A Project of The Annenberg Public Policy Center

‘No Guarantee’ — With Plan, or Without


Conservatives for Patients’ Rights, whose ads we have faulted in the past, is airing a new spot that calls for dropping any federal insurance option from the health care overhaul bills.

"Despite what the president or Congress say," the narrator tells us, "their health care proposals do not guarantee you can keep your own doctor." And there’s no guarantee you won’t "wait longer for care," face "rationing," or "lose your insurance," either, she says.

Why not? Because "the president’s public option plan could lead to government-run health care," says the narrator. "Don’t be fooled." On screen we see the words "Public Option Health Plan" throughout the ad.

This isn’t the first time that CPR, a group headed by former Columbia/HCA head Rick Scott, has tried to tie health care overhaul efforts to "government-run health care." In an ad last spring, Scott said that a federal council to gather research on which treatments work best would be the "first step" toward government control of health care. We pointed out the problems with that leap of logic.

This time, CPR is saying that the federal health plan  – which is presented as an option for individuals and very small businesses (at first) in the pending bills – is the route by which government is going to take over the health system, and the trigger for the clearly undesirable dangers described in the ad.

The narrator is right about those hazards: There is "no guarantee" that they won’t happen. But what CPR doesn’t mention is that they could also happen – and in some cases are already occurring – under the current health care system.

Lose your own doctor? Many people experience that today, if their employer changes insurance plans, if they change jobs, or if they become uninsured for any reason. Wait longer for care? Given the shortage of family doctors, which is only expected to worsen, we can expect wait times to increase even if the system remains untouched. Pending overhaul legislation aims to ease that, in fact, by increasing certain payments to physicians and making other adjustments to encourage training of primary care physicians.

Rationing? That occurs on a regular basis today, whenever insurance companies or government programs like Medicare reject claims, or when the companies drop people who have become ill for not disclosing often minor and unrelated preexisting conditions. Under pending legislation, insurance companies would be unable to deny coverage to individuals because of preexisting conditions.

And when it comes to losing one’s insurance, that’s another everyday occurrence under today’s system, as millions of people who have lost their jobs in the recession have found. Under the pending proposals, individuals could lose their current insurance plans, though for different reasons; small businesses might decide to buy coverage through a newly created health insurance exchange, for instance, rather than stick with their current plans. The big difference? For the vast majority, if not all, people, "losing your insurance" would simply mean switching insurance plans – not losing coverage, as many do today.

As for whether "the president’s public option plan could lead to government-run health care," the operative word is "could," which makes it hard to disprove. The real question is, how likely is it? As we said before, Obama has not proposed a government-run system and, in fact, has rejected the idea. Some think it would come into being de facto, however, if vast numbers of people ditched the private system and opted for the public plan. But under the pending Senate bill and the House Energy and Commerce Committee bill, the plan’s cost structure wouldn’t be all that different from that of private insurance – so it would be unlikely to draw a huge number of takers. The original House bill had a provider payment formula that would make the plan cheaper for consumers. That type of plan could attract a lot of people – if eligibility was eventually expanded beyond individuals and employers with 20 or fewer workers, which is where the bill stops.