Maybe Albert Brooks knows how much they spend: When people die and go to heaven, are their friends awaiting them there—laughing at them for failing to see that human life was a practical joke?

We call this the Albert Brooks Hypothesis (Defending Your Life). Occasionally, this possibility crosses our mind rather strongly, so absurd are events around us. And uh-oh! Yesterday, this feeling seized us, when we perused this puzzling post about health care spending. At Salon.

“Healthcare, American style,” said the headline. “We spend far more per person than other wealthy nations, but we're less healthy. What's wrong with this picture?”

It sounded good—and it sounded important. People need to understand the mammoth size of our spending. (Reasons cited below.) But when we clicked, we saw “what was wrong with the picture” Salon had offered. And we thought about Albert Brooks.

What was wrong with that picture? Bizarrely, this was Salon’s idea of the way to help us see how much more the United States spends. Can you see what’s odd about this list? Can it be that this life is a joke?

SALON (9/8/09):
National per capita spending on healthcare, 2007
United States: $7,290
Norway: $4,763
Switzerland: $4,417
Luxembourg: $4,162
Canada: $3,895
Austria: $3,761
France: $3,601
Germany: $3,588
Netherlands: $3,527
Belgium: $3,462
OECD average: $2,964

You can probably see why that presentation was so ill-advised—so odd.

(Our advice: Cut the author a minor break here. That headline/synopsis doesn’t fit his overall presentation real well.)

In an effort to show us how much more we spend, Salon compares our spending figures to those of other nations. But weirdly, it only includes those developed nations whose spending is closest to ours! Tiny, big-spending Luxembourg makes the cut. Big, low-spending Great Britain does not! If we’re trying to help people understand how much more the United States spends, wouldn’t the following list make more sense? This list includes the large nations to which we’re most commonly—and most sensibly—compared:

Total spending on health care, per person, 2007
United States: $7290
Canada: $3895
France: $3601
Germany: $3588
United Kingdom: $2992
Italy: $2686
Spain: $2671
Japan: $2581 (2006)

If you were trying to help voters understand how much more we spend, why would you omit those last four countries? For the record, Italy and Spain were ranked very highly in the famous WHO list of the world’s health systems. Click here.

Why did Salon present that list? Jesus Christ, people! With five million people, Norway was in. With 61 million, the UK was out! Routinely, it’s stunning to see the way we liberals try to explain our most basic political topics.

Is human life a practical joke? If the thought has never crossed your mind, you may not be paying attention.

The egghead’s tale: Is human life a practical joke? In yesterday’s Washington Post, Matt Miller wrote an op-ed column arguing that the “public option” shouldn’t be a deal-breaker. Whatever you may think of that view, Miller explained—or failed to explain—a very important point in the course of this column.

At one point, Miller explained that the Netherlands provides full health coverage at a much lower cost than we do, achieving better outcomes in the process. That’s a very important point; Americans will never rebel against current looting until they digest such startling facts. But good God. This is the way Miller explained this very important point:

MILLER (9/8/09): The first fallacy of the "public option or nothing" mantra is the notion that we'll never cover everyone without a Medicare-style program for Americans under 65. The experiences of Switzerland and the Netherlands prove that this isn't the case. Both have pioneered market-based universal health care. Both cover all their citizens using private insurers, and they do so for much less cost—10 percent of gross domestic product for the Dutch and 12 percent for Switzerland, compared with 17 percent in the United States, where nearly 50 million people are still uninsured.

Those countries also boast better health outcomes than we do, even when compared to states with similar demographics, such as Connecticut and Massachusetts.

Just shoot us! As the eggheads love to do, Miller dragged out the old “health care spending as a percentage of gross domestic product” statistic. Presumably, that statistic is useful in some contexts. (Though we’ll guess that such contexts are few.) But if you’re writing for general readers, that’s an utterly jug-headed way to compare these countries’ health spending.

Aarrgh. Use of that murky, egghead statistic only encourages typical readers to skip ahead murkily to the next point. It also disguises the degree of difference in national spending! If you wanted to establish Miller’s point, why in the name of Pallas Athena wouldn’t you do it like this?

Total spending on health care, per person, 2007
United States: $7290
The Netherlands: $3527

People! The Netherlands provides full coverage, with better outcomes, at less than half our cost! American citizens will always get looted in health care spending until such facts get understood. But few citizens really understand those startling facts—thanks in part to these endlessly bollixed presentations. (In larger part, thanks to the refusal of Big Democrats to drive this point. Including our alleged liberal lions.)

Aristotle said we’re the rational animal. Is he on Olympus, laughing? Does Olympus have corporate sponsorship now? Maybe Albert Brooks knows.

Special report: Enabling the (un)real McCoys!

PART 2—WHAT THE FAKE MCCAUGHEY SAID: Yesterday, we ventured back in time, back to an earlier age. We recalled a time when Major Republican movers and shakers were still allowed to be sane.

Under President Bush the Elder, Gail Wilensky was in charge of Medicare and Medicaid. Last Thursday, in a major health forum, she behaved like someone from that earlier age (see THE DAILY HOWLER, 9/8/09). She gave a long and sensible answer to a very sad question; she said it’s “really unfortunate” that people have pushed all those “red herrings” about “death panels.” She was talking about Sarah Palin—and about Betsy McCaughey.

McCaughey is from the modern world—a world in which major Republicans and conservatives are expected to advance “ridiculous falsehoods” every time they speak. In Wilensky’s more courteous language, they’re expected to invent and advance “red herrings”—claims which are “really unfortunate.”

By happenstance, McCaughey herself popped up last Thursday, writing a typically slick/slippery letter in the New York Times. McCaughey hit the scene in 1994, helping usher in an age in which sane Republicans, people like Wilensky, seem like museum pieces. That year, McCaughey invented a set of “blatant, ridiculous falsehoods” about the Clinton health plan. Earlier this year, she did the same thing to Obama’s health plan.

Last Thursday, Wilensky gave a long, thoughtful answer to a question about those imagined “death panels.” But McCaughey belongs to a different race. This is the slick/slippery letter she wrote the Times, on the same day, on the same topic:

To the editor:

I support helping the uninsured, but a provision in the House health bill (H.R. 3200) would use Medicare reimbursement to coerce elderly people to undergo the kind of end-of-life consultation the government deems appropriate. Many people have claimed that the new provision for end-of-life consultations is voluntary. But when there is a penalty on the doctors for noncompliance (in the form of lower reimbursements), it is not voluntary.

This month, the Senate Finance Committee ripped a similar provision from its health bill draft.

It is claimed that the bill merely provides Medicare coverage for end-of-life consultations. Providing coverage would take only a paragraph, not six pages (425-430). The bill prescribes what must be discussed in the consultation, a matter that should be left to patients and doctors.

Worse, the bill suggests that Medicare will rate a doctor’s quality (potentially affecting a doctor’s reimbursement) based partly on the percentage of the doctor’s patients who create living wills and adhere to them.

Paying doctors for consultations is fine. Penalizing them based on their patients’ choices, which may end up being contrary to their written instructions, is wrong (page 432). Some people say that they’d never want to be on a ventilator, but when the time comes, they choose it over death. As a patient advocate, I see these difficult situations and know that the government should not be involved.

For the record, I have never used the phrase “death panels.”

That letter is very hard to parse (examples below). That’s typical of the work of public dissemblers like this fake McCaughey, who has now misled the public about two consecutive health reform plans! But in its most basic representation, McCaughey’s letter seems to say that Medicare recipients would be “coerced” into having discussions about living wills—that their participation in such discussions wouldn’t be “voluntary.” It would take a very long effort to sift through all the misdirection in McCaughey’s letter. But if we’re still speaking English here, those specific suggestions are just false, as Wilensky sadly explained.

Is McCaughey just on the take from her employers in the medical industry? Or is she just a screaming nut? Does she truly believe her own twaddle? In the individual case, such questions are hard to answer. But McCaughey is part of a new Republican/“conservative” class, a class of blatant public dissemblers. They’ve replaced Wilensky’s class.

Heres’s what’s truly remarkable: The fact that a blatant fraud like McCaughey was able to invent screaming falsehoods again. Eventually, everyone knew that her claims about the Clinton plan were just screamingly wrong. Even Andrew Sullivan—the incompetent who published her gong-show—has pretty much said that by now. And yet, we live in a world where a nut like McCaughey could step forward this year and do it again! Scott Ritter was right on Iraq—and got banished. McCaughey was famously, massively wrong—and lived to deceive us again!

Disastrously, a race of McCaugheys has now replaced an earlier race of Wilenskys. This calls to mind an unfortunate question: Who enables their long careers? How in the world could Betsy McCaughey live to deceive the public again? What explains the way this race can endlessly bollix our discourse?

We’ve seen that question answered, again and again, in recent days and nights. In part, the answer involves the press. More significantly, it involves alleged “liberals.”

Tomorrow—Part 3: One side won’t stop telling lies. And one side won’t tell the truth.

The slickness of this new race: How silly is that slick/slippery letter? Just consider the loud boo-hooing found in this one paragraph:

MCCAUGHEY: It is claimed that the bill merely provides Medicare coverage for end-of-life consultations. Providing coverage would take only a paragraph, not six pages (425-430). The bill prescribes what must be discussed in the consultation, a matter that should be left to patients and doctors.

Maybe there’s a way to get dumber than that. If so, McCaughey will surely find it. When she does, she’ll be welcomed out in public, to confuse the voters again.

Why does this bill “prescribe what must be discussed in the consultation?” You’d pretty much have to ask the authors, but an obvious answer does come to mind. If the federal government, or anyone else, is going to pay someone for a service, that entity will likely want to define the service that will be provided. McCaughey says she fears a dire possibility—the possibility that Medicare recipients will be bullied into “pull the plug” orders. But when the government prescribes what must be discussed in those consultations, it is presumably trying to avoid that possibility (among others). If doctors are required to discuss a wide range of relevant points, the occasional crackpot would have less leeway to push a patient toward ghoulish, self-imposed death.

Duh. Are we supposed to be surprised to learn that the government may set parameters on consultations for which it will pay? Yes—in the world of the phony McCoys. By the way: At a later point in this big hack’s letter, note the wonderfully slick/slippery way she employs a key word: “suggests.”

What has enabled our modern world—a world in which a fake McCoy could rise to deceive the public again?

What has enabled this race of McCaugheys? We’ve been seeing the answer each day and each night. More on that question tomorrow.