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THURSDAY, JUNE 11, 2009

The rational animal stumbles again/Health care framework edition: Is modern man [sic] really the rational animal? As our analysts follow our major debates, they chuckle mordantly at this ancient, self-flattering western-world notion.

How under-informed are our major debates? Consider two dueling frameworks about health care policy in this morning’s newspapers.

On the one hand, you have the framework offered by Nicholas Kristof in his New York Times column. When it comes to health care, we spend twice as much as our northern neighbors—but they get better results:

KRISTOF (6/11/09): No doubt there are some genuine horror stories in Canada, as there are here in the United States.

But the bottom line is that America’s health care system spends nearly twice as much per person as Canada’s (building the wealth of hospital tycoons like Mr. Scott). Yet our infant mortality rate is 40 percent higher than Canada’s, and American mothers are 57 percent more likely to die in childbirth than Canadian ones.

Kristof may have his thumb on the scale a small minor tad here. We’ll guess that the difference in those mortality rates might be somewhat smaller if we adjust for certain demographics. (Comparing middle class to middle class, for example. Our benighted ancestors spent centuries creating certain kinds of poverty zones which may not exist to the north.) But in this passage, Kristof presents a truly startling framework—one to which Americans are rarely exposed. We spend much more on health care than other developed nations. And our results aren’t as good!

That’s one framework. But in this morning’s Washington Post, Lori Montgomery reports on another. “What Would a Health Overhaul Cost?” her headline asks. “All Eyes on the CBO.” Montgomery reports on the attempt to determine how much more it will cost the U.S. to overhaul its health system. She’s writing about Douglas Elmendorf, head of the CBO:

MONTGOMERY (6/11/09): Now Elmendorf, 47, faces the toughest task of his brief tenure: attaching a price to a monumental overhaul of the nation's health-care system, which holds out the promise of delivering care to millions of uninsured Americans, cutting costs for an overburdened federal government and sealing the political legacy of a popular new president.

The stakes are enormous. The nonpartisan budget office was created by Congress to serve as Washington's official scorekeeper, offering independent estimates of the cost of legislation. If the CBO says a health plan will break the bank, lawmakers generally will assume it's true.

Too funny! We pay twice as much as Canada does. But getting a system as good as theirs may “break the bank”—may cost enormously more!

Let’s be clear: There’s nothing “wrong” with Montgomery’s framework—and there’s nothing “wrong” with Kristof’s. But there is something massively wrong with the way this nation frames its health care discussion. Very few citizens understand the facts behind Kristof’s remarkable statement. As a result, almost no one is struck by the sheer absurdity involved in these dueling frameworks.
We know what the pedants are saying! There is private money and public money involved in Kristof’s statistic; Montgomery is only discussing the need to introduce more public money into the system. But the absurdity of the discussion remains, no matter how poorly we rationals grasp it: We spend twice as much as Canada does. And yet, it turns out that we can’t afford a system as good as theirs! Even after we “monumentally overhaul” ours!

Is any other major policy area as discussed as clownishly as health care? (Education comes close.) Major newspapers simply refuse to discuss the shape of health care in other developed nations. The Giulianis are allowed to parade about, making absurd claims about European health care; big newspapers like the Times would rather die than introduce some basic perspective. When Michael Moore explained some basic facts a few years ago, Sanja Gupta jumped up and (inaccurately) sought to “correct” him. But so what? Obama was so impressed with Gupta’s star turn that he later tried to make him his Information Czar.

As a result, very few of us rational animals really see how odd the state of play is.

We spend twice as Canada does—and we can’t afford what they have! These frameworks appear in this morning’s papers, fed to us rational folk.

IT HAPPENED LAST TIME: Tragically and painfully, a certain percentage of people are mentally ill. (Translation: They strongly believe wide networks of things which are plainly absurd or untrue.) Tragically, James von Brunn was numbered among them. Yesterday, at age 89, he acted. As a result, a sane, decent person is dead.

Last week, Scott Roeder killed Dr. George Tiller. Result: Some are wondering if the rise of Obama is creating stress in the minds of some unbalanced people, stress which has led them to act. This is a thoroughly worthwhile discussion. And it’s worth remembering that the same damn thing pretty much happened the last time.

By “last time,” we mean the last time we had a Democrat president. As you may recall, that president was Bill Clinton—and crazy stories spread far and wide about his intolerable ways. The liberal world ran off and hid in the woods—and, to all intents and purposes, the “mainstream press corps” didn’t exist. And sure enough! By September 1994, a man name Frank Corder decided to act. This incident largely went down the memory hole, like most misconduct directed at Clinton. But in real time, Judy Keen reported the apparent attempt on the president’s life in USA Today.

“Crash exposes risks,” the headline said. “How tough is it to protect a president?” Even after 9/11, this event remained largely deep-sixed:

KEEN (9/13/94): Frank Corder's flight in his tiny red-and-white Cessna exposed one of the White House's main vulnerabilities—an attack from the air.

"It finally happened," says Marlin Fitzwater, press secretary to former presidents George Bush and Ronald Reagan. “Everybody has always speculated that someone could fly kamikaze-style into the White House. I don't think there's any way to prevent it.” If there is, Secret Service officials are hunting for it now.

President Clinton and his family were asleep at Blair House, across the street from the White House, when Corder flew over Washington's treetops under a sliver of moonlight, somehow evaded what's supposed to be the world's best security and crashed into an old magnolia tree two floors below the Clintons' empty bedrooms.

The worst damage: a cracked window.

But the "what ifs" surrounding the incident reignited ominous questions around the capital—questions that get to the heart of how tough it is to protect a president. What if the plane had been carrying explosives? What if terrorists had been piloting it instead of the inexperienced Corder?

The White House's occupants made light of the dramatic crash. "This has been quite an unusual day here at the White House," Hillary Rodham Clinton told guests.

Still, one fact loomed large: Monday's incident was the worst White House security breach in nearly two decades.

In fairness, the Clintons were murderers, drug-dealers, socialists. Perhaps for that reason (no one seemed to know), Corder had finally decided to act. He tried to crash his plane into the White House, hitting a large tree instead. Corder died in the incident.

It was “the worst White House security breach in nearly two decades,” Keen reported. And a few weeks later, it happened again. “Target: White House,” said the headline on Keen’s report. “Did bullets also bring a wake-up call?”

KEEN (10/31/94): Two weeks ago, President Clinton stood at a podium outside the White House's north entrance to welcome a U.S. delegation home from Haiti.

Saturday, that same north entrance was sprayed with a gunman's bullets.

If the motives for the shooting spree at the White House were murky Sunday, one thing seems increasingly clear: This president—who loves to mingle with crowds and chafes at being trapped in the Secret Service's protective bubble—is probably about to change his ways.

That may mean no more meandering across Lafayette Park on his way home from church, as he did a few weekends ago, with tourists flocking just feet away. And no more north entrance appearances.

The shooting was the second frightening White House security breach in six weeks.
Last month, a Maryland man crashed a stolen plane onto the lawn, killing himself.

"These two incidents may save this president's life at some point, because he's had a wakeup call," says terrorism expert Neil Livingstone.

In this incident, a man named Francisco Duran “pulled a rifle from his coat, stuck it through the fence and started spraying rounds,” Keen reported. “It took Duran 10 seconds, the Secret Service estimates, to squeeze off 20 to 30 rounds” before “two passersby subdued him.”

Given the zeitgeist of the 1990s, memory of these incidents quickly disappeared. We recall them because, as a comedian, we did a few jokes about these events (and perhaps one other) for a brief time in early 1995. Our premise? The crazy attacks seemed to stop as soon as Newt Gingrich became House speaker. (In the wake of the November 1994 elections.) Our jokes got a few laughs in DC. (We were surprised.) We didn’t try them elsewhere.

Were unbalanced people driven to act by all the crazy talk about Clinton? Are unbalanced people being so moved by Obama’s rise today? By crazy and semi-crazy talk about him? Von Brunn, who killed a decent person, apparently believed Obama isn’t a citizen. But then, Corder and Duran may well have thought that Clinton kept murdering people. Not to mention his drug-dealing ways!

We think it’s worth remembering that this happened the last time too. Beyond that, we think it’s worth wondering why the attacks by Corder and Duran found their way down the memory hole to the extent that they did. Hint: This was very much the way of the 1990s. In its own more dignified manner, the mainstream press corps was also flying little planes into the White House at this time. (They have never tried to explain why.) Later, they spent two year flying planes into Campaign 2000. In that case, they finally got their way. Are we happy with how that turned out?

A few questions have been raised, from a press perspective, by these recent attacks:

First: Is it time for the mainstream press to come to terms with America’s underworld discourse? For decades, the mainstream press has tended to avoid the cauldron of craziness bubbling beneath the surface of our public discussions. In the 1990s, the insider press was closely involved with the spread of crazy talk about Clinton, then Gore. Today, the insider press is much less interested in spewing wild tales about Obama. But the mainstream press corps loves to avoid all such difficult, unpleasant regions. Isn’t it time to report it out straight? There are crazy areas of our discourse, in which people are encouraged to believe crazy things. Yes, we know: Powerful people are sometimes involved in these wild promulgations. But isn’t it time to report it out straight: That there’s lunacy inside our discourse?

Second: We’d suggest that liberals and progressives should think about the frameworks we bring to this discussion. For example: In what ways do we want to discuss and approach those who are anti-abortion?

Rachel Maddow has done some truly superb reporting in the wake of Dr. Tiller’s murder. For a couple of nights, she put all her snark and mugging and clowning away; she behaved like a smart, deeply caring reporter. (Her work was extremely informative. Some work of this type has continued.) On the other hand, we thought Maddow and Melissa Harris-Lacewell staged a very unintelligent, unwise discussion on last Friday night’s program. To watch the full segment, just click here.

Harris-Lacewell appears about halfway through. This was an early framework:

MADDOW (6/5/09): Melissa, your writing on this subject this week has been really provocative and really interesting. It’s one of the reasons I wanted to have you on the show tonight to talk about it. And in one of your columns this week about it, you wrote that the anti-choice community operates with a totalitarian impulse that generates a culture of terror rather than a culture of life. What do you mean by totalitarian impulse?

HARRIS-LACEWELL: Well, what I mean by totalitarianism is the idea that there’s only one right way. There’s only one correct answer, that there’s no gray areas, there’s nothing complex.

Every time Harris-Lacewell appears on Maddow, our estimation of the meaning of the Princeton degree drops by roughly twenty percent. That said, we thought Friday’s appearance was an unfortunate classic. To Harris-Lacewell, the anti-choice community thinks there’s only one right way. There’s only one correct answer. There are no gray areas, there’s nothing complex. For our money, the professor went on to fashion a discussion in which there was only one right way. There was only one correct answer. There were no gray areas; there was nothing complex.

People who don’t think Harris-Lacewell’s way need to be shamed into silence, she said. Few distinctions could be found on the set. “We want to start making it feel like being an anti-choice group is like being in the KKK,” she eventually said. But you know how she loves those gray areas!

In our view, Harris-Lacewell is a semi-disaster; your mileage may differ. But how should liberal/progressive/pro-choice people frame future discussions with those who oppose the right to abortion? For whatever reason, millions of people don’t agree with pro-choice views—and they’re all citizens, just like you are. How should pro-choice people approach them? We recommend the segment from Friday’s show (again, just click here). We thought the impulses on display were profoundly unhelpful—and sometimes daft. You may not agree with that view.