Health Care Debate: Myths Vs. Facts

As the debate over how to change the nation's health care system heats up, activists from all sides of the issue are pushing messages intended to influence the national conversation. But amidst all the rhetoric, it can be hard to separate myth from fact. Host Michel Martin talks to a progressive Democratic blogger and a Republican lobbyist about the dueling messages of the health care debate.

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MICHEL MARTIN, Host:

I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, the Moms talk about a YouTube video that's gone viral and opened up some painful conversations about black parenting styles and ideas about hair. That conversation is a little later in the program.

But first, heat and light in the health care debate. Often when an issue heats up facts fly out of the window, so we decided to try to sort out some of the more sensational arguments being made about the health care overhaul moving through Congress to try get to some truth, if we can. We called two people with very different perspectives on the issue who've joined us before to analyze the politics of reform. Now let's see if they can help us pin down some of the facts. Vin Weber and David Dan.

Mr. Weber is a former Minnesota Republican Congressman turned Washington, D.C. lobbyist and public relations strategist. He's on the phone with us from Minnesota and Mr. Dan is a prominent liberal blogger. He's in our studio at NPR West in Culver City. Welcome to you both. Welcome back, I should say.

VIN WEBER: Good morning. Good to be with you.

DAVID DAN: Thanks for having me.

MARTIN: Let's pick up where we left off with Congressman Lloyd Doggett. He says that the people who are showing up at these town hall meetings - this not grassroots. This is not a grassroots movement. This is kind of an organized, partisan attack on Democrats. Vin Weber, true or not true?

WEBER: Well, I listened to that. I thought it was very interesting. It's the first - as somebody who has run for office a few times, I don't very often take solace in the fact that the opposition is well organized. That's usually a bad sign. Of course, there's organized opposition and the Democrats and liberals are going to have organized support throughout the August recess as well. But the polling shows that there has very clearly also been a broad shift in public attitudes towards health care. There's just no question about that.

The notion of comprehensive health care reform earlier in this year drew 60 to 65 percent support consistently in the polls. And now that has fallen off to no better than about a 50-50 ratio depending on how you ask the question. So there is genuine grassroots opposition rising to the Obama style of health care reform, but of course what can happen in Congressman Doggett's district was indeed well organized.

MARTIN: David?

DAN: Well there is grassroots organization and there's what's called Astroturf organization and that is when corporate interests direct and, in many cases, fund, in the case of Mr. Doggett, what he said is bus in a group of people to make it look like that there is grassroots organization. It's what we saw down in Florida during the Brooks Brothers riot when you had people dressed up as local interests who came down to Florida. They were actually a lot of staffers, congressional staffers, Republicans, to disrupt the counting in 2000 of the Miami-Dade County Board of Elections, so, you know...

MARTIN: How do you dress up as a local interest?

(SOUNDBITE OF LAUGHTER)

MARTIN: Short khakis versus long khakis?

DAN: Yeah I guess it was Bermuda shorts in the case of Florida.

MARTIN: Okay, so David this - in your view this is interest group led and Vin Weber, you're saying whether it is or isn't, it reflects a point of view.

DAN: I don't think it's my view. We have documentation. There are actual, you know, five-page letters from people who work for places like Freedom Marts which are, you know, corporate-funded lobbyist organizations. They in fact bought Empower America, which Mr. Weber founded. You know...

MARTIN: Okay let's move on, let's move on to another issue that I think a lot of people have heard...

WEBER: (unintelligible)

MARTIN: Okay. Let's move on to another issue that I think a lot of people will have heard about, this question of whether health care reform will lead to euthanasia and end of life rationing and some people calling it the kill-granny campaign. Here's pro-life activist Randall Terry on his radio program.

RANDALL TERRY: About half of all of our medical expenditures are spent in the last six months or year of someone's life. In other words, when you're trying to keep Dad or Mom alive, Grandma or Grandpa alive, you're spending a ton of money and they often just end up dead anyway. And so I'm starting to get it. Now in case you didn't know, if your Mom, your Dad, your Grandma, your Grandpa gets sick and they've got a little bit of equity in their home, a little bit of money stashed away, the government is going to come for that money to offset some of the Medicare costs. So that money, rather than going to you as your inheritance, gets poured down a government rat hole.

MARTIN: David Dan, truth or false?

DAN: I don't really know what to make of that. You know, this particular talking point seems to have come up from the ether. There's a lady named Betsy McKay who used to be the lieutenant governor of New York, who in '94 wrote an article called "No Exit" which kind of set conventional wisdom. And her job basically is to misread Congressional bills and she has misread this bill to say that, you know, every five years, government agents are gonna come to your house and try to figure out whether or not, you know, try to tell you how to die and push you in the direction of euthanasia. That's not what the bill says whatsoever.

MARTIN: What does the bill say?

DAN: The bill says that Medicare will pay for you if you choose, completely voluntary, to have a conversation about how you want things - if you slip into a coma, if you need life-sustaining support and Medicare will pay for that consultation. It's a benefit that has been put into the bill. It was actually written initially by Susan Collins, who is a Republican.

MARTIN: Vin Weber, what do you say?

WEBER: Yeah that's pretty much right. Look, this is a scary topic because everybody at some point faces it. Someone at some point makes a decision about end-of-life options. In the past, it was always families themselves that made it. Insurance companies get involved, they have to influence those decision and now if we're gonna have a big expansion of the government's role in health care, government will be more involved. But it's - it's not a nefarious plot to euthanize people or anything like that. It simply is dealing with the reality which is that we spend most of our health care dollars in the last months of life and increasingly it's gonna be hard to make those kinds of decisions.

But it is accurate to say that this bill would have an increased role for government in counseling those people. A lot of physicians have expressed concern about government getting too involved where they already think insurance companies and others are too involved in that decision and it should be a patient-doctor decision. But I don't think that there's any way of avoiding having some kind of controversy surrounding these kinds of decisions going forward because the decisions are only gonna get more difficult.

MARTIN: Let's talk about how the plan is paid for. Karl Rove, the former Deputy Chief of Staff in the Bush White House, argued in an opinion piece in The Wall Street Journal that most - that small business would suffer the most from any health care reform in the form of higher taxes. He said the surcharge, for example, on incomes over a million dollars, he said, would primarily hit small business owners. Vin Weber, true or not true?

WEBER: Yes. It depends on how you define small business. I mean, they've changed it somewhat in the House so that it would affect larger small businesses, but a million-dollar business is still very much a small business compared...

MARTIN: Well, a lot of liberal bloggers are saying and analysts are saying that this is just a made up number - that just is not possible. There is no percentage higher than 3 percent of the incomes in any given state that would be attached by this. That's on the outside. What do you say to that?

WEBER: No, I don't think that - first of all, we don't know for sure because we don't have a bill. We've got a number of bills that are working their way through the House. The president hasn't put a specific proposal for we already got a number of bills that are working their way through the Senate. An employer tax is one option that's been proposed to pay for it. The overriding reality is, as Congressional Budget Office has pointed out, we need to come up with hundreds of billions of dollars if we're going to do this and someone is going to pay for it. A small business tax is one option. Maybe that's not the way we'll go, but if we don't do it that way we'll pay for it some other way. This is not a free choice.

MARTIN: David, your take?

DAN: Yeah, well, I mean we heard this a lot during the campaign about how small businesses were going to be inordinately affected by any kind of tax raise on income which, you know, isn't entirely accurate. I mean, there are very few small businesses that have the kind of payroll and the kind of income that would come in that would actually be hit by this. I think three percent is what you said. I think it's more like 1.2 percent.

You know, the Congressman's right that we're going to have to pay for this in some way. I think there are some areas of common ground. I think the most common one where liberals and conservatives have talked about this being a good idea is to remove or at least limit or cap the employer deduction that is given to every business that provides health care for their workers.

MARTIN: Well, overall, for the gentlemen - we only have literally a minute left for each of you, and just at the end of the day, do you feel that this debate is proceeding along fair terms? Do you feel at the end of the day that the voters are getting at least a reasonably accurate picture of what the debate is all about or not? David, I'll give you the first one on this.

DAN: Well, I mean I think there's a lot of, you know, wheat and chaff to separate between when you're talking about a big issue like this where certain interests want to confuse and, you know, turn the debate a certain way and direct it in a certain way. That's always going to be difficult for the side that wants reform, because it sort of suits the status quo to have a situation where there's a confusing amount of information out there, and it's just hard to play whack-a-mole and tamp everything down.

MARTIN: Okay, Vin Weber, final thought from you?

WEBER: Well, there is certainly a lot of misinformation out there on both sides of the argument, but I think that from my perspective, the American people are getting the big picture, which is this is a substantial expansion of the size, scope and cost of government, and it will result in a substantial change in the way health care is delivered in this country, and people just have to decide if they want that or not, and I think they're increasingly deciding they don't.

MARTIN: All right. Vin Weber is a former congressman - a former Republican congressman. He's also a lobbyist and public relations strategist here in Washington, D.C., but he was kind enough to join us on the phone from Minnesota; and progressive blogger David DAN was in our studio at NPR West in Culver City, California.

Needless to say, we'll have links to both of these gentlemen's work and any op-eds that they have written. Thank you both so much for joining us.

DAN: Thank you.

WEBER: Thank you.

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