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PolitiFact's Credulous Romney-Ryan Health Care Attacks

3:32 PM, Aug 27, 2012 • By MARK HEMINGWAY
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Perhaps if we all ignore PolitiFact, they'll go away. But for the time being, the supposedly independent organization continues to crank out skewed and partisan work. There's no better example of this than the the current jihad the "fact checking" organization is waging against the Romney-Ryan health care plan.

A quick spin around the site reveals some pretty disingenous things. For instance, PolitiFact rated Paul Ryan "mostly false" for his critique of Obamacare's Independent Payment Advisory Board (IPAB)—a board created by Obamacare in an attempt to control Medicare costs. I discussed how IPAB is supposed to work in a piece earlier this year:

Here’s how IPAB works: It’s a panel of 15 presidential appointees who are tasked with reducing Medicare spending. The panel is given certain spending targets, beginning in 2014. At first those targets are on a sliding scale, but by 2018 spending growth is limited to the rate of growth of GDP with an additional percentage point tacked on.

Any decisions IPAB makes about Medicare spending automatically become law. To override IPAB requires a three-fifths majority vote in the Senate, a high legislative hurdle. Alternatively, Congress can pass its own Medicare plan that meets the same spending target. There’s no administrative process allowing doctors or citizens to challenge the board’s decisions. Since Medicare comprises about 13 percent of the federal budget, that’s an awesome amount of power to be placing in the hands of unelected bureaucrats.

In order to assuage fears that the board would go on a rationing tear, the commission was supposedly given a narrow mandate. IPAB can’t adjust premiums or Medicare’s cost-sharing mechanisms, such as copayments and deductibles.

It can, however, adjust the rates at which doctors are reimbursed. But Medicare reimbursement rates are already well below market rates, and consequently doctors are treating fewer and fewer Medicare patients as they lose money on them. Doctor access is already a huge problem for Medicaid for this same reason: Over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients, according to a 2009 survey by Merritt Hawkins and Associates on physician wait times. As it is, Medicare reimbursement rates are set to drop below Medicaid’s in the coming decade—and that’s without IPAB.

Here's what Paul Ryan said about IPAB that PolitiFact claims is untrue: "[Obama puts] 15 unelected, unaccountable bureaucrats in charge of Medicare, who are required to cut Medicare ... that will lead to denied care for current seniors." That may be more concise than my lengthier explanation, but what Paul Ryan is saying is bang on. Perhaps you could quibble with his assumption that ratcheting down reimbursement rates will reduce doctor access to Medicare, but as I noted, there's a preponderance of evidence to suggest that will happen.

Ok, now here's PolitiFact's conclusion to their piece saying Ryan's statement is "mostly false":

Ryan said that Obama "puts a board of 15 unelected, unaccountable bureaucrats in charge of Medicare who are required to cut Medicare in ways that will lead to denied care for current seniors."

Board members aren’t elected, but it’s a stretch to say they’re entirely unaccountable. They’re appointed by the president and approved by the Senate. The president can fire them for neglect of duty or malfeasance.They’re required to recommend cuts to Medicare in years that other cost-saving measures don’t meet growth targets — but Congress can overrule their recommendations.

Did you catch that bit about "it's a stretch to say that they're entirely unaccountable"? What a mendacious mischaracterization that is. Ryan didn't say that IPAB was "entirely unaccountable" he simply said it was "unaccountable." That's reading into Ryan far more than what he said. And when 15 unelected bureaucrats are able to set 13 percent of the federal budget without congressional approval, that's more than a fair thing to say. There's also the not-insignificant matter that under the separation of powers in the constitution, the executive branch isn't supposed to make law, which is exactly what presidentially appointed IPAB bureaucrats are doing and why the Goldwater Insititute has filed a lawsuit over IPAB on the grounds it's unconstitutional. PolitiFact continues:

Meanwhile, "denied care" is a strong way to phrase the board’s possible effect. It’s expected to recommend cutting provider payments, with an eye on cutting waste and inefficiency. That could restrict some seniors’ access to care, depending on the what actions the board actually takes. Meanwhile, the board oversees only a small percentage of the Medicare savings in the health care law.

Ryan creates the specter of an unaccountable board making all of Medicare’s spending decisions, but that’s scarcely the case. There’s an element of truth to his claim, but his overstatements add up to a Mostly False impression.

This soft-pedaling of the very real issue that IPAB could lead to reduced access to health care for seniors is a bizarre conclusion to reach, considering what PolitiFact said about it in the same piece:

Ryan said the board would "cut Medicare in ways that will lead to denied care for current seniors."

But by law, the board can’t ration care. It can’t change benefits. It can’t change eligibility. It can’t increase what seniors pay.

So it’s expected to cut payments to providers. That could be a problem, since some providers say they’re underpaid already. New York Times and USA Today stories in 2009 and 2010, for example, feature doctors opting out of Medicare because of its low payment rates.

How might that affect care? Imagine, say critics, being unable to find a nearby hospital or doctor who takes Medicare. Or discovering that payments for a particular service or procedure have been reduced.

"In that way, at least in theory, you could get actual denial of care," said Michael Tanner, a health care analyst for the libertarian Cato Institute, who opposes the health care law.

The Medicare actuary, Richard Foster, estimated that savings from the entire health care law would make about 15 percent of hospitals, skilled nursing facilities and home health agencies unprofitable by 2019.

That means, presumably, that to stay open they would need to shift costs to non-Medicare patients, merge with other providers or withdraw from Medicare, he said.

That’s one reason he’s testified that growth reduction under the law isn’t sustainable in the long range.

It’s "a serious issue," said Wilensky, the Bush-era Medicare official.

What the heck is going on here? It's one thing to ignore the evidence that what Ryan is saying is entirely defensible, but it's quite another to report it and then pretend it's irrelevant to your conclusion that Ryan is making "overstatements" that add up to a "Mostly False impression."

Now that it's understood PolitiFact is going out of their way miscontrue what Paul Ryan is saying, let's look at how they defend a blatantly misleading charge about Ryan's health care plan from the Obama campaign. Here's an Obama campaign ad—unfortunately titled "facts"—that PolitiFact says is half-true:

At one point, the narrator says that "experts say (Ryan’s) voucher plan could raise future retirees’ costs more than $6,000." An on-screen visual adds the text, "Raise seniors’ costs by $6,400 a year. Center on Budget and Policy Priorities, 4/8/11."

Except that, as John McCormack noted, the Obama campaign is presenting figures from a questionable analysis of an outdated version of Ryan's plan that Romney and Ryan are not campaigning on. Here's how Ramesh Ponnuru explains the difference:

Under the original Ryan plan, retirees would have chosen a private health plan and the government would have contributed money toward the cost. The amount of money would have depended on the beneficiary’s age and health status. Over time the average amount of money would have risen with inflation.

Critics pointed out that health-care costs have risen faster than inflation for a long time. If competition failed to change this trend, senior citizens would indeed have been left paying more.

The new version of the plan cleverly fixes the problem. Insurers would submit competitive bids to see who could cover Medicare’s traditional benefits for the lowest premium. The average amount of financial assistance would be equal to the second-lowest bid. So seniors will always have an option that leaves them with no higher costs than now. If they pick something even cheaper, they will come out ahead.

Also note that the Romney campaign has also explained all this in detail. So how does PolitiFact get away with saying this ad is half-true?:

The Obama ad would have been more accurate if it had specified that it was referring to a previous Ryan plan for Medicare rather than the current one. We simply don’t have enough details to know how much extra money seniors might have to pay under the current Ryan plan. Still, the Obama campaign gave itself some wiggle room by saying that the plan "could" raise out-of-pocket costs by more than $6,000. On balance, we rate the statement Half True.

Here's something for PolitiFact to ponder—I know this is difficult to believe, but maybe the Obama campaign didn't specify that they were referring to an outdated version of the Ryan plan because they were trying to be deliberately misleading. That's an obvious conclusion to consider here, as it's not like political ads have a reputation for strict veracity. And since when is it ok to give the Obama campaign "wiggle room" because they said that it "could" cost seniors more than $6,000? If the Romney-Ryan campaign releases an ad saying that the president "could" be putting dead hobos in the crawlspace under the Oval Office, will they be granted "wiggle room" for making their accusation conditional in the absence of evidence?

This is a remarkable conclusion because, once again, PolitiFact ignored the evidence they themselves provided that says otherwise. Here's what they say earlier in the piece about what the cost of the new Romney-Ryan plan would be:

The Obama campaign said it would be happy to update its numbers if CBO or the Romney-Ryan campaign provided new data, but neither has. Peter Orszag, Obama’s former Office of Management and Budget director, recently wrote that "if Ryan believes that changes to his plan since (the original plan was released) would result in any different conclusions, he should request that CBO publish an updated analysis."

But there is one clue that the number wouldn’t be close to $6,400. A study published Aug. 1, 2012, in the Journal of the American Medical Association says that if Ryan’s plan had been in place in 2009, the cost of the second-cheapest Medicare Advantage plan (and thus the size of the premium support payment) would have been 9 percent less than traditional Medicare.

That would have required an out-of-pocket payment for seniors who wanted to use traditional Medicare of $64 a month — which adds up to less than $800 a year.

PolitiFact presents no evidence that the current Romney-Ryan Medicare plan will costs seniors anywhere close to $6,000. So how the heck, in the total absense of evidence, does that statement rate even "half true"?

The fact that Obama is getting a "half true" rating and Ryan is getting a "mostly false" rating tells you everything you need to know about PolitiFact's well-documented bias against Republicans

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