Commentary: Ryan VP nod re-opens spigot of healthcare lies, half-truths

If you were tired of the lies, half-truths and fear-mongering that has pervaded the health reform debate for the past three years, well strap on your hip waders, because it's about to get deep.

A funny thing happened on the way to a presidential campaign that promised to focus on jobs, taxes and the economy: Mitt Romney picked Paul Ryan to be his running mate. In one deft move, Camp Romney brought healthcare and Ryan's 2011 bill to radically alter the structure of Medicare back into focus for the duration of the campaign.

"I think Governor Romney chose Ryan despite his Medicare plan and not because of it," said Robert Blendon, a professor of health policy and political analysis with the Harvard School of Public Health. "Because right away (the Romney campaign) has to spend the first days after the announcement running around Florida and Iowa convincing people he is supportive of Medicare."

Almost on cue, in order to divert attention from the Ryan Medicare plan, Romney trotted out this lie to paint President Obama as an enemy of Medicare: "(Obama) has taken $716 billion out of the Medicare Trust Fund to pay for Obamacare."

Obama's deputy campaign manager Stephanie Cutler took the Romney campaign to task for that statement, as well as other false contentions that seniors' health benefits will be reduced by that same $700 billion-plus, noting the figure represents savings over the course of 10 years based on reduced payments for private insurers' Medicare Advantage plans and reduced reimbursement rates to hospitals.

Cutler also pointed out that the $700 billion in savings attacked by Romney on the stump were the same $700 billion in savings contained in Paul Ryan's Medicare plan, according to the non-partisan political fact checking site PolitiFact.org.

While her statements refuting Romney were spot on, Cutler has also ventured to the other side of truth and repeated PolitiFact's 2011, "Lie of the Year" when she stated on CBS' Face the Nation that: "It says something about Mitt Romney that he chose someone who has a budget that would be the end of Medicare as we know it."

In fact, the Ryan Medicare plan, which was also co-written by Senate Democrat Ron Wyden, won't affect current seniors, or even working people who are 10 years or less from retirement.

Medicare lies have legs
Regardless of the truth, Blendon thinks this particular lie may have legs with the electorate. "Seniors are distrustful and concerned about preserving two things: Social Security and Medicare," he noted. "The thing is, for most seniors they think it is affecting them. People who have retired have gotten scared and they begin to think that if Medicare will change for younger people, what's to stop (politicians) from changing it for them sooner?"

It's likely the focus for healthcare will remain on Medicare for the candidates until Election Day, since the senior population turns out in far higher numbers for elections and because their motivation to vote is tied strongly to preserving Medicare.

It is equally likely that the lies and negative ads around Medicare will continue. According to Joe Urbany, a marketing professor with the Mendoza College of Business at the University of Notre Dame who has researched negative ads during campaigns, the simple reason candidates continue these tactics is because they work.

"When negatives are raised, it is attention getting and influential," Urbany said. "People who are in favor a particular candidate will be defensive and will counter-argue the point, but there are a few folks in the middle who have the potential to be swayed."

Further, he noted, the candidates themselves don't take much of a hit to their reputation among the voters they are attempting to sway since "the way we perceive people is that there is a general focus on the positive  -  a default assumption that we look at people's positives."

While he doesn't have data to confirm this, Urbany said he perceives that this election cycle may be different than past elections in terms of the charges and counter-charges of lying.

Media role in charged atmosphere
If lying in the campaign is indeed more prevalent today than it has been in the past, it may have the media to blame, according to Mother Jones blogger Kevin Drum.

As he sees it, lying has always been more prevalent in local elections where candidates could lie and reasonably expect not to be called out by local media. He argues that the splintering of the national media and the rising importance of blogs and social media has effectively made national politics local.

"Politicians have increasingly discovered over the past couple of decades that even on a national stage you can lie pretty blatantly and pay no price since the mainstream media, trapped in its culture of objectivity, won't really call you on it, limiting themselves to fact checking pieces...." Drum writes. "And because virtually nobody except political junkies ever sees this stuff, it doesn't hurt their campaigns at all."

With that as the political landscape leading up to November and as the candidates scramble for the undecided voters, the lies and negative messages delivered will become simpler and not delve into the nuances and truths of each candidate's healthcare plans.

"People who are undecided and moveable are often people who are less likely to follow policy decisions. So if you are going to reach them, it is pretty basic stuff: this is a bad thing to do, this is a good thing to do," Blendon said.

"For people who are experts this is very frustrating, because you would like a debate around the issues and there should be honest debate about it," he added.

And it seems, this year anyway, hoping for honesty in the healthcare debate is about as likely as getting Republicans and Democrats to agree on whether those not buying health insurance in 2014 will pay a tax or a fine.

Editor's Note: This commentary is part of Political Malpractice, a joint project of MedTech Media's publications, including Healthcare IT News, Healthcare Finance News and Government Health IT, that explores the issue of healthcare in the 2012 election season.