This week, readers sent us comments on illegal immigrants and health insurance, medical bankruptcies, and terminology in the abortion debate.
In the FactCheck Mailbag we feature some of the e-mail we receive. Readers can send comments to firstname.lastname@example.org. Letters may be edited for length.
Opting Out of Insurance
I would like to challenge one assertion you make in your fact check of Obama’s health care speech. ["Obama’s Health Care Speech," Sept. 10.]
Obama states that 30 million American citizens "cannot get coverage." Your response asserts that the number should be higher, in the range of 45 million, representing the total number of uninsured American citizens.
I noticed that Obama’s number differed from the numbers typically quoted for the number of uninsured in the U.S., but I assumed that his number took into account that some uninsured citizens are not uninsured because they "cannot" afford coverage, but rather because they "choose not" to afford coverage.
I think the distinction here is actually quite critical because the proposed plan would require that all citizens purchase coverage, including many citizens who currently have "voted with their wallet" that the insurance options currently available to them are not high value options – or at least are of less value than consumption in some other facet of their lives.
One impact of the proposed plan will be a restriction on the freedom for some citizens to opt out of a system that fails to offer them an acceptable value proposition. From a policy perspective, is that a reasonable trade-off in return for ensuring that all Americans have access to medical care? Perhaps, but I sure wish the issue of "value in health care" would occasionally take a little attention away from fictitious "death panels" and demonized industry profits. For now though, I’ll settle for an acknowledgement of the distinction between those who "cannot get coverage" and those who "do not get coverage."
Many thanks for all of your analysis which is almost unerringly accurate and refreshingly unbiased.
San Francisco, Calif.
FactCheck.org responds: Our article stated that the number of U.S. citizens without health insurance would be about 35.7 million, not 45 million. Certainly there are some in that number that choose not to get coverage, as our reader says. It’s unclear what that number may be. For more on the uninsured, see our June 24 article "The Real Uninsured."
Health Care for Illegal Immigrants
The law requires emergency rooms to provide medical care to everyone, regardless of ability to pay or citizenship. We all pay higher premiums to subsidize this reality, so for the president to say his health care plan will not cover illegal aliens is what I would call a high level obfuscation.
I’m pretty tired of all the lies and obfuscations presented by our elected officials. I, for one, don’t slight the congressman for being unable to stomach any more of it either.
In this discussion it is stated that: “The CRS report states, as we have reported, that section ‘246 would bar unauthorized aliens from receiving any premium or cost-sharing credit.’ " ["Immigrants and Insurance," Sept. 11.] Elsewhere the article implies that undocumented (unauthorized) aliens would cost the taxpayers nothing.
It is a fact that currently people who have no health insurance (both US citizens and unauthorized aliens) cost the taxpayers millions of dollars annually because they seek medical care at emergency rooms. ERs and hospitals currently are prohibited from turning anyone away who seeks medical help. When they can’t pay for those medical services the cost falls back on the hospital and the taxpayer and raises the overall cost of health care. This is just one of several issues that needs to be addressed, but doesn’t appear to be in present congressional or presidential proposals.
Lake Almanor, Calif.
Looks like Joe Wilson was more right than you give him credit for. Your page here is not up to date or accurate
The Senate yesterday closed the loopholes that could (would) have allowed illegal aliens to receive healthcare.
If Wilson was wrong, why did the Senate committee bother to close this loophole? Because he was right. Though the language in section 146 is accurate as you portray it, there were still several loopholes in H.R. 3200 that could (would) have allowed illegal aliens to get health care. Wilson knew this. He shouldn’t have stated President Obama lied in a joint chamber session, but he absolutely was dead on right that the bill as it is currently structured did not prevent illegal aliens from getting health care.
I hope you will do the right thing and show how these loopholes had to be closed. Will you do the right thing?
Los Angeles, Calif.
FactCheck.org responds: It’s true that illegal immigrants, and anyone else without health insurance, can get emergency care in emergency rooms in the United States. Medicaid pays for emergency care for noncitizens and has for a long time, but it doesn’t cover routine care. We know of no proposal in Congress to mandate that hospitals deny emergency care until a patient can prove citizenship. As for the "loopholes," our reader refers to the fact that there is no restriction in the House bill on illegal immigrants buying coverage on their own through the health insurance exchange. As we noted in a Wire post, there is no current restriction on the ability of illegal immigrants to buy their own health coverage, either. Late last week, however, the White House told reporters that the president does favor requiring anyone buying insurance through the exchange to prove U.S. citizenship.
Something I just saw circulated and I was wondering if it was true. I’m not sure of a source, other than someone posting it on a Facebook site.
Here is what was posted: "In fact only about 18% of US personal bankruptcies are due to medical debts, about the same percentage as in Canada, home of everyone’s ideal medical insurance system. It’s time for reform, but what the Democrats are proposing isn’t the solution."
But another site says this: "With the recent debate on health care reform causing uprisings at many town hall meetings held by congressmen in their home districts, it strikes me as funny that medical bills are involved in 60 percent of personal bankruptcy cases in 2007." Source: http://www.higginsandassociates.com/bankruptcy-articles/statistics-show-many-bankruptcies-linked-to-medical-bills/
We’ve all heard that the number one reason for bankruptcy in America is due to health care. Can FactCheck.org shed some light on this? I expect it to be the next spin.
FactCheck.org responds: We wrote about claims that "about half" of personal bankruptcies were due to medical bills in December 2008. Actually, the statistic comes from a 2005 Harvard study that found about half of bankruptcy filers said that medical expenses, illness or a health-care-related loss of jobs caused them to do so. As we noted, a lesser number, 27 percent, said medical bills were the specific cause of their filing. The authors of the study released updated numbers this year, saying that "[o]ver 60% of all bankruptcies in the United States in 2007 were driven by medical incidents." The methodology of the reports has been challenged. Northwestern University researchers wrote of the 2005 numbers in the journal Health Affairs: "Our analysis of their data finds a causal link in only 17 percent of personal bankruptcies."
On Truth and Political Discourse
FactCheck Mailbag comment, week of Sept. 1 – Sept. 8: "If there is one thing the health care reform debate has shed light on, it is that the American public is starving for the truth. "
In my opinion, the "one thing" would be (far more credibly) that the American people generally are so unsophisticated as to think that there is one "truth," or a finite set of "truths," about any complex legislation. No social legislation like health care can address every conceivable event. Politicians make hay with opposition to any legislation by nibbling at the edges. I wish that news organizations would deal with both the accuracy of factual criticisms and the position of the criticism on the scale of its significance to the passage or impact of the legislation. Factual "truth" in legislation is a slippery and ephemeral thing. FactCheck should start to explore the ramifications of factual distortions, not just the distortions themselves. This can certainly be done in an objective, nonpartisan manner.
For example, the reprehensible behavior of the Representative of South Carolina’s District 2 (shouting "You lie!") turns him into a hero in the estimation of people, many sadly from the shouter’s and my home state, who lack the curiosity or sophistication (or perhaps integrity) to dig a bit deeper to discover whether those few illegals who may receive health care under Obama’s plan actually matter a hill of beans in the context of the overall legislation as proposed. The important issue was not whether illegals might obtain care under the plan, but whether illegals would be explicitly excluded from coverage under the plan. In fact, of course, there is no plan under serious consideration that would "cover" illegals in the sense of failing to declare that they will be excluded from the provisions of the legislation. Sic transit rational political discourse!