Lil White Lies: The Thief Shouting Robber

Eric Levine of the blog Content in Reality correctly analyzed the “professed bias” of Bryan White and Jeff Dyberg’s blog PolitiFact Bias with a story about two dogs he named Rex and Dex:

One could theoretically argue that one political party has made a disproportionately higher number of false claims than the other, and that this is subsequently reflected in the distribution of ratings on the PolitiFact site. However, there is no evidence offered by PolitiFact that this is their calculus in decision-making." Yet they don't look for evidence that their [PolitiFact Bias’] explanation is the better one. To show the fallacy in this kind of thinking, let me present an analogy: Let's say i have two dogs that roam free in my house all day, Rex and Dex. I come home one day to find my couch clawed to pieces. I cannot find evidence that Rex did it, so I assume Dex did it (even though I found no evidence specifically pointing to Dex). This is exactly the same fallacy they employ. They don't specifically have evidence of a Republican tendency towards falsehoods so they assume it must be a Politifact tendency towards liberal bias. Like I noted earlier, the article did not randomly chose articles.

So to extend Levine’s canine example of Rex and Dex, it can be applied likewise to the logic that Grading PolitiFact employs when poster Bryan White says that Pat Boone’s statement about Medicare “rationing care to pay for wasteful spending” cannot possibly be Pants on Fire false as determined by PolitiFact, but “somewhat accurate when considered objectively.”

Republican "Death Panel"

Let’s say one of my older kids brings home two dogs, one named Rex from Red’s Pets and one named Dex from Blue’s Pets. I find that both dogs have fleas, but Rex has fleas and a bit of mange. I can see they both have had the infestations for a while. I go visit Red’s Pets and before telling him the problems with Rex I admit I’ve been to Blue’s Pets. The owner of Red’s Pets (Red) proclaims,” you don’t want to buy a dog at Blue’s Pets, they all have fleas.”

In this statatement from Red, the implication is that his dogs don’t have them. Yet Rex is actually in worse shape than Dex. Yes, Blue’s pets have fleas, but is Red’s statement a credible one?

In this case, Pat Boone is the owner of Red’s Pets. ALL the dogs have fleas—and his dogs have not just fleas but mange, but he’s telling you only his competitors’ dogs have fleas as if his dogs didn't.

Taken in context, it’s clear Pat Boone was fear mongering seniors about their Medicare, and not only that, misleading them about the alternative (to both Medicare and "wasteful spending"), which was worse….much worse.

Grading PolitiFact author Bryan White’s problem is that he does not (or refuses to) recognize that rationing exists systemically for any scarce resource, and that America’s method of rationing healthcare is very poor given what we spend as a percentage of GDP. ACA is meant to ration….more rationally, but not in the context Pat Boone was conveying.

The healthcare market is NOT a free market. It is similar to a utility: the supply is severely constricted (as one of my economics professors told my class, the most powerful union in the world is the AMA) and everyone is compelled to use it, especially in an emergency. While American healthcare in general is rationed by employment and cost, Medicare is rationed by age and price (and employment through retirement benefits): Simply put, Medicare Part A is major medical, which pays 80%, and is “free” once one reaches the age of 65, Part B is for outpatient services, for which a monthly premium is required (now about $100 monthly). Medicare pays 80% over a deductible; which means, for most people, a “Medi-Gap” insurance policy must be purchased (or is provided as an employer benefit) to cover the other 20%.

The issue with Pat Boone’s stating that a board will ration care is not just the context in which it was used, but the “pot calling the kettle black” (the Thief shouting Robber) implications of it. Unfortunately, the IPAB  provides the Republicans an easy target at which it can shoot criticisms. The systemic rationing of healthcare is often also referred to as “covert” which makes it easy to pretend that it didn’t exist until a board of experts was created with ACA to recommend cost containment measures.

Recall what happened last year when Paul Ryan came up with a plan “to end Medicare as we know it” (PolitiFact’s 2011 Lie of the Year). It basically turned Medicare over to the insurance companies and gave people what amounted to insurance discount coupons (“premium support”). Systemically, there is no doubt that this would be a much more drastic rationing method (some estimate as many as 1 million additional people would be removed from the Medicare rolls, i.e., denied treatment), and obviously people caught on as complaints mounted, and Ryan quietly re-drew the plan to “include” Medicare as we have it today.

Ryan provided this choice (which will be phased out) in a new budget plan announced recently. It does make sense politically: if you’re going to ration Medicare and restrict growth using even more constrained per-capita cost caps (rationing) than the IPAB, put a fanciful, mischaracterizing name on it, like “Medicare reform to protect Medicare” and make a big deal about getting rid of the IPAB “death panel” and instead rely on covert, systemic rationing (ah, “plausible deniability” at its best!) . Because some people might believe that they’re getting more when they’re really getting less. In other words, you think the IPAB is going to deny you medical treatments—you wait until you get on RyanCare! Or, trust Red about Dex, until you take a good look at Rex.

The REAL covert death panels Republicans won't tell you about.

FactCheck.Org agreed with PolitiFact; in fact, the Boone ad is a repeat of similar ads from 2011, when FactCheck.Org reported on it.  PolitiFact Ohio reviewed this claim in 2011 as well, with the same Pants on Fire result.

But let’s back to the RyanCare reforms for covert rationing of Medicare in America (I’ve noted in brackets [ ] where the covert method of rationing is described):

Like last year’s Ryan/Wyden reform plan, beginning in 2023, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system [BIG RATIONING]. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or — unlike Ryan’s original budget — traditional fee-for-service Medicare. That annual government contribution will no longer be indexed to an arbitrary indicator of inflation plus 1 percent [rationing], but would increase with health care costs and rely on market competition [free market rationing] to control health care spending. Individuals who choose a plan that costs more than the benchmark would pay the difference [rationing], while those who enroll in a lower-cost plan would receive a rebate. Lower-income seniors would also be eligible for additional assistance.

Finally, the budget adopts President Obama’s a per capita cost cap of GDP growth plus 0.5 percent [BIG RATIONING ](while repealing the ACA’s Independent Payment Advisory Board), which would act as a “fallback to assure the federal government budgetary savings” and encourage providers to adopt greater efficiencies [rationing]. But since it’s unclear how this cap would be enforced [very covert rationing], it’s likely that the cap would limit the government contribution provided to beneficiaries [BIG RATIONING]. Since the proposed growth rate is much slower than the projected growth in health care costs, CBO estimates that new beneficiaries could pay up to $1,200 more by 2030 and more than $5,900 more by 2050. [i.e., price rationing]

As noted, there are several methods of rationing here at work: the Grading PolitiFact review already identified caps and spending ceilings, which the Ryan Plan is directly copying from Obamacare, as being rationing mechanisms. Grading PolitiFact makes it seem that this rationing is only part of Obama’s Medicare. The increased cost being passed to consumers is price rationing. Another one not mentioned is that the eligibility age will be raised to 67, which is another rationing control.

Here is how Senator Tom Coburn, one of the Republican Budget/Medicare plan sponsors, plays the same trick as Pat Boone and Bryan White by using the word ("actually") ration for Medicare, while describing actual covert rationing as allocation by “market forces":

“You can control health care one of two ways,” Coburn said. “You can allocate resources from a bureaucracy, from a government-related planned manner that saves money and actually rations care. Or you can say, even with its defects, market forces might allocate it better.”

It should also be noted is that if the cost caps are not exceeded, the IPAB does not need to make any “rationing” recommendations. Indeed, the CBO predicts this will be the case for a number of years. So perhaps this is much ado about nothing. And speaking of that, I predict that the majority-conservative SCOTUS will conveniently rule at the most politically advantageous time (maybe closer to the election than the reported date of around the end of June) that even with much precedent (after all, that’s never stopped them before, like in 2000) the mandatory insurance feature of Obamacare is unconstitutional, which will effectively gut it.

On top of all that, in lieu of using the Medicare “savings” for wasteful spending as Pat Boone proclaims, does Ryan’s budget plan use any savings from rationing Medicare to pay down our huge deficits—the implication? Nope…in fact, it makes it worse because the budget gives more tax cuts to corporations and the wealthy.

So, to sum up succinctly, here's Current TV host and former Michigan governor Jennifer Granholm:

So, here is your choice, America:

Guaranteed health care benefits for seniors, or tax cuts for the wealthy?

Food for poor children, or no taxes on offshore profits for multinational corporations?

Increases in defense spending, or 48 million Americans keeping health care?

As was so aptly stated in a comment at Talking Points Memo:

Then, if they can pull off privatization, they'll be able to deny emergency room care to seniors as well and save taxpayers a ton of money. Imagine the joy among conservatives when they can finally say to seniors: "We gave you a subsidy to buy insurance; it's not our fault you screwed it up. Go find a place to die."

In view of that, there’s one other point about conservatives dismissing how many more people who will die from not having access to healthcare because of free market rationing: Is that pro-life? While that’s another long post, it’s certainly food for thought.