PolitiFlub: PolitiFact covering for Democrats on Medicare

Today PolitiFact's Angie Drobnic Holan unveiled a PolitiFact primer on Medicare.

It's not all bad.  It provides some helpful information.

But it ignores and/or distorts perhaps the central issue in the Medicare debate:  cost.

How does PolitiFact do it?

PolitiFact (bold emphasis added):

The health care law, though, is loaded with other changes to Medicare. Most notably, Democrats found ways to reduce projected spending by $500 billion over 10 years, which they then counted as deficit reductions against new spending in the health care law.

The idea is to steer Medicare away from paying for each treatment (called "fee for service") and toward a system that pays doctors and hospitals based on improving patient health.

The savings came from reducing payments to Medicare Advantage and to hospitals, nursing homes and other skilled nursing facilities and home health agencies. The reductions are part of programs intended to improve care and make it more efficient — for instance, by lowering payments for preventable hospital readmissions.

The above three paragraphs from PolitiFact are fairly loaded with misdirection.

First example:  "Democrats found ways to reduce projected spending by $500 billion over 10 years."  The statement is true but misleading.  Democrats found ways to reduce projected spending by pretending the "Doc fix" will not occur.  The "Doc fix" keeps Medicare reimbursement rate schedules from dropping so low that it chases doctors from the practice of medicine with a resulting shortage of services. 

Here's how the Trustees of the Social Security and Medicare trust funds described it in a 2012 report:

Most of the ACA-related cost saving is attributable to a reduction in the annual payment updates for most Medicare services (other than physicians’ services and drugs) by total economy multifactor productivity growth, which the Trustees project will average 1.1 percent per year. The report notes that sustaining these payment reductions indefinitely will require unprecedented efficiency-enhancing innovations in health care payment and delivery systems that are by no means certain. In addition, the Trustees assume an almost 31-percent reduction in Medicare payment rates for physician services will be implemented in 2013 as required by current law, which is also highly uncertain.

Drobnic Holan's second paragraph above settles on a relatively minor feature of the Democrats' health care reform.  As the Medicare trustees note, savings from changing the nature of reimbursement does not certainly lead to savings.  Incentives for better patient care lead to patients living longer and thus more likely needing additional medical services in the future.  Does it lead in practice to a net savings over a baseline projection?

In her third paragraph Drobnic Holan pulls a "bury the lede" move by sticking the cuts to Medicare Advantage in just ahead of cuts to traditional Medicare services.   Seriously, try reading it this way:  "The savings came from reducing payments to hospitals, nursing homes and other skilled nursing facilities and home health agencies, as well as to Medicare Advantage."  For the ACA's first 10 years a large share of the projected savings come from also cutting payments to doctors (see "Doc fix").

Paying for Medicare in its current form will not just be "a challenge," as Drobnic Holan puts it.  The structure of Medicare under the ACA makes it likely that "Medicare as we know it" will end in fiscal ruin unless reforms under the ACA result in deep and widespread rationing of services.

Democrats running for election in 2012 will appreciate it if we're all unaware of that.  And PolitiFact did its part to help.

PolitiFlub: False assumptions equal true foundations

The PolitiFlub label exists for times when I don't intend a full evaluation but nonetheless have found something worth criticizing in a PolitiFact story.

Such as this one.

Sometimes I don't know whether laugh, stare or simply fall out of my chair:

When we ran the White House's approach by Boehner's office, a spokesman said that they're based on a faulty assumption -- that the Boehner proposal would institute identical, across-the-board cuts for every department and program. In fact, the spokesman said, the proposal would be to set the entire discretionary budget to 2008 levels and then negotiate cuts in each program to meet that target.

That's all well and good, but the fact is that Boehner's news release doesn't explain exactly how its cuts would be made. So, given the information available, we think it's reasonable for Axelrod to have based his claim on an across-the-board cut. Moreover, if Boehner's office is suggesting that under his proposal, the cuts in education could in fact be less than 20 percent, then by the same logic they could also end up higher than 20 percent.

Yes, ladies and gentlemen, PolitiFact just informed you that, in the context of a fact check, it is reasonable for David Axelrod to make a false assumption where the available information does not directly forbid the assumption.

I suppose this is the type of fallacious reasoning we should expect from a fact check organization that has as one of its principles the notion that the failure of a subject to substantiate their claim amounts to a failure to meet the burden of proof and can justify a "False" rating on the "Truth-O-Meter."

Blech.

PolitiFlub: The SEIU take on the Fair Tax

I don't have time to do a full in-depth grading on every flawed PolitiFact story I see, hence the new story category, "PolitiFlub."

PolitiFact very recently posted a new story about an SEIU ad attacking a Republican candidate for one of  Indiana's congressional seats:

PolitiFact commits at least one major blunder in concurring with the SEIU that the Fair Tax would result in double taxation.  The PolitiFact story omits the fact that income and Social Security taxes are already embedded in the things we buy.  So seniors are already double-taxed as it is, but the taxes are hidden in the cost of the item.

PolitiFact used FairTax.org as a source, yet apparently neglected to notice a key statement:

The tax is completely transparent in that it is easily seen and understood at the time of purchase. As such, it makes clear to the citizenry the amount of federal revenues collected. This transparency also makes embedding “hidden” federal taxes almost impossible, unlike the current system which taxes goods and services multiple times before the point of purchase.

It isn't certain at this point whether the rate of the Fair Tax would necessarily exceed the current amount of embedded taxation.  Some claim that the 23 percent rate would prove insufficient for maintaining the government's current funding level.  But that's another story.  The story here has PolitiFact omitting information critical to a proper understanding of the Fair Tax and thereby lending the SEIU undue credibility.