Recently, Digby wrote a post about the pathological tendency of right-wing activists to insist that their rights are being trampled while they themselves push to shut down town hall meetings intended to inform the public about health care. Death threats, violence and other efforts to close down debate are coming from the same people who insist that a fascist tide sweeping America is strangling their right to air their views. About this phenomenon, Digby writes:
I know. This kind of full-on psychotic projection is disorienting and weird. I've never been very good a dealing with this particular wingnut tactic and I don't think anyone is.
That post got me to thinking more prosaically about the main right-wing talking points against health care reform. What is striking about those talking points is that every horror that the right-wing alleges is a feature of Obamacare is actually a mainstay of American health care as it currently stands. Below are five broad claims against Obamacare that fit this pattern.
1) Claim: that Obamacare will entail runaway costs, exploding our deficits. Reality: We currently spend far more than any other OECD country for health care relative to GDP. And every significant proposed cost-control initiative -- like a public option, or allowing the government to actually negotiate lower prices with the pharmaceutical industry -- is being attacked full-on by opponents of reform. There is simply no serious debate about whether our insanely convoluted, privately-based insurance system is far more expensive than any comprehensive single-payer system would be.
2) Claim: Obamacare represents a frontal attack on Americans' freedom, including their freedom to choose the health care that is best for them. Reality: The current market for health insurance in the United States is, for most Americans under the age of 65, a state-by-state market. And, far from being characterized by competition and choice, most states' health insurance markets are highly concentrated, with near-monopolies in numerous states. A public option would, in fact, clearly give many Americans more choice and more freedom than they have now, because Americans' fear of losing health insurance constrains their job mobility.
3) Claim: Obamacare will mean runaway bureaucracy. Reality: Private insurers are far more bureaucratic and far less efficient than is Medicare, whose overhead costs are a fraction of the private insurers. Why? Because private insurers incur massive expense trying to figure out whom to insure and to whom they should deny coverage. Universal systems, like Medicare, don't have this problem. Some defenders of the status quo insist that private insurers incur high bureaucratic costs because they are trying to prevent fraud. But this is bogus. Fraud is a concern for Medicare and Medicaid as much as it is private insurers. Just ask Rick Scott. He's a ringleader of the anti-reform movement. He's also the founder of Columbia/HCA, a health care company that had to pay $1.7 billion in fines to the federal government, the largest medical fraud case in U.S. history.
4) Claim: Obamacare means rationing of health care. Reality: let's leave aside, for the moment, the hysterical claims being made about socialism trampling on our rights to get the care we want. The fact is that we now have rationing of health care. Every time an insurance company denies a claim, it's rationing health care. And denials of claims, as sentient American knows, are endemic in our system, as is the related practice of rescission, whereby insurance companies try to strip policy-holders of their coverage once the policy-holder becomes sick and actually needs coverage.
5) Claim: Obamacare will set up death panels that will play God and decide who gets to live and who is condemned to die. This meme has become a staple of anti-reform propaganda and Sarah Palin weighed in this weekend to say that her son Trig might have been doomed to death by one such panel. Reality: We already have bureaucrats determining who gets to live and who gets to die -- insurance companies do this everyday. Chris Hayes, writing in the Nation, tells one such story:
I am 36 years old and have Blue Shield HMO health insurance coverage through my employer. In January 2009, I was diagnosed with metastatic (stage 4) breast cancer.... My doctors prescribed a medication that targets and removes the cancer throughout the body like a "smart bomb"; however Blue Shield of California denied coverage of my doctors' recommended treatment. Blue Shield also denied a radiation procedure that would target and remove the two lesions in my brain. In both cases, Blue Shield denied the original requests and subsequent appeals I filed on the grounds that the treatments are not a medical necessity. I have learned that insurance companies will use "medical necessity" as an excuse to not cover treatment when it appears that the patient is "too sick" (read: not worth it).
There are, of course, many, many stories just like this one.
In sum, everything the anti-reformers hate about Obamacare is a feature of the current health care system in America, a textbook case of projection.
Jonathan Weiler's second book, Authoritarianism and Polarization in Contemporary American Politics, co-authored with Marc Hetherington, is due out from Cambridge University Press in August 2009. He blogs daily about sports and politics at www.jonathanweiler.com