Fact or Fiction? The Truth About Four Health Care Fears

Dr. Timothy Johnson attacks the top 4 fears about health care reform.

August 13, 2009, 7:05 AM

Aug. 13, 2009— -- The scrabble over health care reform reached a new level of volume and vitriol as crowds confronted members of Congress at town hall meetings across the country. As the health care debate rages, so too does speculation about what proposed legislation will mean for Americans' health care choices.

Among the most hotly discussed issues have been charges that the proposed legislation would create so-called "death panels" to ration care for the old and infirm; that it would use taxpayer dollars to fund abortions; that its passage would mark the end of Medicare; and that it would open the door to socialized medicine.

But how accurate are the assumptions? The White House says some are completely false. It has set up a website it says is designed to separate fact from fiction when it comes to the potential changes in the country's health care system. Still, those on both sides of the political spectrum continue to trade blows over the perceived language of the bill.

To help clear up the confusion, ABC News Chief Medical Editor Dr. Timothy Johnson talked to Chris Cuomo on today's Good Morning America about four of the most commonly expressed worries over the proposed health care legislation now being mulled by Congress.

Verdict: Fiction

One of the most controversial claims in the health care debate is that the health care reform bill would provide for "death panels" to decide whether sick seniors and children with birth defects should receive medical care.

But Johnson said there is no evidence of any such provision in the text of the health care bill. The most likely explanation, he said, is that the rumors of such a provision spring from a misinterpretation of a proposal to offer Medicare patients an optional service known as "advanced care planning consultation."

Such a service would help patients and their families discuss the potentially uncomfortable subject of end-of-life care with their doctors. But it would not represent a "death panel."

"This provision makes clear this is entirely voluntary for patients; it is not mandatory," Johnson said. "Most surveys show seniors want this desperately from their doctors, and only very few get it... I think when seniors find out what this is really about, they'll welcome it."

Fact or Fiction: Will Tax Dollars Pay for Abortions?

Verdict: Unclear

Another controversial issue – that of abortion – is also getting attention in the health care reform debate. Many opponents of the proposed health care legislation say that the plan as it is written could end up subsidizing some abortions.

Johnson said that unlike some of the other assertions about the bill, the possibility that this could come to pass is still not clear.

"None of [the bills] say abortions should or could be paid for with tax dollars; in fact, an amendment on one prohibits that," he said. "However, if you look at the language, it gets complicated. It's not crystal clear whether or not that could happen with a so-called 'public option,' and even with private plans that might be subsidized by government, maybe abortion would be allowed."

Still, Johnson said, the specific prohibition of tax money funding abortions raised in the amendment to the House bill may indeed preclude such a situation.

The current debate is not the first to swirl around the possibility of publicly funded abortions. In 1976, Congress passed what has become known as the Hyde amendment, a response to the 1973 Roe v. Wade decision that prohibited the funding of abortions through Medicaid. But whether this same stipulation would apply to other government health care programs remains unclear.

Fact or Fiction: Will Health Care Reform Eliminate Medicare?

Verdict: Fiction

The idea that the proposed health care legislation would eliminate Medicare – a government program that currently provides health care for 44.8 million older Americans – has also taken center stage in recent weeks. But Johnson said that seniors need not worry about such a situation.

"What seniors are hearing that seems to worry them [is] that President Obama talks about reforming Medicare or getting rid of waste, and they are worried his waste might be their need," Johnson said.

Johnson said legislators must be careful to ensure that needed services are not affected. But choosing instead not to cut out the waste in Medicare could lead to the program running out of money in the future, a situation he said would be even worse for seniors.

"The trick will be to cut the waste without cutting needed services," he said.

Verdict: Fiction

Some also assert that the proposed health care legislation is a first step toward "socialized medicine." But Johnson said such claims are off-base.

"True socialized medicine means the government not only finances, but also owns and operates the hospitals; that is not going to happen in this country," Johnson said. "Almost all other industrialized countries have a combination of government regulation and private competition. And that's what the president is more or less advocating."

Johnson said such an approach would be analogous to what is currently seen in the airline industry. While the government heavily regulates the training of pilots and the inspection of planes, the actual business of providing air travel falls on the shoulders of private airline companies.