Sunday, August 21, 2016

Universal health plans that aren't

From time to time we remind our readers that only the lack of time keeps us from finding many more examples of PolitiFact's bias and incompetence.

Here's one we missed from 2012, involving then-San Antonio Mayor Julian Castro:

As the captured image shows, Castro said Seven U.S. presidents had tried to expand health care to all Americans. PolitiFact rated the claim "Mostly True," but based on very questionable evidence.

Two U.S. presidents tried to provide health care for all Americans. A few others tried to expand the provision of health care to more Americans. In fact, PolitiFact used something like the latter wording to paraphrase Castro, perhaps reasoning that changing what Castro said would make the evidence stack up better in his favor (bold emphasis added):
President Barack Obama’s health care law has been one of the most polarizing aspects of his presidency, with Republicans criticizing it at every turn. But the keynote speaker at the Democratic National Convention in Charlotte, N.C., San Antonio Mayor Julian Castro, didn’t run from it. He applauded Obama for pursuing expanded health care -- and succeeding where his predecessors had failed.
Castro mentioned expanding health care to "all Americans," not the bar-lowering "expanded health care" offered by PolitiFact. By replacing Castro's actual words, PolitiFact avoided the embarrassment of admitting that Castro was wrong when he went on to say Obama succeeded in providing health care to "all Americans." The Affordable Care Act succeeded in growing the number of Americans who have some type of insurance--often Medicaid--but the ACA did not achieve universal coverage.

It takes universal coverage to bring health care to "all Americans."

Fact-checking is great, right?

The Ultimate List of non-Universal Universal Health Care Plans




Let’s start with the presidents who almost certainly fit Castro’s definition of having "tried to expand health care to all Americans."
 Oops. PolitiFact mentioned "all Americans" just like Castro did. That bodes ill for Castro.

We'll follow PolitiFact's lead in building the list in non-alphabetical and non-chronological order.

President Truman

Truman said Americans should have a right to medical care for which the government, either local, state or federal, should bear responsibility. But the plan he proposed would not have achieved universal coverage. It was a voluntary plan for workers. The poor would continue to receive various types of subsidized or charity care.

It's worth noting that PolitiFact's source list includes no link to Truman's plan. We've linked to Truman's description of his plan, which included federal assistance to build medical facilities all over the country to expand the availability of medical coverage. PolitiFact stuck with bare bones description from the Truman Library, which did nothing more than describe the voluntary national insurance fund Truman proposed.

How would Truman's plan "almost certainly fit Castro's definition of 'tried to expand health care to all Americans"? To us, sheer imagination seems like the key to counting Truman's plan as evidence supporting Castro's claim.

President Nixon

PolitiFact touts the 1974 Nixon plan that it says would cover "all, or nearly all, Americans." PolitiFact's fact-finding improved in that it included a link to Nixon's speech describing the plan. But we fault PolitiFact for omitting a key detail of the plan.

One of these three plans would be available to every American, but for everyone, participation in the program would be voluntary.
Give me a pair of the rose-colored glasses that allow a voluntary program to cover all Americans. Jacobson? Adair? C'mon, share!

How about the plan Nixon proposed in 1971? PolitiFact doesn't link to that one, but we'll take care of that.

The 1971 plan actually comes closer to universal coverage than the 1974 plan, though Nixon's description sketches it in terms of two health insurance plans. One was an employer mandate proposal requiring all employers to offer and help pay for insurance. The other was a plan for the unemployed. Nixon proposed no funding mechanism for the latter. Perhaps he envisioned the government picking up the tab.

What happens with people who lose their jobs but do not qualify for the second of Nixon's insurance plans? Nixon did not include that detail in his description. We're giving PolitiFact the benefit of the doubt if we call the 1971 proposal a universal health care plan. Nixon wrote in 1991 of his opposition to mandatory health insurance. Had he changed his mind by then?

President Clinton

PolitiFact says the proposed health care overhaul by President Clinton would have resulted in universal coverage.

PolitiFact failed to even link to a secondhand description of the Clinton plan in this case. But the Clinton plan was advertised as universal. Everybody would get a card that would guarantee health care according to mandated levels of care. The Clinton plan lives up to Castro's advertising.

PolitiFact called the above cases "the easy three." How low can they drop the bar?

President Johnson

Apparently PolitiFact can drop the bar quite a bit:
Technically, Johnson never sought full universal health care. But it seems churlish to deny inclusion on this list to the man who signed Medicare and Medicaid into law. They aren’t universal care for everybody, but they are universal care for large subsets of the population.

You can add a few more if you lower the bar a bit.
Consider what just happened. The fact checkers just told us that providing health care for a large subset of the population can count as universal coverage.

That better qualifies as dishonesty than as fact-checking. And PolitiFact wants to lower the bar more as we proceed down the list???

President Kennedy

PolitiFact counts John F. Kennedy because Kennedy supported the legislation that later became Medicare. The bar is so low now that PolitiFact has buried it.

President Ford

PolitiFact counts Gerald R. Ford in support of Castro's claim because Ford endorsed Nixon's 1974 non-universal universal health insurance plan. PolitiFact provides no evidence that Ford gave that endorsement after he assumed the presidency.

Our research shows Ford giving a nod to health insurance proposals made when he was vice president while prompting Congress toward some vague compromise measure:
As Vice President, I studied various proposals for better health care financing. I saw them coming closer together and urged my friends in the Congress and in the Administration to sit down and sweat out a sound compromise. The comprehensive health insurance plan goes a long ways toward providing early relief to people who are sick.

Why don't we write--and I ask this with the greatest spirit of cooperation-why don't we write a good health bill on the statute books in 1974, before this Congress adjourns?
It appears PolitiFact counts Ford's alleged endorsement of Nixon's non-universal 1974 plan as a presidential attempt to achieve universal medical coverage.

President Carter

Jimmy Carter's health reform proposal, as noted in the PolitiFact story, occurred late in his one term in office. It was not a proposal for universal health care but rather a reform Carter hoped would later lead to universal health care. Carter said as much himself:
A universal, comprehensive national health insurance program is one of the major unfinished items on America's social agenda. The National Health Plan I am proposing today creates both the framework and the momentum to reach that long-sought goal.
If non-universal health care plans count as universal then Carter's plan certainly qualifies.

PolitiFact goes on to suggest that Teddy Roosevelt, Franklin D. Roosevelt, Dwight D. Eisenhower and Ronald Reagan might earn inclusion "if you bend Castro’s definition even further."

What definition did Castro offer? Did Castro somehow define "all Americans" as "most Americans" or "many Americans" somewhere along the line?

Remember, Castro's claim specifies that seven presidents tried and failed to pass health care that would cover "all Americans." That serves as the basis for his contrast with Obama, who supposedly covered all Americans with the ACA. PolitiFact found evidence that two presidents at most tried to implement universal health care. Clinton definitely fills the bill, and Nixon's 1971 proposal might fill the bill. None of the others seem to fit the definition of "universal health care" provided by the World Health Organization.

A bizarre approach to the fact check

Indeed, why would PolitiFact fail to establish a definition and then expect Castro to stick to it? Instead we get useless hand-waving about expanding Castro's definition when Castro didn't define anything. Castro just said "all Americans" and PolitiFact happily counts Medicare and Medicaid as programs that only a churl would deny meet Castro's definition.That's a fairy tale, not a fact check.

Though PolitiFact gives its readers the impression that it relied on experts to develop its list, the fact check hides the basics of that process from readers. We do not know what definition the experts used.

If "all" means "all" and "universal" means "universal" then two presidents, at most, worked to legislate universal health care. Castro said the number of presidents was seven, and then compounded the untruth by suggesting that President Obama had succeeded in passing universal health care where his seven alleged predecessors had failed. And PolitiFact gave Castro a "Mostly True" rating.

A fact check that grades a statement without comparing it to a clear benchmark is a fraud.

That's what we have here. PolitiFraud.

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