Healthcare's 15 mintues of debate fame: Spin, more than substance

Among the pods of debate in Denver last night, the issue of healthcare was every bit as fiery as the oft-considered more popular economy, jobs, and the widely-divisive role of government.

While short on tangible insights about either candidate’s vision particular to healthcare – GOP nominee Mitt Romney continued his “repeal and replace” mantra while President Obama looked to tout some of the law’s accomplishments – the night was filled with barbs, twists of fact and even half-truths that have already been fact-checked myriad times.

Even before the healthcare pod began, the candidates traded jabs as GOP nominee Mitt Romney referred to the Patient Protection and Affordable Care Act by the formerly derogatory “Obamacare,” then flashed Obama a glance while saying “Sorry, Mr. President,” to which Obama quipped “I like it.” 

[See also: Obama, Romney give NEJM glimpses of healthcare visions.]

Among the achievements Obama alluded to is the potential cost-savings within the Patient Protection and Affordable Care Act. “The fact of the matter is that, when Obamacare is fully implemented, we’re going to be in a position to show that costs are going down,” President Obama said. “And over the last two years, healthcare premiums have gone up, but they’ve gone up slower than any time in the last 50 years. So we’re already beginning to see progress.”

Perhaps unfortunately for the President, that argument seemed to go over much better for former President Bill Clinton when he made it at the Democratic National Convention.

“The growth in employer-sponsored family premiums has fluctuated in recent years. It went up just 4 percent from 2011 to 2012, according to an annual survey by the Kaiser Family Foundation, but it increased 9 percent the year before, a big jump from the mere 3 percent increase between 2009 and 2010,” wrote in Dubious Denver debate declarations. “Clearly the growth rate over the last two years isn’t a 50-year low – it was sitting around 5 percent from 2007 to 2009. However, the growth of healthcare costs is at a 50-year low for the past two years.”

Romney also spouted some questionable statistics, namely that $716 billon number again. The same one his vice-presidential running mate Paul Ryan has been publicly smacked down for using before the party conventions. This time, Politifact dubbed it a half-truth.

"That amount – $716 billion – refers to Obamacare's reductions in Medicare spending over 10 years, primarily paid to insurers and hospitals," PolitiFact wrote. "The statement gives the impression that the law takes money already allocated to Medicare away from current recipients."

And then there’s the death panel. Romney, avoiding the moniker “death panel” pressed the President on the Independent Payment Advisory Board (IPAB) without using that name, by saying the ACA “puts in place an unelected board that's going to tell people, ultimately, what kind of treatments they can have. I don't like that idea."

Obama countered that “the board cannot do that, it’s in the law.”

Citing a Kaiser Family Foundation analysis, pointed out that IPAB is limited to Medicare Advantage, the Part D prescription drug program and certain care settings that include ambulatory surgical, dialysis, durable medical equipment, home health, and skilled nursing.

[Related: What the political platforms tell us about parties' stances on health IT.]

Amid the fact-twisting by both candidates, Governor Romney did maintain that he would leave health reform to the states, and use a voucher system to provide seniors with a choice between Medicare and private insurance. President Obama responded that economists who have investigated the voucher system find it will lead to Medicare collapse, in time.

And he jabbed at Romney’s promise to repeal and replace. “He now says he’s going to replace Obamacare,” the President began. “Is the reason Governor Romney is keeping all these plans for repeal a secret because they’re too good? Is it because somehow middle class families are going to benefit from them too much?” 

Romney shot back that “my experience as governor is that if I come in and lay down a piece of legislation and say 'my way or the highway,’ I don't get a lot done.”

There’s little question that GOP nominee Mitt Romney walked off the stage a winner. Whether because of the expectations adjustment strategy the Romney campaign employed last week by suggesting that President Obama would emerge victor of the debates, or Romney simply outmaneuvered the President on the topics, a CBS InstaPoll on Wednesday night found that among uncommitted voters 46 percent viewed Romney as the winner, 22 percent think Obama won, and 32 percent call it a tie.

That’s overall, of course, not just on healthcare. But it does spark the question that CNN asked on Wednesday: Do U.S. presidential debates matter?

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