"Lies, damned lies, and statistics" is Mark Twain's oft-used sardonic advice on how to lie effectively.  Progressive Democrats have updated Twain's phrase with lies, damned lies, and health care promises.

The most recent example is Biden's self-contradictory titled bill, Inflation Reduction Act of 2022.  This will increase inflation and is primarily a health care expansion bill.  The bill promises to lower drug prices (true, but at a prohibitive cost), to stop any increases in drug prices (how do pharmaceutical companies cope with inflation?), and to extend ACA (Obamacare) subsidies set to expire.  The promises will be kept, strictly speaking, but the effects on Americans will be highly toxic, and Democrats know this.

Medicare will now negotiate drug prices, in reality dictating what it will pay.  This brings to mind a soldier with a handgun "negotiating" with a B-52 bomber, or a weekend camper "negotiating" with a hungry black bear.  Medicare can control and reduce drug prices, but price-fixing will suppress pharmaceutical research and development.  Net effect: cheaper drugs but fewer miracle drugs in the future.

The CBO says the Inflation Reduction Act will cost at least $740 billion, so Biden will have to print more dollars, further jacking up inflation, giving the lie to the title.  The bulk of spending will pay for extension of ACA insurance subsidies.  Pelosi, et al. hail this as benefiting those in need, but that is another highly deceptive promise.  The bulk of the enhanced subsidies will go to middle-class individuals who currently have private insurance but can save money by accepting these generous government handouts and canceling their private coverage.  Result: Medicaid will drive private insurers out of the market, and Americans will be left with — surprise! — single-payer.

The assurances given for the 2022 Inflation Reduction Act are a continuation of a "lies, damned lies, and health care promises" strategy Democrats have been deploying for more than 60 years, starting with Lyndon Johnson's Great Society addenda — Medicare and Medicaid — to the Social Security Act.  

Medicare was passed in 1965, promising to provide all the health care needs for retired persons over 65 years of age.  The original law imposed a payroll tax on every working American and placed the cash in virtual lockboxes with each contributor's name on them.  Sometime in the 1970s, Congress surreptitiously broke open the lockboxes, took the cash, and used it for other projects.  They replaced the money with IOUs, which could not be invested and therefore cannot grow over time.

Medicare trustees say the trust will run out of money — i.e., be insolvent — by 2026.  At that time, the promise of care for seniors will vanish like smoke on a windy day.

In the same year as Medicare (1965), Congress passed Medicaid, along with the fictional health care promise of all the care poor people need, for free, when they need it.

The bill approved the formation of fifty programs, each supposedly created and run solely by the individual states and funded jointly by state and Washington.  Section 1801 of the Medicaid law states: "Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided."  This is more than a promise — this is law prohibiting Washington from controlling Medicaid.  Yet CMS (the Centers for Medicare and Medicaid Services in Washington) makes all Medicaid decisions, both medical and fiscal.  Another false health care promise, AKA a lie — is exposed.

There are two more that are worse.

Democrats promise that Medicaid coverage will lead to timely, quality medical care.  Americans know otherwise.  More than 750 Illinoisans died waiting in line for medical care that wasn't available in time to save them.  Medicaid enrollees have worse medical as well as surgical outcomes than those with no insurance at all!  Adequate, timely care for Medicaid recipients is simply another "lie, damned lie, and health care promise."

No one mentions MERP (the Medicaid Estate Recovery Program), which allows states to claw back hundreds of thousands of dollars from the estates of deceased Medicaid recipients.  "Medicaid is free" is another bare-faced health care falsehood.

EMTALA (the Emergency Medical Transport and Active Labor Act of 1986), the anti-dumping law, promised to prevent transferring acutely ill uninsured patients to county hospitals.  It did not promise to create the uninsured mandate that cost American taxpayers hundreds of billions of dollars and dramatically increased insurance premiums, but that is what it did.

The most egregious promises were made for the Affordable Care Act, starting with the title word "care."  President Obama guaranteed Americans that his namesake bill would reform health care so Americans could get "all the care they need when they need it."  After the bill was signed, he quietly admitted that the bill would reform health insurance, not care at all.

To pay for the massive expansion of ACA bureaucracy, more than $700 billion was taken out of Medicare.  How does stripping the Medicare trust fund provide "all the care we need"?

The ACA's expansion of Medicaid eligibility came with a reduction in payments to Medicaid physicians.  Thus, more people would expect (and demand) medical care from fewer care providers.  Half the physicians in Texas no longer accept Medicaid insurance.  Wait times to see a physician increased to a medically unconscionable four months!  Twelve-year-old Deamonte Driver died from complications of a dental cavity because there were no local pediatric dentists willing to accept Medicaid enrollees.

The promise of timely, quality care with the Affordable Care Act is an outrageous, intentional health care lie.

There are numerous other examples of lies, damned lies, and health care promises.  There was HIPAA (the Health Insurance Portability and Accountability Act of 1996), which did not make insurance portable.  There was UMRA (the Unfunded Mandate Reform Act of 1995), which did nothing to reform the unfunded mandate.

Americans will continue to suffer from Democrats' health care promises, AKA overt falsehoods, as long as progressives control the levers of power, both political and administrative. 

Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine. 

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