, and false, advertising that will be coming our way this summer and fall. They have an excellent, brief rebuttal to the most pernicious at the link above, but here is their summary:


An independent payment advisory board created by the health care reform law "can ration care and deny certain Medicare treatments." Pat Boone makes this claim as the front man for an ad from the 60 Plus Association that aired this spring and targets five Democratic senators, including Ohio's Sherrod Brown. The law creates a 15-member Independent Payment Advisory Board to suggest ways to limit Medicare's spending growth, but the board may be overruled by Congress, and it makes no decisions about individual care. It is specifically forbidden from making any recommendations that would ration care, reduce benefits, raise premiums or cost-sharing or alter eligibility for Medicare. The 60 Plus Association was spending $720,000 on a campaign in Ohio aimed at Brown when PolitiFact Ohio ran the claim through the Truth-O-Meter and called it Pants On Fire

The national health care reform is "a government takeover of health care." We've heard it before -- so often that PolitiFact national named it the 2010 Lie of the Year -- and we'll surely hear it again. It has come recently from third-party advocacy ads. While the law gives the federal government a larger role in the health insurance industry, it relies overwhelmingly on the private market. In fact, the reform is projected to increase the number of citizens with private health insurance. PolitiFact has noted that the claim has been proven wrong over and over again. The rating: Pants On Fire. 

The Affordable Care Act contains "a series of slush funds, set up to stay on the books automatically, with little or no oversight." So said House Speaker John Boehner in a news release and video, and again during debate on college student loan rates. PolitiFact Ohio found that the health care bill provides several pools of money that the secretary of health and human services can disburse for purposes designated by the legislation. But slush funds? Merriam-Webster defines a "slush fund" as "an unregulated fund often used for illicit purposes." The money in question is designated for programs specifically defined by the law. Congress also has the power to oversee the bill's implementation. The rating: Pants On Fire

The health care law "slapped Ohio small businesses with a $500 billion tax increase." This statement came from the National Republican Senatorial Committee. PolitiFact Ohio found that the $500 billion figure was a fair number for total revenue raised nationally by the 2010 health care law, as estimated by the Congressional Budget Office at the time of the December 2009 vote on it. But the number for just taxes is lower, probably between $400 billion and $465 billion. The rest was for various other fees and revenue enhancements, and for all new revenue nationwide -- not just for the share to be paid in taxes by small businesses in Ohio. To pick a national number and apply it to one segment of one state is not accurate, simply ridiculous and gets a rating of Pants on Fire. 

"Preventive care . . . saves money for families, for businesses, for government, for everybody." Ad claims in support of the health care law have been exponentially fewer than attacks, but this sweeping claim came from President Obama. Is preventive care a good idea? It can often save lives and keep patients healthier, and certain preventive measures may save money as well. But the findings of the Congressional Budget Office and physicians who have studied the medical literature say otherwise, including a Feb. 14, 2008, article in the New England Journal of Medicine that noted that "the vast majority" of preventive health measures that were "reviewed in the health economics literature do not" save money. The rating: False[CMHMD: I am going to revisit this in a blog post, either here or on my own blog, very soon. I think it deserves more exposition than given here.]

"Obamacare . . . will kill jobs across America." The U.S. Chamber of Commerce made this claim in ads that targeted Brown and other Democrats, and "job-killing" is the standard epithet applied to the health care law by opponents. PolitiFact looked at the best projections available when the claim was raised, based on how the law is actually written, and found that they do not suggest that the law will "kill" jobs. PolitiFact also looked at evidence provided by the Chamber to support its claim, including a brief from the Heritage Foundation, a conservative think tank that has been critical of the law. When the authors were asked whether their brief supported the claim, they responded that "our paper does not provide evidence that the [health care law] would cause job loss." The rating: False

The health care law "will cut $500 billion from Medicare." This claim from candidates and advocacy groups has been examined numerous times by PolitiFact national, PolitiFact Ohio and other PolitiFact state operations. The important point there is that $500 billion is not taken out of the current Medicare budget and that nowhere in the bill are benefits eliminated. The $500 billion represents the projected saving by slowing the projected growth in Medicare spending over 10 years. Medicare spending will still increase. The rating: Mostly False.


I will add a couple more here, courtesy of the more extreme elements of the conservative coalition, that we have covered before. Your socks may be knocked off by the brazen lies and misinformation in a recent email/video going around. There are not massive premium increases on the way on Medicare nor a real estate sales tax due to the ACA. I also think the DirecTV ads are a nice counterpoint to the "slippery slope" arguments we hear about the individual mandate and broccoli. Maybe Congress will mandate that you reenact scenes from Platoon with Charlie Sheen!

The Obamacare opponents hate is not the one that we actually have. They need it to be awful, but it just isn't. You can find out all the good things it does with a quick perusal of our Progress Notes blog!                                       

So we have this thing called ObamaCare, which does infinitely more good to our system than its critics will acknowledge, and it does not do the harmful things that they imagine, and we will continue to have to fight for it. It is our duty as Medical Professionals. But you knew that already.

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