WASHINGTON – Confusing claims and outright distortions have animated the national debate over changes in the health care system. Opponents of proposals by President Barack Obama and congressional Democrats falsely claim that government agents will force elderly people to discuss end-of-life wishes. Obama has played down the possibility that a health care overhaul would cause large numbers of people to change doctors and insurers.

A look at some claims being made about health care proposals:

CLAIM: The House bill “may start us down a treacherous path toward government-encouraged euthanasia,” House Republican Leader John Boehner of Ohio said July 23.

Former New York Lt. Gov. Betsy McCaughey said in a July 17 article: “One troubling provision of the House bill compels seniors to submit to a counseling session every five years … about alternatives for end-of-life care.”

THE FACTS: The bill would require Medicare to pay for advance directive consultations with health care professionals. But it would not require anyone to use the benefit.

Advance directives lay out a patient’s wishes for life-extending measures under various scenarios involving terminal illness, severe brain damage and situations. Patients and their families would consult with health professionals, not government agents, if they used the proposed benefit.

CLAIM: Health care revisions would lead to government-funded abortions.

Tony Perkins of the Family Research Council says in a video, “Unless Congress states otherwise, under a government takeover of health care, taxpayers will be forced to fund abortions for the first time in over three decades.”

THE FACTS: The proposed bills would not undo the Hyde Amendment, which bars paying for abortions through Medicaid, the government insurance program for the poor. But a health care overhaul could create a government-run insurance program, or insurance “exchanges,” that would not involve Medicaid and whose abortion guidelines are not yet clear.

Obama recently told CBS that the nation should continue a tradition of “not financing abortions as part of government-funded health care.”

The House Energy and Commerce Committee amended the House bill Thursday to state that health insurance plans have the option of covering abortion, but no public money can be used to fund abortions. The bill says health plans in a new purchasing exchange would not be required to cover abortion but that each region of the country should have at least one plan that does.

Congressional action this fall will determine whether such language is in the final bill.

CLAIM: Americans won’t have to change doctors or insurance companies.

“If you like your plan and you like your doctor, you won’t have to do a thing,” Obama said on June 23. “You keep your plan; you keep your doctor.”

THE FACTS: The proposed legislation would not require people to drop their doctor or insurer. But some tax provisions, depending on how they are written, might make it cheaper for some employers to pay a fee to end their health coverage. Their workers presumably would move to a public insurance plan that might not include their current doctors.

CLAIM: The Democrats’ plans will lead to rationing, or the government determining which medical procedures a patient can have.

“Expanding government health programs will hasten the day that government rations medical care to seniors,” conservative writer Michael Cannon said in the Washington Times.

THE FACTS: Millions of Americans already face rationing, as insurance companies rule on procedures they will cover.

Denying coverage for certain procedures might increase under proposals to have a government-appointed agency identify medicines and procedures best suited for various conditions.

Obama says the goal is to identify the most effective and efficient medical practices, and to steer patients and providers to them. He recently told a forum: “We don’t want to ration by dictating to somebody, ‘OK, you know what? We don’t think that this senior should get a hip replacement.’ What we do want to be able to do is to provide information to that senior and to her doctor about, you know, this is the thing that is going to be most helpful to you in dealing with your condition.”

CLAIM: Overhauling health care will not expand the federal deficit over the long term.

Obama has pledged that “health insurance reform will not add to our deficit over the next decade, and I mean it.”

THE FACTS: Obama’s pledge does not apply to proposed spending of about $245 billion over the next decade to increase Medicare fees for doctors. The White House says the extra payment, designed to prevent a scheduled cut of about 21 percent in doctor fees, already was part of the administration’s policy.

Beyond that, the nonpartisan Congressional Budget Office said the House bill lacks mechanisms to bring health care costs under control. In response, the White House and Democratic lawmakers are talking about creating a powerful new board to root out waste in government health programs. But it’s unclear how that would work.

Budget experts also warn of accounting gimmicks that can mask true burdens on the deficit. The bipartisan Committee for a Responsible Federal Budget says they include back-loading the heaviest costs at the end of the 10-year period and beyond.

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