PJ Media

It's a Health Care Overhaul, Not Health Care Reform

Because “government-run health care” — both the phrase and the actuality of the idea — go over like a lead balloon with the American people, the Democrats have chosen new language hoping to obscure their intent to remake the health care system. The new language key word: “reform.”

Reform is a good word. It sounds like making something that’s okay a lot better. You know, get rid of the bad stuff, add some good. Unfortunately, the changes in the system are not reforms which suggest refinements. Rather they’re wholesale changes that will remake the very fabric of American society should they be implemented.

Just as an example, John David Lewis, a college professor read the bill and came up with some questions, the answers from the bill, and the implications. Here is one such example [the link is a goldmine for pulling important passages of the bill and explaining them]:


This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:

‘(ii) EXCLUSION OF CERTAIN READMISSIONS.—For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.

and, under “Definitions”:

‘‘(A) APPLICABLE CONDITION.—The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary …


‘‘(E) READMISSION. — The term ‘readmission’ means, in the case of an individual who is discharged from an applicable hospital, the admission of the individual to the same or another applicable hospital within a time period specified by the Secretary from the date of such discharge.


‘‘(6) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of—  …

‘‘(C) the measures of readmissions …


1. This section amends the Social Security Act

2. The government has the power to determine what constitutes an “applicable [medical] condition.”

3. The government has the power to determine who is allowed readmission into a hospital.

4. This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.

5. This is government rationing, pure, simple, and straight up.

6. There can be no judicial review of decisions made here. The Secretary is above the courts.

7. The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.

What is described in the bill here is not simply a reform. The tax code, legal system, hospitals, insurance companies, doctors, and the patient experience are radically changed. Radical change does not suggest reform. It suggests transformation.

Transforming the health care system is more the aim of this legislation. The progressive left, who have clung to the notion of a single-payer system, want nothing less than transformation, but the bold pronouncements make Americans nervous.

To assuage voters nerves, the president and the congresspeople talking to their constituents while on recess are using more soothing, less dramatic language. It is disingenuous and misleading to the public.

Worse, Republicans play along with the Democrats’ semantic games and use phrases like “the president’s health care reform.” Their language unintentionally reinforces the gentler message the president and progressives want out there about this life-altering legislation.

By giving credence to the false premise that this legislation is reform and there are “bipartisan efforts at reform,” the Republicans help the Democrats make their bad case.

Those in opposition to the current House plan must speak plainly and describe the bill as it is — a radical, systemic overhaul of one sixth of the American economy. This legislation will result in government-run health care. It will be costly. It will transform the patient experience, and not for the better. It will inextricably alter the doctor-patient relationship. It will ration care. It will deny care.

In short, it is a falsehood to promote this legislation as any sort of reform, unless one strips the word of any sort of meaning.

Nearly all Americans agree that some reform of the health care system is needed. That’s why Democrats like the word. That’s why Republicans want to appear like team players.

However, a minority of Americans desire any sort of single-payer system. The legislation as it is written will give America a hard shove toward what I call “soft socialism.” Socialized health care is just one radical part of it. The vast majority of Americans want a free market solution — reform, yes. Ease in insurance portability from job to job, say. Access to insurance rates that big businesses get, etc. Reform. Americans want small changes that would make a big difference for quality of life.

The Democrats do not want health care reform. The Democrats want health care transformation. They want a government-run health-care solution.

The Democrats’ policies run in direct contradiction to what American citizens want, so they are co-opting words that sound more pleasing. The rhetorical manipulation doesn’t change their actions. Democrats should be proud of their ideas and name them accurately.

And Republicans should stop accepting the premises laid out by the Democrats and the press. Once again, Sarah Palin shows how it’s done. On Facebook Wednesday night, she directly addressed President Obama’s dismissal of her critique with facts, going after the heart of the “proposals.” She does not give any credence to the notion of reform. Both in language and substance she points out the radical nature of the bill and, even better, uses a friend of the president’s writing to do it:

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility … or a hospice program.” [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones…. If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

Republicans need to be braver on the substance of the debate. They also need to redefine it semantically. Do not accept Nancy Pelosi’s pronouncements about how to talk about the bill. Do not accept Barack Obama’s disingenuous language. Do no accept a reporter’s premise when using the word “reform.” Challenge the words. Challenge the substance.

Language is important. In the policy debates, it matters how words are used. Words used accurately clarify and inform. Words can also deceive and obscure the truth. The true reformers need to point out that the current Democrat plan is not health-care reform, it’s government-run health care and it’s an overhaul.