From the debunked "death panels" rumor over the summer to a politician's prediction of "Armageddon," overstated or outright false statements about the impact of reform are drowning out legitimate concerns over changes in the nation's health care system, some local health industry leaders worry.
Supporters of reform also have exaggerated claims during the epic year-long debate, said Brooks Jackson, director of FactCheck.org, a project of the Annenberg Public Policy Center.
"This is the most-lied about piece of legislation I've ever seen," he said.
Below, the Times Free Press explores the validity of a few claims about reform, some rooted in reality and some that are unsubstantiated.
Claim: The reform bill reduces the federal deficit.
Calculations by the Congressional Budget Office have found that the health reform package cuts the federal deficit over the next 10 years, meaning new revenues will more than offset new spending. However, those estimates are based on the assumption that the provisions in the bill will hold up over time, which is not necessarily -- or likely -- the case, some in the medical field say.
"If those assumptions are wrong, then their predictions are going to be wrong," said Dr. B.W. Ruffner, president-elect of the Tennessee Medical Association.
For one, the bill assumes a scheduled 21 percent cut to physicians' Medicare payments will go through. Doctors believe that cut almost certainly will be delayed or canceled, as have similar cuts in the past. That would add an estimated $210 billion in Medicare spending over 10 years, according to the CBO.
Additionally, other major provisions of reform counted upon for savings or revenues don't go into effect for years, such as taxes on so-called "Cadillac" insurance plans planned to take effect in 2018. If eight years from now Congress doesn't want to implement politically unpopular reforms, those expected revenues won't ever materialize.
Claim: Reform will result in a surge of taxpayer-funded abortions.
Supporters of reform, including pro-life Democrats, maintain that taxpayer dollars will not be used to fund abortion. The president has issued an executive memo that affirms that reform will not change the status-quo on abortion. (Federal regulations already prohibit federal funding of abortions except in the case of rape, incest or danger to the life of the mother.) Under reform, no health plan would have to offer abortion coverage, and those that do cover abortion would have to be paid for separately by policyholders into an account kept isolated from public money, the Associated Press reported.
Still, some remain opposed due to the fact that people who receive federal subsidies even will have the option of purchasing an insurance plan that covers abortion.
Some fear if women have access to abortion coverage, the abortion rate will increase, but statistics don't back up that claim. United Nations data show that countries such as Britain and Germany with universal health care have lower abortion rates than the United States, the Washington Post reported. A recent New England Journal of Medicine study found that the abortion rate declined in Massachusetts after the start of a universal health care program in 2007.
Health care means better access to contraception and fewer unwanted pregnancies, resulting in fewer abortions, said Mary Alice Carr, spokeswoman for the National Institute for Reproductive Health in New York. Also, when women feel they'll have access to prenatal and post-natal care, they are more inclined to carry a pregnancy to term, she said.
Claim: Health care reform is a "government takeover" of the health care industry.
To the disappointment of some progressive Democrats, the health care reform legislation did not include the controversial public option, a government-supported health plan that had been promoted as a means to add competition in the private health insurance marketplace. Critics had said the public plan would run private insurers out of the marketplace, leaving only the public program for consumers.
The final legislation does create a health insurance exchange, or marketplace, in which individuals and small businesses can choose from a variety of private insurance plans. The government will require that those private plans in the exchange offer at least a minimum set of benefits.
"The idea that the government is taking over health care is simply not true," said Dr. Vince Viscomi, a local pulmonologist opposed to the legislation that has passed Congress.
Still, he said, there are valid concerns about how an exchange regulated by the government could undermine the free market system. And some are concerned that an Independent Payment Advisory Board, tasked with coming up with ways to reduce costs in Medicare, could result in incremental changes to what is covered under Medicare, which could influence the private insurance market's coverage decisions.
"It's a logical extension," Dr. Ruffner said. "The pressure on both Medicare and the private insurers to bend the (cost) curve is going to get worse and worse."
Claim: Medicare enrollees will lose their benefits.
Reform largely is paid for by massive reductions in future spending in Medicare. Advocates for the elderly, including the AARP and Medicare Rights Center, maintain that Medicare enrollees will not be harmed by the planned reductions, which aim to cut down on waste and fraud in the program and will reduce payments to hospitals and other providers.
The bill does impose significant reductions in payments to private Medicare Advantage plans -- an alternative to traditional Medicare that costs the government 14 percent more than traditional Medicare -- which could result in some cuts to benefits for enrollees in those plans, who account for about a quarter of Medicare recipients.
Others predict that as health care costs continue to rise, and if anticipated savings from waste and fraud reductions don't pan out, Medicare inevitably will have to reduce benefits to remain solvent.