The Post below originally appeared on Healthinsurance.org (mm)
Wild rumors, such as the one claiming Obamacare premiums will start at $20,000 a year for a family of five, are much jucier than the truth.
About a week ago, Investor Daily’s website published a “Fact-Check” post that illustrates how misinformation spreads.
In the post, Jed Graham explains that when the IRS published a final rule about penalties under the Affordable Care Act (ACA), it included a few hypotheticals. For example, the IRS wrote, “The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000′ in 2016.”
The $20,000 figure was just an example, Graham explains. “The IRS always uses hypothetical numerical examples in its regulations to illustrate how the rules will work in practice and this was no different.”
Nevertheless, before long, the “conservative news site CNSNews.com began to blare out this shocking headline: ‘IRS: Cheapest Obama Care Plan Will Be $20,000 Per Family.’”
From there, “the ‘fact’ got picked up by countless media outlets and pundits” Graham reports, “most of them on the right,” including:
•Betsy McCaughey writing for the New York Post;
•On the left, even Naked Capitalism (a well-researched blog,) reported the news bulletin from CNSNews.com.
This is the problem: Once a faux-fact gets out there, even reporters who have no axe to grind continue to repeat it. If you see the number often enough, you assume it must be true.
How could a reporter tell that $20,000 wasn’t an IRS estimate?
It should have been clear that this was a hypothetical, Graham points out, if you just looked at other hypotheticals in the IRS ruling. “For example: ‘the annual national average bronze plan premium for a family of 4 (1 adult, 3 children) is $18,000.’
“Both examples can’t be true,” he observes, “unless an adult’s premium is $2,000 and a child’s is $5,333.”
But too many journalists and bloggers cut and paste numbers, without stopping to think: “Wait a minute – that can’t be right!”This is especially true if an outrageous number happens to support their suspicions about Obamacare.
Doing a quick Google search, I found at least one hundred media reports that cited this IRS hypothetical as an IRS fact, including:
Graham’s Correction Receives Little Attention
In his post, Graham acknowledged, “In this case, I’m guessing the truth won’t go viral.”
He was right. When I Googled his Investors.com story, I couldn’t find a single blog or newspaper that had picked it up. Good news just isn’t that sexy.
Still, you may be wondering: “How much will a family plan cost in 2016? ”
To read the rest of this post, please go to the original on Healthinsurance.org If you like, come back here to comment.
The truth is rarely interesting, and generally has no hook.
All of this aside, isn’t it a damned shame that $125 million in campaign bribes was able to keep single-payer off the table. Instead, thanks to the insurance and drug industries, we were given ObamaCare. A system that expands the for-profit insurance industry and will surely increase our country’s health costs by 20%. If the dems were smart they would repeal ObamaCare themselves and install Dennis Kucinich’s HR676. (Note that I said *IF* they were smart… they aren’t).
I spend 1/2 of my time explaining and the other 1/2 defending. Kind of disappointing when all they can do is throw wild accusations out there to sell news.
Have you read Time (mag) and their take on Medicare?
Chris, Run and Jack
Chris- Yes, lies excite passions.
The truth often requires thought.
Run– I’m assuming you mean the long piece by
Brill. It’s fine as far as it goes, but it just tells us that our health care system is “Money-Driven.”
This we know. “Consumers” (i.e. patients) have little power: drugmakers, hospitals, doctors can charge whatever they wish. If you’re sick (and 75% of our health care dollars are spent when you’re very ill), you have no leverage. You can’t say: “I’ll wait until prices come down.”
We’re the only developed country in the world that has turned healthcare into a for-profit enterprise, and too often, the profit motive gets in the way of doing what’s best for the patient.
I wrote about all of this in Money-Driven Medicine:
The Real Reason Health Care Costs So Much (2006)
Meanwhile, Brill focuses only on half of the story: Cost.
He doesn’t discuss Quality.
The problem in our system is not just the prices, but the fact that too many Americans are over-treated, and thus exposed to risk without benefit. In addition here are too many preventable errors which not only add to the costs (longer hospital stays, a second surgery) but main and kill patients.
If we focus on quality, costs will come down. Better care is less expensive.
I’m also disappointed that Brill doesn’t talk about reform.
He doesn’t seem aware of how the Affordable Care Act will be –and is–changing things.
For the past three years, the growth in health care spending has slowed dramatically–both Medicare spending and in the private sector–in part because hospitals realize that if they’re going to survive under reform (which will trim their revenues by 1% a year for 10 years) they’ll have to become more efficient.
Going forward, the Affordable Care Act will replace fee-for-service (which rewards providers for volume) with various forms of “accountable care” payment that reward providers for better care at a lower price (and penalize providers who don’t achieve these goals.)
As I keep saying this will take time. But we’re moving forward.
Jack– This post is not about single-payer.
Moreover, the notion that bribes killed single-payer is simply another example of misinformation that has gone viral. The majority of Americans don’t want single-payer and that is why neither President Obama nor the Democrats in Congress who want reform tried to push single-payer. No country in Western Europe uses single-payer– only Canada and the UK have single-payer, and their health care systems are not as good (measured by outcomes and patient satisfaction) as systems in Europe.
Under the ACA, most insureds will have an out of pocket limit in the $7500 range for a family. This will enable them (I dearly hope) to ignore a bill for $27,000 for outpatient ankle surgery or the like.
Under the ACA, I know of no provision that prevents hospitals from trying to abuse the uninsured. Nor do I know of any alternative to the crazy making but necessary hospital ploy of raising the charge master to ludicrous levels in order to squeeze an extra $1000 or so out of insurance companies.
The crazy fact is that most large insurers in the USA work rather hard at cost control.
But it does not benefit the many uninsured, obviously, and it does not always even benefit the customers of Aetna, Blue Cross, et al, because of actuarial death spirals.
The customers of Blue Cross in their tiniest pools are on average so sick that even cost control does not prevent stratospheric premiums.
The ACA doesn’t try to protect the uninsured from stratospheric hospital bills because
the goal of the ACA is to perusade everyone to join the pool, and become insured.
(In that way, we can all protect each other.)
The subsidies will make insurance affordable for low income and median-income people.
I’m a bit worried about people who earn just a little too much for a subsidy. (Say, a family of
four earnign $94,000). But when you get to that income level most people are working for a large employer who
will pay an average of 60% of their premium. So they already have a subsidy. If they are self-employed,
they can deduct premiums on their income tases–it’s a good deduction.
Moreover in the Exchanges where indviduals and small businesses will be buying insurance,
insurers will all have to offer very similar productws with essential benefits, free preventive care,
cap on deductible, cap on out of pocket spending,etc. etc.
As a result, about the only way in insurer can make is product more attractive than other companies offerings is
by competing on price. This is why insurance coverage should wind up being cheaper (and much better) than what
is available in the small group and individual markets today.
Bottom line: there should be no reason for someone Not to buy insurance. If they choose not to, and wind up
with a stratospheric hospital bill, I don’t think other taxpayers should bail them out . .
And if you look at what happened in Mass, it turns out that virtually everyone has signed up for insurance.
Ultimately, I think this is what will happen nationwide.