In what way does this fulfill public media’s supposed role of better informing the public?

Posted by AzBlueMeanie:

Arizona Public Media is failing its viewers by interviewing guests who do not know the subject matter on which they speak and simply repeat political talking points aimed at low information voters who know even less about the subject matter than they do. In what way does this fulfill public media's supposed role of better informing the public?

Case in point, the Political Roundtable on Arizona Illustrated on Friday night invited Republican strategist Sam Stone to talk about health-care politics in Arizona, among other topics. I am told Mr. Stone is GOP congressional candidate Martha McSally's campaign manager, a fact not disclosed in the introductions.

For this example I will focus just on the Affordable Care Act topic. Political Roundtable: Health Care, Street Troubles, Bus Fares, Contraception Legislation & More.

Mr. Stone asserted that "right from the start this legislation did nothing to address the problem of rising health care costs in our system." Really? Bending the health care cost curve is primarily what the ACA addresses. Peter Orszag and Ezekiel Emanuel wrote at the New England Journal of Medicine, Health Care Reform and Cost Control — NEJM:

In fact, it institutes myriad elements that experts have long advocated as the foundation for effective cost control. More important is how the legislation approaches this goal. The ACA does not establish a rigid bureaucratic structure to be changed only episodically through arduous legislative action. Rather, it establishes dynamic and flexible structures that can develop and institute policies that respond in real time to changes in the system in order to improve quality and restrain unnecessary cost growth.

The article goes on to address the various cost containment programs. In addition, the Congressional Budget Office:

(CBO) determined that the ACA will reduce the federal budget deficit by more than $100 billion over the first decade and by more than $1 trillion between 2020 and 2030. And the Commonwealth Fund recently projected that expenditures for the whole health care system will be reduced by nearly $600 billion in the first decade.

In fact, the Commonwealth Fund's most recent study (January 2012) is projecting lower health spending over the rest of the decade. Bending the Health Care Cost Curve – The Commonwealth Fund:

CMS's estimates of health care spending through the end of the decade have been steadily falling over the last year and a half. As shown in Exhibit 1, the most recent projection of national health spending in 2020 is $4.6 trillion, or 19.8 percent of gross domestic product (GDP), compared with its projection of $4.9 trillion, or 21.1 percent of GDP, in 2009 in the absence of reform. This represents a $275 billion (5.6 percent) reduction for 2020, compared with pre-reform estimates. Moreover, that projection represents a cumulative reduction of $1.7 trillion over the 10 years from 2011 to 2020.

This reduction in projected national health spending is particularly important because the pre-reform projection of health care costs was used by the Congressional Budget Office (CBO) and the CMS Office of the Actuary in estimating the cost and impact of health reform. Already, spending is far below the trajectory projected to result from implementation of the Affordable Care Act. In fact, reduction in utilization of health services and trims in payment rates under the Affordable Care Act more than offset the projected cost of covering the uninsured.

Mr. Stone next asserted that the Supreme Court Justices are looking at this an an "unfunded mandate," an unconstitutional mandate. Really? The Center on Budget and Policy Priorities reports Federal Government Will Pick Up Nearly All Costs of Health Reform's Medicaid Expansion:

Claims that states will bear a significant share of the costs of the Affordable Care Act’s (ACA) Medicaid expansion — and that this will place a heavy financial burden on states — do not hold up under scrutiny.

Congressional Budget Office (CBO) analysis indicates that between 2014 and 2022, the ACA’s Medicaid expansion will add just 2.8 percent to what states spend on Medicaid, while providing health coverage to 17 million more low-income adults and children. In addition, the Medicaid expansion will produce savings in state and local government costs for uncompensated care, which will offset at least some of the added state Medicaid costs.

* * *

The health reform law provides a favorable financial deal for states, in several respects.

• CBO estimates show that the federal government will bear nearly 93 percent of the costs of the Medicaid expansion over its first nine years.
• The additional cost to the states represents a 2.8 percent increase in what states would have spent on Medicaid from 2014 to 2022 in the absence of health reform.
• This 2.8 percent figure overstates the net impact on state budgets because it does not reflect the savings that state and local governments will realize in health-care costs for the uninsured.

In short, the Medicaid expansion will significantly increase coverage at a modest cost to state Medicaid programs, and it will lower state costs for providing care to the uninsured.

Mr. Stone next asserted that when we talk about changing a hundred years of law by asking people to buy private insurance through a federal mandate — "a federal mandate has never happened before." Really? As I previously posted, the Founding Fathers imposed a federal madate for health insurance for seamen. The Founding Fathers and Mandates.

There is also the social security payroll tax mandate and the Medicare payroll tax mandate, held constitutional by the U.S. Supreme Court.

Oh, and there is the 1986 Emergency Medical Treatment and Active Labor Act which requires nearly all hospitals to treat and stabilize anyone needing emergency care, regardless of ability to pay or legal U.S. residency (signed into law by Saint Ronnie Reagan himself). There is the 1996 Mental Health Parity Act which prohibits group health plans from setting lower annual or lifetime dollar limits for mental health benefits as compared with medical and surgical benefits. And there is the 1996 Newborns' and Mothers' Health Protection Act which requires plans offering maternity coverage to pay for at a least a 48-hour hospital stay following most normal deliveries, and 96 hours following a Caesarean section.

A federal mandate has "never happened" Mr. Stone?

Don't even get me started on the use of Byron Schlomach of the Goldwater Institute as an "expert" on medical costs. The Goldwater Institute parrots the libertarian Heritage Foundation, and the Heritage Foundation actually designed the health insurance mandate back in the 1990's which was a Republican-backed plan until President Obama said, "OK, let's adopt your plan." Republicans Hatched Idea For Obama's Health Insurance Mandate. Then Republicans were suddenly against it simply because President Obama was for it.

Schlomack's restaurant analogy is one of the stupidest things I have heard stated by someone purported to be an "economist." His intellectually dishonest analogy is a poor attempt to describe the fee-for-service system that we currently have in which doctors order unnecessary tests and treatments to maximize their income — a driver of health care costs — rather than the cultural change towards a fee-for-results system that the ACA begins to put in place. See Health Care Reform and Cost Control — NEJM. New Rule: never use the Goldwater Institute as an "expert" on any topic, ever. GI is wingnut propaganda.

Mr. Stone next asserted that one of the primary drivers of increasing health care costs is medical malpractice suits. Seriously, Dude? That old canard? The lawyers in the audience call bullshit on this patent falsehood. From the American Association for Justice (American Trial Lawyers Association), Malpractice a Tiny Percentage of Health Care Costs:

One of the principal myths surrounding medical malpractice is its effect on overall health care costs. Medical malpractice is actually a tiny percentage of health care costs, in part because medical malpractice claims are far less frequent than many people believe.

In 2004, the CBO calculated malpractice costs amounted to “less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.”

Five years later, the CBO revisited the issue of medical negligence costs. This time, they attempted to account for the indirect costs of medical negligence, mainly the idea that doctors order extra tests to avoid liability. Again, the CBO found that tort reform would only save 0.5 percent of all health care costs.

Other authorities have also found that the direct costs associated with medical negligence are a tiny fraction of health care costs. According to the National Association of Insurance Commissioners (NAIC), the total amount of money spent defending claims and compensating victims of medical negligence in 2010 was $5.8 billion, or just 0.3 percent of the $2.6 trillion spent on health care in the U.S. that same year.

And this was just Mr. Stone's comments on the Affordable Care Act.

The difference between lawyers and reporters is that a lawyer never asks a question to which he or she does not already know the answer and has an exhibit ready at hand to challenge the witness on the facts when the witness lies. The relationship is adversarial.

Reporters too frequently ask open-ended questions to which they do not know the answer and simply take the answer of the person interviewed without ever challenging the speaker. Too often the relationship is collegial. This is an incentive for political operatives to lie because they know that they can get away with it and never be held accountable. They are rarely, if ever, fact checked.

And fact checks like this come after the fact. Few people will ever see the fact check or correction to what was originally aired. This is yet another incentive for political operatives to lie because they know that they can get away with it and never be held accountable.

The viewing public expects better than this. When a reporter asks a question, he or she should have the supporting document or video queued up for a "let's go to the video!" moment to challenge the speaker right then and there when a speaker engages in this kind of misleading dishonesty.