Last Tuesday night was the second of three scheduled presidential debates, with President Obama and Governor Romney going toe-to-toe before a public audience at Hofstra University.
I’ve never been a big fan of watching the presidential debates, seeing as they come so late in the campaign cycle when I’ve already made my ballot decision. I also find the so-called “Town Hall” format of last night’s debate questionable, with its handpicked questions from supposedly undecided voters. Finally, I find that these debates are less about substance and facts then about carefully crafted zingers and deliberately deceptive half-truths.
Despite my best intentions, however, I watched the debate from start to finish (as I did with the first presidential debate and last week’s vice-presidential debate). In all three debates so far, my areas of expertise – health care and science policy – received relatively short shrift despite looming crises in these areas. Despite this, it is worth examining in detail what was said on these topics, and fact checking each of the candidates’ statements.
In both debates, for example, Governor Romney claimed that Presidentl Obama promised that the Affordable Health Care Act would lower health care costs by $2,500 for every American family. Romney also alleges that insurance premiums have, in fact, gone up by an average of $2,500 a year and will likely go up another $2,500 should the Act be fully implemented.
This is largely false. Obama did make the promise, as yet unmet, that insurance rates would go down. They have indeed gone up as Romney states. But a recent survey by the Henry J. Kaiser Family Foundation and the Health Research and Educational Trust found that employer-provided health insurance premiums have risen by an average of $2,400 since Obama took office four years ago. The rate of increase has slowed compared to the previous eight years under President Bush. Employers pick up a large share of those costs, with families only paying $800 more since 2008. That’s an increase of $200 a year for families, less than 10% of what Romney claims.
Moreover, the actual increase in insurance premiums has little to do with the Affordable Care Act. According to filings from industry giants like Aetna and Anthem, insurance costs are rising primarily because providers are raising their prices and consumers are accessing care more often. Costs associated with the preventative care benefits that must now be offered under the Affordable Care Act account for less than 1% of the increase.
Finally, as for the claim that premiums will increase another $2,500 once the Act is fully implemented? That is also false. The Congressional Budget Office estimates that insurance premiums would barely change for those with employer-based health care coverage. For those that do not get health care through their employer – most of who currently don’t have insurance at all – the average policy for families would cost about $2,100, but federal subsidies would cover most of those costs.
For his part, President Obama has made it a point to highlight the Romney-Ryan plan to partially privatize Medicare, offering seniors a voucher that they can use to buy their own insurance in the marketplace. This voucher plan, the President claims, will not keep up with health care inflation and eventually cost the cost the average senior over $6,000 a year.
This too is false. The oft-quoted increase in costs or seniors comes from an analysis of an older plan, and is predicated on some rather grandiose predictions about rising insurance premiums. In fact, the Romney-Ryan plan would put a cap on rising insurance premiums with the same economic formula used by the Affordable Care Act.
In fact, nearly everything that the candidates have said in the debates with respect to health care is false. Claims that $716 billion is being cut from Medicare? False. Claims that 20 to 75 million people will lose their current insurance under the various plans proposed or implemented? False. Claims that a panel of unelected government bureaucrats will be making health care decisions for all Americans? False. Claims that the government, or your employer, or your church will get to decide whether or not you can use birth control? False. Claims that the Affordable Care Act hinders job creation and economic growth. False.
So what is true?
The good news is that more people are now covered. The number of people without insurance dropped in 2011, despite lingering economic challenges. This is particularly true for young adults who can now remain on their parents insurance until they turn 26. Prescription drug costs have also decreased an average of $600 per year for those on Medicare.
The bad news is that insurance premiums continue to go up, but the annual rate of increase is the lowest it has ever been. Moreover, individuals and families with work-based plans will be called upon to pay even more as companies share more of the cost with their employees. This will be true no matter who wins the election.
Why the candidates just can’t admit this, I’ll never know.
A public health researcher and ethicist by training, Dr. Sean Philpott is a professor of bioethics at Union Graduate College in Schenectady, New York. He is also the Chair of the US Environmental Protection Agency’s Human Studies Review Board, which reviews all research involving human participants submitted to the EPA for regulatory purposes.
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