New Year’s is the time for lists that recap memorable events in the year just passed. In 2014, health care remained a central focus of public attention that produced much to remember, including a steady flow of statements from public figures. Some of them were astute, many were misguided, and some were just plain dumb.
Here is my list of the five dumbest statements made about health care in 2014.
#5: Illegal migrants are bringing Ebola into the U.S.
Ebola and illegal immigration were two of the most emotional issues attracting public attention during the year. Both fed irrational fears and calls to panic. When combined, they inspired a perfect storm of idiocy. In July, Representative Phil Gingrey (R-Georgia) included this statement in a letter to the Centers for Disease Control and Prevention about unaccompanied children entering the United States along the southern border: "Reports of illegal migrants carrying deadly diseases such as swine flu, dengue fever, Ebola virus and tuberculosis are particularly concerning."
In order to acquire Ebola, those children would have had to stop in west Africa on their way, since not a single case of Ebola has been reported in Latin America. Rep. Gingrey is a physician. He might pay closer attention to developments in his own field.
#4: We should repeal all of Obamacare but keep the insurance exchanges and the Medicaid expansion
Say what? How can you both repeal the entire law and retain its most central features at the same time?
That seeming contradiction didn't faze Senator minority leader, now majority leader, Mitch McConnell. In his only debate with election opponent Alison Lundergran Grimes in October, he declared, "the best interests of the country would be achieved by pulling out Obamacare root and branch." But he also called for retaining the Obamacare insurance exchanged operated by his home state of Kentucky, Kynect, and the state's expansion of Medicaid. He distinguished Kynect from the rest of Obamacare by explaining that it is "a website."
Of course it's a website. That's the form Obamacare directed it to take.
#3 Obamacare has resulted in a net loss of people with health insurance
That's what House speaker John Boehner claimed at a press conference in March. He based his assertion on a rough estimate of the number of people whose policies were cancelled because of Obamacare and the number who signed up for new coverage on an insurance exchange.
As described in the Washington Post's Wonkblog, that calculation makes no sense. Most of those who lost their policies were automatically rolled over into new coverage without going through an exchange. Those signing up through an exchange are, for the most part, an entirely different group of people.
In fact, actual statistics show that the rate of uninsurance reached an historic low in 2014. It fell to 11.3% in first half of the year, down from 14.4% during the year before Obamacare went into effect. Real statistics tell a very different story from fuzzy math.
#2 The stupidity of the American voter was critical to passing Obamacare
It's not American voters who were stupid but Jonathan Gruber, the MIT economist and key adviser in the crafting of Obamacare, who made that statement. Although he said it in 2013 at a conference at the University of Pennsylvania, it reached a broad audience this past November when a Philadelphia man found a video of it online and posted it for wide dissemination.
Obamacare passed because of a desire by Democrats to reduce the number of uninsured Americans. It is an extremely complicated law, just like Medicare, Medicaid, and President George W. Bush's Medicare expansion in 2003. None of those laws passed because voters were too stupid to understand their subtleties. Their complexity was not the result of attempts at deception but responses to the underlying complexity of health care. It's a good thing Professor Gruber doesn't teach political science.
#1 The US healthcare system is the best in the world
Some day, this may be true, but unfortunately, that day is not today. Numerous studies highlight our system's failings. But factual comparisons didn't convince Fox News business commentator Todd Wilemon, who declared American health care the best in the world in an interview on Comedy Central's The Daily Show in March.
Several politicians echoed his assessment. Senator Rand Paul declared American health care the greatest in the world in an interview in October referring to America's capacity to respond to the threat of Ebola.
In June, the nonprofit Commonwealth Fund published a comparison of health systems in 11 developed countries that ranked the United States last. This was the same rank our system achieved in four previous comparisons dating back to 2004. The study assessed systems on measures of access, efficiency and equity. The result is similar to those reached in comparisons by other research organizations, including the National Research Council and the Institute of Medicine. Health care outcomes are no better in the United States, or even worse, than in other countries, and costs are off the charts.
Having the best system in the world should be our goal, but we have a long way to go before we reach it.
These are certainly not the only dumb statement about health care made last year, but they are all, at the least, among the more notable.
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