Five myths of health care

Fictions don’t become facts through repetition.

Keep that in mind next time you hear a politician breathlessly decry the horrors of the American health-care system and then explain how he intends to fix it. Some of the most popular talking points in the health-care debate pass as the gospel truth simply because, well, they’re popular — not because they’re true.

Below, I debunk the five most prominent health-care myths:

(1) Forty-seven million Americans do not have health insurance.

This figure comes from the U.S. Census Bureau. What most people don’t know, however, is that the Bureau counts anyone who went without health insurance during any part of the previous year as “uninsured.” So if you weren’t covered for just one day in 2007, you’re one of the 47 million.

That also includes 10.2 million illegal immigrants, and about 14 million people who are eligible for public health-care programs like Medicaid or the State Children’s Health Insurance Program but have yet to enroll. And nearly 10 million of the “uninsured” have household incomes of more than $75,000 — so they can probably afford to buy health insurance but choose not to.

(2) Universal health-care coverage can be achieved via “individual mandate.”

According to the federal census, nearly two-thirds of the uninsured are aged 18 to 34. This makes sense — healthy people aren’t going to pay for expensive insurance they’ll never use.

Those who support an “individual mandate” — like Sen. Hillary Clinton and several governors — believe by legally requiring all Americans to buy health insurance the young and the healthy will increase the size of the risk pool and therefore lower premiums for everyone. As a way to enforce an individual mandate, Mrs. Clinton has suggested garnishing wages.

But many states require insurers to charge everyone the same rate. So young people would end up paying far more in premiums than they should — or could — pay. It’s patently unfair to force people to purchase insurance they can’t afford. Even in Massachusetts, which offers substantial premium subsidies for low-income residents, the government had to exempt a fifth of Bay Staters from the individual mandate because insurance was still so expensive. And, the plan is already $147 million over budget.

The real way to attract young adults into the insurance market is to lower premiums — not to impose draconian sanctions. This can be done by having states reduce costly mandates like coverage of in-vitro fertilization and by allowing people to buy insurance across state lines.

(3) Expensive prescription drugs are a big reason health-care costs increase.

The real price of prescription drugs is actually decreasing. In 2007, inflation rose more than 4 percent, while drug prices increased just 1 percent. So in real terms, drugs were 3 percent cheaper last year than in 2006, on average.

What’s more, drug spending is but a small slice of total health-care spending — less than 11 cents out of every health-care dollar goes to prescription meds.

And drugs actually reduce health-care costs in the long-term. Medicare, for instance, saves $2.06 for every additional dollar it spends on pharmaceutical drugs, according to a paper recently published by the National Bureau for Economic Research. Prescription drugs often obviate the need for expensive surgeries and hospital stays.

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