Conservative Health Care Response Ignores Facts

The reviews of President Obama's health care speech before a joint session of Congress have been fairly glowing. Most agree that the President made a strong case for health insurance reform and did a good job of explaining why the public option is important, even if he stopped short of refusing to sign a bill without it. Early opinion polls [1] even show that Americans who tuned in to listen were moved by the speech, and support for meaningful health insurance reform jumped.

One group that apparently didn't spend too much time listening to the speech was conservatives, as evidenced by Rep. Charles Boustany's (R-LA) official rebuttal to the President's speech. Now I can't say whether Boustany was otherwise engaged during the speech--perhaps yelling at the President or sending text messages--but from his speech it seems clear he wasn't paying very close attention.

Below is the transcript of his speech [2], which I have conveniently color coded to make it easier to read. You'll note that I have highlighted lies in orange, hypocrisy in green and bad ideas in blue.

Good evening. I’m Dr. Charles Boustany, and I’m proud to serve the people of Louisiana’s Seventh Congressional District. I’m also a heart surgeon with more than 20 years of experience, during which I saw first-hand the need for lowering health care costs.

Republicans are pleased that President Obama came to the Capitol tonight. We agree much needs to be done to lower the cost of health care for all Americans. On that goal, Republicans are ready – and we’ve been ready – to work with the President for common-sense reforms that our nation can afford^{1 [3]}.

Afford is an important word. Our country is facing many challenges. The cost of health care is rising. Federal spending is soaring. We’re piling huge debt on our children^{2 [4]}. And families and small businesses are struggling through a jobless recovery^{3 [5]}, with more than 2.4 million private-sector jobs lost since February.

It’s clear the American people want health care reform, but they want their elected leaders to get it right. Most Americans wanted to hear the President tell Speaker Pelosi, Majority Leader Reid and the rest of Congress that it’s time to start over on a common-sense, bipartisan plan focused on lowering the cost of health care while improving quality^{4 [6]}. That’s what I heard over the past several months in talking to thousands of my constituents.

Replacing your family’s current health care with government-run health care^{5 [7]} is not the answer. In fact, it’ll make health care much more expensive. That’s not just my personal diagnosis as a doctor or a Republican; it’s the conclusion of the nonpartisan Congressional Budget Office^{6 [8]} – the neutral scorekeeper that determines the cost of major bills.

I read the bill Democrats passed through committee in July. It creates 53 new government bureaucracies^{7 [9]}, adds hundreds of billions to our national debt^{8 [10]}, and raises taxes on job-creators by $600 billion^{9 [11]}. And, it cuts Medicare by $500 billion, while doing virtually nothing to make the program better for our seniors^{10 [12]}.

The President had a chance tonight to take government-run health care^{5 [7]} off the table. Unfortunately, he didn’t do it.

We can do better, with a targeted approach that tackles the biggest problems. Here are four important areas where we can agree, right now:

One, all individuals should have access to coverage, regardless of preexisting conditions^{11 [13]}.

Two, individuals, small businesses and other groups should be able to join together to get health insurance at lower prices, the same way large businesses and labor unions do^{12 [14]}.

Three, we can provide assistance to those who still cannot access a doctor^{13 [15]}.

And, four, insurers should be able to offer incentives for wellness care and prevention^{14 [16]} – something particularly important to me. I operated on too many people who could have avoided surgery if they’d simply made healthier choices earlier in life.

We do have ideas the President hasn’t agreed with. We’re grateful the President mentioned medical liability reform, and we hope he’s serious. We need to establish tough liability reform standards, encourage speedy resolution of claims, and deter junk lawsuits that drive up the cost of care^{15 [17]}. Real reform must do this.

Let’s also talk about letting families and businesses buy insurance across state lines^{16 [18]}. I and many other Republicans believe that that will provide real choice and competition to lower the cost of health insurance^{17 [19]}. Unfortunately, the President disagrees.

You can read more about all these reforms at healthcare.gop.gov. These are common-sense reforms we can achieve right away – without destroying jobs, exploding the deficit, rationing care, or taking away the freedom American families cherish^{18 [20]}.

This Congress can pass meaningful reform soon to reduce some of the fear and anxiety families are feeling in these very difficult times^{19 [21]}. Working together in a bipartisan way, we can truly lower the cost of health care while improving quality for the American people^{20 [22]}. I’m Dr. Charles Boustany. Thanks for listening.

1 - Lie - Rep. Boustany starts off by claiming that Republicans are ready, and have been ready, to "work with the President for common-sense reforms"...which is a lie. With the exception of one or two moderate Republicans, like Sen. Olympia Snowe of Maine, the Republican Party has refused to come to the table with serious ideas for achieving the President's goals of increasing affordability, reigning in the explosive price of health care, and providing universal coverage to all Americans.

In fact, conservatives have been spending inordinate energy in smearing actual common-sense reforms, like a public health insurance option and end-of-life counseling. And despite all of the concessions Democrats have already given to conservatives, they have signaled that few, if any, Republicans will vote for the legislation [23]. It is the American Recovery and Reinvestment Act all over again--water it down with bad conservative ideas, then then oppose it anyway. [ up [24] ]

2 - Hypocrisy - For me, one of the most telling parts of last night was the disparate reactions of the two sides of the aisle. Of particular interest was when President Obama explained that not only would the bill not add a single penny to the deficit, but it would actually return a modest surplus according to estimates, conservatives sat on their hands. Despite all of their grandstanding about "fiscal responsibility" they wouldn't applaud a deficit neutral (or even a deficit positive) health insurance reform bill.

Understandably, they were also not ecstatic when the President noted the hypocrisy of their opposition to a deficit neutral health insurance reform bill on the false grounds that it will add to our debt, while these same people steadfastly supported the costly war in Iraq and Bush's tax giveaways to the rich, which each cost far more than universal health care would under Obama's plan. And what did we get for the war and tax cuts for the rich? More dead Americans than the terrorists managed to kill on 9/11, and inequality we haven't seen since the Gilded Age [25] of the Robber Barons.

So for Rep. Boustany, or any conservative, to decry the federal debt, and use it as a weapon to attack vitally necessary programs like health insurance reform, is the height of hypocrisy and disingenuousness. Rep. Boustany apparently thinks Americans don't remember anything prior to January 20th, 2009. [ up [24] ]

3 - Lie - The recovery has not been jobless. Is unemployment still rising? Yes. But does this mean we wouldn't be doing far worse than we are now without the recovery? Definitely not. The Recovery Act has been creating jobs all around the country, and protecting existing jobs from layoffs. Even cynical conservatives, who repeatedly attack the stimulus as failed and wasteful spending, have gone back to their home districts to brag about the jobs it has created [26], and tried to take credit for these jobs. Yeah, they seem to think no one is watching their doublespeak. [ up [24] ]

4 - Lie - It is funny that Rep. Boustany should mention what the public wants. He seems to think they want to start all over from the beginning, because of course nearly a century of trying to achieve universal health care in this country is just too quick! And of course it couldn't be a cynical ploy to stretch out the reform battle until the public is so tired of hearing about it that war fatigue sets in and they are able to kill reform altogether! Nooo...that couldn't be why they want us to go back to the very beginning. [ up [24] ]

He also seems to think that Americans oppose the reforms that Obama supports, especially the public option. This of course is, and has always been, a lie. A public insurance option has always enjoyed the support of a majority of Americans [27], and the crazy season of August hasn't changed a thing. In fact a recent poll showed that 8 in 10 Americans support a public health insurance option [28], including a sizable majority of Republicans.

5 - Lie - Ahh, the good ol' standby favorite lie of conservatives, the "government takeover" boogeyman. This is what leads me to believe that Rep. Boustany was otherwise engaged during the President's speech, because like the other favorite right-wing lies about health insurance reform, Obama did an excellent job of setting the record straight. This made it all the more amusing when Rep. Boustany, unfazed by the preemptive myth-busting, predictably repeated the same tired old lies. [ up [24] ]

6 - Lie - Another lie. The CBO has absolutely not found that the inclusion of a public health insurance option would raise health care costs. In fact, as the President explained in his speech, the exact opposite is true. In fact, it was at this point in Obama's speech that I was impressed with how he articulated, in an easy to understand manner, how a public insurance option would drive down costs by breaking up harmful insurance industry monopolies and open up health insurance markets to competition. Conservatives want you to believe that somehow increased competition leads to higher prices. Boustany may have been a doctor, but he obviously never sat through a freshman economics course (and he is hoping you haven't either). [ up [24] ]

7 - Lie - Typical conservative lie here. When sometime is complex (you know, because running a country isn't exactly paint by numbers), throw out ridiculous numbers, create ridiculously confusing and inaccurate flow charts, and just yell "ZOMG it is sooo complicated!!" These "53 new government bureaucracies" are made out to sound like each and every one is a huge new agency, but in fact the vast majority of them are single positions or oversight committees. For instance, every position specifically created by the bill isn't described as a new job by conservatives; no, it is described as a "whole new bureaucracy", like "Special Inspector General for the Health Insurance Exchange" (yes, any position charged with making sure things work correctly is evil, just take their word for it, you don't have to think!).

Other horrible "bureaucracies" include the "Public Health Investment Fund", which sounds more like a fund than a giant bureaucratic octopus strangling the country, and the "Public health workforce loan forgiveness program", which is obviously evil as well, because forgiving loans for people who dedicate their lives to improving public health is horrible! In fact, quite a few of these "new bureaucracies" are nothing more than funds for various improvements, oversight positions to make sure things are working efficiently, and a couple committees. Look for yourself [29], the list is ridiculous, and just another example of conservatives thinking (hoping) you are stupid. [ up [24] ]

8 - Lie - As I noted in #2 [4], and as the President made crystal clear in his speech before Congress, health insurance reform will not add a single penny to the debt. In fact, that was one of the few lines in the sand the President actually drew during his speech--he vowed in no uncertain terms to veto any health insurance reform legislation that would increase the national debt. Not only are conservatives lying to you here, they apparently think you are deaf. [ up [24] ]

9 - Lie - According to the nonpartisan Congressional Joint Committee on Taxation, 96% of small businesses would see absolutely no tax increase [30] under the health insurance reform plan. Small business would actually benefit from increases purchasing power through the new health insurance exchange. And for small business that cannot afford this health insurance, the government would provide tax credits to make coverage affordable. Horrible, isn't it? Conservatives are not worried about small businesses here, they are worried about protecting profits for large corporations, their biggest sponsors. [ up [24] ]

10 - Lie - Health insurance reform would not cut Medicare [31]. The legislation identifies $500 billion in savings in Medicare, mostly by eliminating overpayments, but also by adding efficiencies to the system, but this most certainly does not equal any kind of cuts in benefits or quality.

And I need to add a little shout out to their shameless hypocrisy on this one as well, because these Medicare related attacks are especially ironic coming from the same people who opposed this highly popular, government-run health care system for decades (including calling it "socialized" medicine that would destroy everything when it was being debated in the 60s), and who have tried at every turn to weaken or destroy it [32]. [ up [24] ]

11 - Hypocrisy - You gotta love how conservatives are now pretending to be in favor of such common-sense reforms like banning insurance companies from denying coverage based on preexisting conditions. And what about all of those years that we've been trying to do this while conservatives have been steadfast in their opposition to additional regulations on the insurance industry (and every industry)? If conservatives have been on board with these reforms, as liberals obviously have been, why couldn't this pass Congress in the past? Why didn't conservatives introduce this legislation when they controlled Congress and occupied the White House? Who have been blocking these reforms all this time...? Hmmm...

Sorry, we weren't born yesterday. You can't oppose these things for decades, defend the current system, and then pretend right before the clock runs out and you know you've lost that you are a consumer champion. That isn't how this works. [ up [24] ]

12 - Hypocrisy - Wow, first a conservative talking about how they favor stronger government regulations on the insurance industry and now a conservative saying we should be more like labor unions [33]?? This is just getting silly. [ up [24] ]

13 - Hypocrisy - See, they want to provide assistance to those who cannot afford it, yet have consistently opposed programs that would do just that. Interesting. So what exactly is your plan to achieve this? Oh, there is no plan, no details, no solutions, no anything (well, except the word "NO!" of course)! Well, if they actually had a plan, you could safely assume that it would include no funding, no oversight, and no new positions (see #7 [9]). I can't wait to see how that is supposed to work! [ up [24] ]

14 - Bad Idea - This doesn't sound like a bad idea at first glance, since encouraging people to be healthier is important (and something that Obama has repeatedly emphasized), but that of course isn't what Boustany is talking about. Offering "incentives" is code for what we have now, which basically translates to "if you do anything that could possibly put you at increased risk of anything, you'll have to pay more than everyone else."

If we take away the ability of the insurance industry to deny coverage based on preexisting conditions, they'll do the exact same thing with "incentives", and if you don't receive enough "incentives" you'll find yourself with much much more expensive premiums than most people. Maybe your premiums will be so expensive that you just won't be able to afford to be covered anymore... I'm sure that would break some insurance company CEO's heart. [ up [24] ]

15 - Lie - This is more a gross exaggeration than an actual lie. There is nothing stopping us from looking at tort reform, and perhaps it wouldn't be a bad idea, but tort reform isn't the panacea conservatives have been pretending it is for decades. It isn't junk lawsuits that are driving up the cost of care, it is the near-monopoly within the health insurance market, which any economist can tell you is a sign of an inefficient market that is broken.

What inevitably happens in these monopolistic environments is that "producers" (i.e. the dominate insurance company in the market), having no competition forcing them to lower prices or increase quality, are free to charge whatever they can get away with (which in the case of health insurance is often whatever they can change without sending their customers into bankruptcy, which they frequently do [34]).

Consumers, basically at the mercy of the insurance provider, are left with the choice between one or two expensive private options, or nothing at all. THAT is what is actually driving up premiums, not lawsuits. You can read more about the tort-reform boogeyman here [35]. [ up [24] ]

16 - Bad Idea - "Letting families and businesses buy insurance across state lines" is another decent sounding idea at face value, that isn't so benign when you actually trace the obvious repercussions. The goal here is to start a race to the bottom [36] among states to see who can deregulate the most. This would spell disaster for the health care in this country, and it would be a huge windfall for insurance company profits. [ up [24] ]

17 - Lie - Again, this won't provide consumers with any choice or competition. All health insurance companies would move to set up shop in whichever state deregulated the most (read: gave them the most flexibility to do whatever they want with you) and soon customers would face a whole new array of equally horrible options for health insurance. An insurance company dream. Ask yourself this: Do you really want health insurance run like the credit card industry? Have you checked your fine print lately? How are those interest rates doing? How about now? [ up [24] ]

18 - Lie - Lie, lie, lie and lie. This was basically just a rapid fire reiteration of all of the lies above. The fact [37] is that health insurance reform would not destroy jobs, would not explode (or even increase) the deficit, would not ration care [38], and would not take any freedom away from American families (in fact it would only give them greater freedom than they have now, which isn't much given that the market is run by a handful of corporate sharks). [ up [24] ]

19 - Hypocrisy - I absolutely love that conservatives are now worried about reducing the "fear and anxiety families are feeling". This coming from the same people who brought you the "death panel [39]", the "death book [40]", the "pull the plug on grandma [41]", the "march of socialism [41]", the "brainwashing your children [42]", the "Obama is building death camps [41]", and a never-ending litany of insane right-wing smears created for the sole purpose of scaring people into fearing reform. These people are fear merchants! And in the very same speech--nay, the very next sentence after suggesting that health care reform will destroy jobs, explode the deficit, ration care, and take freedom away from American families--they say they want to reduce fear and anxiety! How Orwellian can you get?

Here is a tip, in the immortal words of Sarah Palin, if you want to reduce fear and anxiety, how about you "quit making things up?" [ up [24] ]

20 - Lie - No, I'm sorry, but there is no such thing as a reform that would pick up conservative support AND actually work to achieve the goals of lower costs and improved quality (in addition to universal coverage, which Boustany left out). In fact, conservatives haven't been able to produce any ideas for reform on their own (which is of course why you never heard George W. Bush talking about his health insurance reform plan, and why the issue went nowhere since the last time liberals had power in Washington and were stopped by the same anti-reform crowd). In their mind "bipartisan" means not adding their own ideas, but cutting out as many parts of reform as possible. In essence, their idea is the status quo--what we are suffering with right now--and their idea of "compromise" is getting as close as possible to no change at all. [ up [24] ]

**Note: Since Rep. Boustany's only reason given for why you should trust him at all on the issue of health insurance reform is that he was once a doctor, I would be remiss to not supply a little context to his resume. You can read more about him on this fact sheet [43], but here are the highlights:

Boustany Has Taken More Than $537,000 In Campaign Contributions From Health Care PACs In His Roughly Four And Half Years In Congress. ($1.25 million total [44]) Boustany Served As A Director On Health Insurer Blue Cross Blue Shield Of Louisiana’s Physician Advisory Board Boustany Has Quite A History of Spreading Lies About Health Insurance Reform (many of which he repeated last night). Boustany Is A "Birther" Boustany Was Sued For Malpractice, Three Times.

By the way, if you haven't had a chance to see the President's speech yet, here it is:

Update: I should credit Rep. Boustany for one thing, which is acting like an adult (yes kids, adults lie too). Unlike some of his peers [45], Boustany had the courtesy to wait until his turn to give his rebuttal, instead of interrupting the President of the United States in the middle of an national address before a joint session of Congress. So I want to give him credit for that. And yes, it is sad that we apparently can't take that sort of basic respect for the Commander-in-Chief for granted anymore. But perhaps we should count our blessings that Rep. Joe Wilson (R-SC) or any of his conservative colleagues didn't hang anyone in effigy or bring guns to the town hall protest Congressional address.

I cannot completely fact check the conservative response without including Rep. Joe Wilson's contribution, which went something like this:

President Obama: There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false - the reforms I'm proposing would not apply to those who are here illegally.

Rep. Joe Wilson: You Lie!

Actually no Mr. Wilson, in fact YOU LIE! [46]

Two words, big lie, shocking disrespect, epic irony.