The muddying of the bloodying of PolitiFact

Columbia Journalism Review is at it again, fishing me in with a mention of "PolitiFact."  This time it's Trudy Lieberman, hitting PolitiFact a tad late for its most recent "Lie of the Year" selection while trying to convince us that Republicans really did vote to end Medicare.

Though it's fair to say there was a shred of truth to the Democrats' claim, the arguments for it representing the unvarnished truth leave a great deal to be desired.

Lieberman, a CJR contributing editor as well as a fellow for the Center for Advancing Health and  a member of the Board of Directors for the Association of Health Care Journalists, charges that PolitiFact primarily failed with its "Lie of the Year" because it failed to adequately explain Medicare's complexity:

The fact is Republicans by supporting Ryan’s voucher plan did essentially vote to end Medicare. The Dems who didn’t like that idea should have been more precise in their statements, saying instead “Republicans voted to end Medicare as we know it” or “voted to end Medicare as a social insurance program”—a point that Norman Ornstein, a resident scholar at the American Enterprise Institute, made in PolitiFact’s critique.

PolitiFact and others should have left it there and devoted space to the larger issue. Medicare may be wildly popular, but it is not well understood by most people—be they beneficiaries, politicians, or journalists. Deconstructing how this complicated and misunderstood program works and the historical context for proposed changes would go a long way to helping the public evaluate the arguments from both Democrats and Republicans. For more than a year, Campaign Desk has urged journalists to fill that void.

Good luck understanding Lieberman's rationale for thinking Republicans voted to end Medicare:

There’s no doubt that the voucher plan contemplated by Ryan—and now his new sidekick, Oregon senator Ron Wyden—will eventually change Medicare from a social insurance scheme, where everyone who paid into the program is entitled to a benefit, into private insurance, where the sellers must bow to the profit incentive.

The Ryan-Wyden alternative would not constitute a social insurance scheme?  Why not?  The new plan is sponsored and subsidized by the government.  Lieberman doesn't say why, other than to assure us there's "no doubt" about it.

At a basic level I agree with Lieberman, however.  Explain Medicare to people.  Explain how the changes in national demographics combined with the advance of medical technology make the current system absolutely unsustainable.  Lacking a reform such as that proposed by Ryan, there are two main methods for keeping the system from going destructively into the red.  One is to reimburse health care providers so little (a prominent feature of ObamaCare) that it reduces the supply of health care providers.  As the number of providers shrinks, fewer patients receive services in a timely manner.  A certain number die prior to obtaining expensive treatments.  That's savings.  Second, the government can explicitly limit the number and types of services it makes available.  That also accounts for savings, this time via explicit rationing.

Both methods were what Sarah Palin had in mind when she referred to Obama's "death panel," by the way, summing up principles expressed by economist Thomas Sowell in the process.



Skip the issue of cost as Lieberman does in her CJR column and shortchange the nation on its health care conversation.