Kinsley rations the data: Is human life what Homer imaginedjust a practical joke of the gods? Michael Kinsleys column today raises that age-old question.
Kinsley starts with a very good question: Can we make American health care less costly? As he starts, he seems to say yes. Yes, we actually can:
KINSLEY (6/26/09): The Obama administration believes that health care can be made cheaper without any reduction in quality. It has evidence to back this up. According to the famous Dartmouth studies, health care costs two or three times as much per person in some places in America as it does in others, with no measurable difference in results. Atul Gawande's deservedly admired recent essay in the New Yorker makes a similar point. So in theory it's easy: Just figure out how the cheap places do it and apply this knowledge to bring down the cost in the pricier places.
But quickly, Kinsley moves to a rather odd placea rather odd place for a liberal/progressive, which is the role in which hes still cast in our alleged public discourse. Simply put, Kinsley says rationing as much as he can; he says rationing over and over. (Headline: Health Care Faces the R Word.) And he doesnt make much sense when he doesespecially for a liberal/progressive whos supposed to be very smart. Before long, the columnistor the toy of the godsis suggesting that, under Obamas reforms, wealthy people may be barred from buying the health care they want:
KINSLEY: It may seem absurd to worry about whether wealthy or well-insured people get every last test and exotic or speculative treatment when millions of Americans have no health insurance and millions more have gaping holes in their coverage. But the well-insured happen to include virtually all the people making the key decisions about health-care reformmembers of Congress and their staffs, the White House staff, Washington journalists, and so on. These people's fears that they would lose the right to "choose my own doctor" (code for getting treatment with all the bells and whistles) helped kill Hillary Clinton's attempt to reform health care in the early 1990s. Fear of rationing could kill Obamacare for the same reason.
But hold on! Does Obamacare, in any way, mean that wealthy peoplethose Washington journalistswould be barred from getting treatment with all the bells and whistles? Kinsley never says it doesbut then, he never says it doesnt! Like a tool of some corporate god, he simply spreads this insinuation through this mornings column. By the time hes done, hes even citing that rationing blather from last weeks New York Times. And hes quoting Mickey Kaus with a true-but-irrelevant thought:
KINSLEY: David Leonhardt of the New York Times recently noted that spending so much on health care squeezes out spending on other things that we might prefer, and that is a form of rationing. On the other hand, the blogger Mickey Kaus argues that it makes perfect sense for a society growing richer (as ours soon will be again, we hope) to spend a growing share of that wealth on improving our health and longevity.
Leonhardts right! That really is a form of rationingin much the way a planet like Mars is really a form of a golf ball. (Everythings a form of everythingif we just stretch the language enough.) And Kinsley approvingly cites Kaus picture, in which our society decides to spend more for its health care. But its funny, aint it? In the course of all this bullshit, Kinsley never quite mentions this:
United States: $5711
United Kingdom: $2317
Thats how much money a bunch of developed nations spent per person on health care in 2003. For additional numbers, see THE DAILY HOWLER, 6/18/09.
Funny, aint it? Kinsley is asking if the United States could possibly spend less money on health care. He mentioned those famous Dartmouth studiesstudies which involve health care costs in this country alone. But he forgot to mention these remarkable figures from those foreign lands!
Is your life a joke of the gods? Thats what Homer thought.
Kinsley of course is no average bright boy. More than a decade ago, he was purchased by Bill Gates and relocated to Seattle. This was at the time when Gates was deciding, for purely philanthropical reasons, to get involved in the news business. He hired Kinsley to edit Slate (AKA, the Washington Post West). He teamed with Jack Welch to invent MSNBCnews as the billionaires see it.
Today, Kinsley is still cast as the very-smart liberal in the drama we describe as a national discourse. But its weird, aint it? When he writes a column on health care costs, he keeps saying rationing/rationing/rationing; he even suggests that Obamacare will somehow keep wealthy people from purchasing upper-end health care. And sure enough! He forgets to mention those remarkable international numbersnumbers which always seem to disappear from our mainstream health care debate.
Looking at those remarkable numbers, any damn fool would wonder where all those extra dollars are going. Any damn fool would start to think this: Of course we can do this for less!
Alas! It seems to be much as weve told you: We arent allowed to think about those remarkable numbers here in this country. Our lives may not be a joke of the gods. Increasingly, though, it seems that our lives are a practical joke of the bosses.
So wrote Paul Krugman, in this post from last Sunday, referring to health care reform. We assume the truth of that assessment. For that reason, weve been more struck each passing day by the managed nature of our public discussion of health care.
How do other countries do it? What really goes on in England or France when it comes to health care? In Sicko, Michael Moore offered a funny, intriguing introduction to this fundamental question. We thought it was as good an opening argument as weve seen, on any question.
And of course, thats right where the matter died. (Except for Sanjay Guptas embarrassing attempt to contradict factual statements by Moore.) Weve never see a big newspaper or a major journal offer an expert view of such questions. Our current attempts at health care reform seem to be hopelessly complex. How have they done it in other countriescountries which spend much less than we do, but seem to have better outcomes?
In this country, you cant find out! To all appearances, we have a thoroughly managed discussion. Consider this contrast, for instance:
The American press has no general instinct against international comparisons. In international educational assessments, the United States tends to score around the middle among developed nations. But these comparisons are constantly hyped in the press. Typically, journalists are quite upset that we dont rank right at the top.
Compare that to the treatment of international comparisons concerning health care:
When it comes to health care costs, the US is the absolute, off-the-charts, worst-in-show. And yet, those thoroughly remarkable international comparisons are constantly ignored in the press. No one asks why our costs are so highor even shows the public the numbers. No one profiles other countries, explaining how they manage to run their systems at half the cost.
By the force of some invisible hand, you are simply not allowed to think about such questions. Two things seem remarkable here: First, the fact that our discourse can be so thoroughly managed. Second, the fact that no one seems to notice.
Back to Krugman. Weve never quite understood what lies behind the claim that countries like Italy and France have better health care systems than ours. (As the World Health Organization judged in 2000, for example.) In Sundays post, Krugman seemed to say that these other countries dont really have better health outcomes. He seems to say their health outcomes are similar to oursat roughly half the cost:
KRUGMAN (6/21/09): Not many serious advocates of reform use the life expectancy differences to argue that health care is clearly better in other advanced countries than it is in the United States; when it comes to care, the general assessment seems to be that its comparable, with no advanced country having a clear advantage. The reform argument actually goes like this:
- Every other advanced country has universal coverage, protecting its citizens from the financial risks of uninsurance as well as ensuring that everyone gets basic care.
- They do this while spending far less on health care than we do.
- Yet they dont seem to do worse in overall health results.
When it comes to care, the general assessment seems to be that...no advanced country ha[s] a clear advantage. Other countries dont seem to do worse [than the U.S. does] in overall health results. (The other countries all have full coverage, of course. Thats different from overall outcomes.)
Is that the general assessment? Our outcomes are similar to those of the Euro tigersbut were spending twice as much? Amazingly, we dont really know. The blackout on discussing this issue has long been quite pervasive. (Krugman has been an exception, of course.)
Final note: We understand why pols might defer to industry. Why do big newspapers clam?
Were all Ceci Connolly now: Well, not quite. No one has ever displayed as much skill at misleading us rubes as Connolly did in Campaign 2000, during the twenty months when she covered Gore for the Washington Post.
No one has ever been quite so skilled. But on Tuesday night, Connolly might have said, Heynot bad! If she watched Our Own Rhodes Scholar offer some stage-managed bull-roar.
The question: Had Obama toughened his rhetoric toward Iran at that days press conference? Everyone was saying he hadeveryone but Obama himself, and Our Own Rhodes Scholar. She played tape of Obama giving rhetorical wedgies to a pair of reporters (Todd and Garrett). Then, she stated her premise:
MADDOW (6/23/09): Wow! The president at his press conference today giving rhetorical wedgies to reporters who asked what he plainly thought were ill-informed or off-base questions about his position on Iran.
In addition to the questions on Iran, the president led todays press conference with a lengthy statement about the uprising in Iran that didnt necessarily go further than anything he had said previously. But it did inexplicably, nevertheless, earn him headlines and questions from reporters that implied that he had gone significantly further.
It was inexplicable, Our Scholar said. Reporters implied that Obama had gone significantly further than beforeeven though his opening statement didnt necessarily go further than anything he had said previously.
Didnt necessarily go further. Thats slick, Ceci might well have said.
At any rate, Our Own Rhodes Scholar now began to prove her point. She played tape of what Obama had said. She then said little had changed:
MADDOW (continuing directly): Heres some of what he said today:
OBAMA (videotape): Ive made it clear that the United States respects the sovereignty of the Islamic Republic of Iran and is not interfering with Iran`s affairs. But we must also bear witness to the courage and the dignity of the Iranian people and to a remarkable opening within Iranian society. And we deplore the violence against innocent civilians anywhere that it takes place.
The Iranian people have a universal right to assembly and free speech. If the Iranian government seeks the respect of the international community, they must respect those rights and heed the will of its own people.
MADDOW: That was a statement being billed everywhere as a dramatic escalation of the presidents stance on Iran. Except, when you look back at his previous statements, he was saying pretty much the same thing even more than a week ago.
Too funny! That was indeed just some of what Obama had said that morning. In fact, those were the second and seventh paragraphs of the presidents opening statement. But uh-oh! The alleged escalation of Obamas language had largely occurred in his first paragraph! This is the actual way he opened that mornings press conference. The highlighted paragraph represents the start of his prepared statement:
OBAMA (6/23/09): Hello, everybody. Good afternoon, everybody. Today I want to start by addressing three issues, and then I'll take your questions. First, I'd like to say a few words about the situation in Iran:
The United States and the international community have been appalled and outraged by the threats, the beatings and imprisonments of the last few days. I strongly condemn these unjust actions, and I join with the American people in mourning each and every innocent life that is lost.
I've made it clear that the United States respects the sovereignty of the Islamic Republic of Iran and is not interfering with Iran's affairs. But we must also bear witness to the courage and the dignity of the Iranian people and to a remarkable opening within Iranian society. And we deplore the violence against innocent civilians anywhere that it takes place.
Obamas alleged escalation had largely occurred in that highlighted paragraph. He said the United States was appalled and outraged by Irans conduct in recent days. He said the United States strongly condemned such unjust actions.
Did Obama escalate? Wed say that he didand theres no reason why he shouldnt have. But whatever your own judgment might be, the alleged escalation largely came in the opening paragraph of his prepared statement. Result? Our Own Rhodes Scholar omitted that paragraph when she showed what Obama had said! She fed us rubes his second paragraphthen played tape of earlier statements where hed said similar things.
The press corps judgment was inexplicable, she said. And sure enough! By the time she finished her air-brushing, her statement was pretty much true.
Ceci would have known what to dobut then, so did Our Own Rhodes Scholar! In our view, this sort of thing often occurs at the news network GE has built.
One distinction: Its clear that Connolly typically worked from design. Well guess that Maddows presentation might largely represent inept staff work. Remember: The brains behind this channel, Bill Wolff, got his preparation running sports programs for Fox.
EZRA SI, FROOMKIN NO: Our analysts cried and covered their eyes as they read Professor Rosens interview (see THE DAILY HOWLER, 6/23/09). But hold on there, we admonished the youngsters. Glenn asks a very good question at one point. Why is Dan Froomkin gone from the Post when they employ other liberals?
GREENWALD (6/19/09): Let me ask you this: I imagine if Fred Hiatt were here, he would make the following defense, adopt the following response, which isand he's already said this actually in his very vapid and meaningless form statement: Oh, no, our firing of Froomkin had nothing to do with his political views, and in fact the proof of thathe didn't say this, but I'll make this argument for himis that we have plenty of liberals at the Washington Post, we have Eugene Robinson, and E.J. Dionne and we just hired Ezra Klein as a Washington Post blogger. They hired Greg Sargent away from TPM. So what is it about Froomkin that, in your view, made him intolerable to Fred Hiatt whereas those other individuals I just named at least as of yet are still there?
ROSEN: Because he's not a liberal columnist. That was a complete lie, a description that sticks to him by Harris, the national staff, and ultimately by Fred Hiatt. He's an accountability journalist who practices his craft at the level that the Web makes possible.
Greenwald asked a perfectly decent question: Why did Froomkin get dumped at the Post, even as the paper was hiring other liberals, like Ezra and Greg?
We have been telling you this for years. Year after year after year.
This brings us around to the recent hiring of Ezra Klein, a smart young liberal who just may know how to keep his big trap shut. (Froomkin doesnt do that.)
A few years ago, Ezra broke all the rules! Behaving much like Froomkin himself, he actually wrote something highly importantand perfectly accurateabout the mainstream press corps.
By now, what Ezra wrote that day has become a part of history. But when he wrote it, it was still extremely relevant to an upcoming White House campaign. And omigod! He even wrote it right at the start of an American Prospect cover story! (To read Ezras piece, just click this.)
In his cover story, Ezra was trying to figure out if Gore might run for the White House again, in 2008. As he started, he described a recent speech by Gore. We told you then what we tell you today. By the rules of the Washington mainstream press, this simply cannot be done (see THE DAILY HOWLER, 4/21/06):
KLEIN (4/06): The address was the keynote for the We Media conference, held at the Associated Press headquarters in New York last October and attended by an audience that included both old media luminaries and new media innovators. In attendance were Tom Curley, president of the AP, Andrew Heyward, president of CBS News, and New York Times columnist Nicholas Kristof, all leading lights of a media establishment that, five years earlier, had deputized itself judge, jury, and executioner for Gores 2000 presidential campaign, spinning each days events to portray the stolid, capable vice president as a wild exaggerator, ideological chameleon, and total, unforgivable bore.
Good God. Hed broken the largest rule in the book! Right at the start of a Prospect cover story, he accurately described what the media establishment did in Campaign 2000! He even named three famous news orgs! We dont know why he picked the three he did; NBC News, and the Washington Post, had been much more culpable. But name three orgs he did.
Every establishment journalist knows it: This simply isnt allowed. Youre not allowed to tell the truth about what the coven has done.
Ezra was just a kid in those days; he may not have understood. At any rate, we yodeled and yelled about what he had done, praising him for his bad etiquette. And you may recall what happened next. Ezra went on C-Spans Washington Journal to discuss his cover story. And sure enough! He didnt say a freaking word about the way his story began.
Ezras statement was perfectly accurate. It was also highly relevant to any possible run by Gore. (At the time, we said Gore almost surely wouldnt run, precisely because of what Erza described.) But Ezras statement was also highly relevant to a run by Hillary Clinton. If she had become the Dem nominee, she would quite likely have faced the same treatment Gore got in Campaign 2000.
Voters deserved to be told about that. But so what? On C-Span, Ezra didnt repeat what hed saidand he never discussed it again.
Go ahead: Reread what he wrote. In a rational world, is that remarkable statement the sort of thing a person says just once?
In our novel, heres what had happened: Someone took this bright kid aside and told him he was crazy. You cant write things like that, they said, if you want to advance in this press corps!
That what happens in our novel. It may not have happened in real life. But why is Ezra at the Post? This is what it says in our novel: Ever since making that rookie mistake, hes kept his big trap shut.
Liberals get to write about policy. They arent allowed to tell the truth about the mainstream press corps conduct. Dionne and Robinson know that rule. They know they must never disrespect it.
Froomkin never played by that rule. Today, hes on the street.
In our novel, thats why Froomkin is gone. Unlike the good professor from Neptune, we wont huff and puff and thunder and roar and assert that we actually know that.