Is the ‘Lie of the Year’ about ending Medicare actually true?

Apparently, politicians are prone to fibbing when they talk about healthcare. For the last three years, the “Lie of the Year” -- as determined by the fact-checking website PolitiFact -- has had something to do with the way Americans get their medical care.

* In 2009, the award went to the claim popularized by Sarah Palin that the Patient Protection and Affordable Care Act (perhaps better known as “Obamacare”) included “death panels” that would decide whether people were too old or too sick to be worth treating.

* In 2010, the award went to Republican strategist Frank Luntz and his advisees who called Obamacare a “government takeover of health care.”

* On Tuesday, the award for 2011 was given to Democrats for charging that a bill introduced by Republican Congressman Paul Ryan of Wisconsin in April would “end Medicare,” the government-sponsored health insurance program for seniors.

The selection quickly drew fire from the left. The complaint? The statement that Ryan’s bill would “end Medicare” was actually true.

As Nobel Prize-winning economist Paul Krugman put it on his blog, the Conscience of a Liberal:

Republicans voted to replace Medicare with a voucher system to buy private insurance — and not just that, a voucher system in which the value of the vouchers would systematically lag the cost of health care, so that there was no guarantee that seniors would even be able to afford private insurance.

The new scheme would still be called “Medicare,” but it would bear little resemblance to the current system, which guarantees essential care to all seniors.

How is this not an end to Medicare?

Over at Mother Jones, Kevin Drum writes:

Should PolitiFact have chosen this as its Lie of the Year? Not a chance. Ryan’s plan was an existential change to the current program, which guarantees essentially unlimited medical coverage to all seniors in return for a nominal annual premium. Ryan’s plan doesn’t, and describing that as an entirely different kind of program is perfectly legitimate.

On Slate, Matthew Yglesias acknowledged PolitiFact’s point that Ryan’s legislation wouldn’t have affected people who already use Medicare or those on track to join the system over the next decade. But that doesn’t mean the Democrats were lying:

It’s true that when Democrats said that Paul Ryan’s plan is a plan to end Medicare they didn’t emphasize the fact that it’s a plan to begin ending Medicare ten years in the future. But plans to end Medicare starting ten years from now are a subset of plans to end Medicare.

Some bloggers, including Jonathan Chait at New York magazine and Ezra Klein of the Washington Post, have pointed out that whether the Ryan bill would have “ended Medicare” or not isn’t even a factual question – determining what qualifies as “ending Medicare” is a matter of opinion. As Chait writes:

The plan would turn a single-payer system into vouchers for private insurance, and the value of those vouchers would fall steadily behind the cost of that insurance, so that within a relatively short time it would cover only a small fraction of the cost of insurance.

Is that “ending Medicare?” Well, it’s a matter of opinion. At some point, a change is dramatic enough that it is clearly ending the program. If you proposed to replace Medicare with a plan to give everybody two free aspirinon their 65th birthday, I would hope Politfact would concede that this would be “ending Medicare,” even if you call the free aspirin “Medicare.” On the other hand, small tweaks could not accurately be called “ending Medicare.” Between those two extremes, you have gray areas where you can’t really say with certainty whether a change is radical enough to constitute ending Medicare.

Does the Republican plan indeed end Medicare? I would argue yes. But it’s obviously a question of interpretation, not fact.

Over at PolitiFact, Editor Bill Adair defends the decision to give the Lie of the Year award to Democrats because they “ignored the fact that people 55 and older would remain on traditional Medicare and that even with the privatized system under Ryan’s bill, younger people would still receive a guarantee of care.” In the original post announcing the selection, Adair and Angie Drobnic Holan explain that Democrats have a long history of trying to scare seniors by telling them their beloved entitlement programs are under threat. Here’s an excerpt:

Kathleen Hall Jamieson, an expert on campaign advertising who directs the Annenberg center at the University of Pennsylvania, says Democrats have been using falsehoods and exaggerations about Medicare and Social Security since at least 1952. She calls it the longest-running “Democratic deception.”

It fits with a core theme from Democrats that they will use government to protect seniors and needy people, while Republicans supposedly want to cut those programs, she says. It is a scare tactic that works.

“If you’re reliant on Medicare, a suggestion your benefits are going to be cut in any way is a direct, visceral threat,” said Jamieson.

You can read on and decide for yourself whether the Democrats or PolitiFact is telling the truth.

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