Lets start with a few basic points. We dont know Rick, but wed be amazed if he isnt a very good person. We strongly recommended Nixonland last year (link below), and we strongly recommend it now. But we think Ricks piece in Sundays Post was seriously ill-advisedmisdirected. And we thought he didnt advance the ball in Tuesdays chat when asked these important questions:
Waukesha, Wis..: My question: How can a democratic society ever control the far right and its empty rhetoric? It is frightening to contemplate these looneys actually shooting or physically assaulting elected officials. In America it seems that the fringe too frequently determine the history of this wonderful country. If only civility could rein perhaps we could return to intelligent discourse. Thank you.
Boston, Mass.: Why do you suppose are the the Democrats so bad at messaging and pushing back? I mean, the Republicans' way of using the same blunt talking points, repeating the same words over all interviews, is very effective. Are Democrats just really that much like a herd of cats? Or do they just not have someone to test out talking points (for example, pushing back on "death panels" should have only ever have used the term "living wills". Never should have used "end-of-life discussions".)
Derry, N.H.: I thoroughly appreciate your article and its historical perspective on right-wing paranoiaboth the way history is replaying itself and where it now differs. One critical aspect not covered, however, is what (if anything) can be done to counter such ridiculous and blatant falsehoods in what should be a patriotic dialog rather than a hysterical diatribe. As you noted, merely repeating the falsehoods and even branding them as such merely gives them more airtime and greater credence with some. If you could suggest one way to take on this foolishness, what would it be?
Those readers were asking a crucial question: What kind of messaging should liberals, progressives and Dems adopt? This question is very important, because we have been getting our keisters kicked for decades in the message wars. Weve often found ourselves unable to counter such ridiculous and blatant falsehoods. The pseudo-conservative world can make up any damn fool thing it wants; the liberal world rarely knows how to respond. For much of the past twenty years, Dems havent even tried to respond. When it comes to major messaging, Dems often seem much like the Washington Generals. Dems have seemed willing to lose. (To see Glenn Greenwald advance a similar notion, just click here. We wouldnt necessarily agree with him on this particular point.)
Those are very important questions from Ricks interlocutors. We were mostly struck by the relative weakness of Ricks replies. Rick was also asked a question about our own critique of his piece; we thought his answer there was truly absurd. But the questions raised in this chat are extensiveand very important. Well plan to do a series of posts on the chat next week.
That said, well strongly recommend Ricks bookand well strongly recommend that you reread his piece from Sundays Post (click here). If you care about winning and losing, the questions raised by his piece, and in his chat, could produce an important discussion. Rereading Ricks piece today, we were struck again by the different ways he reacted to three different groups. All three groups are involved in the spread of the current ridiculous and blatant falsehoods about the Obama health program:
The regular people: Ricks piece focused heavily on the everyday peopleroutinely described as crazywho have attended some town hall meetings. His piece began with a 59-year-old former worker for Murrys Steaks who is now on disability. In his second paragraph, he described a father who wheeled his handicapped adult son up to Rep. John Dingell and claimed that, under Obamas plan, this man would be given no care whatsoever. Obviously, that belief is untrue.
The right-wing elites: Ricks piece paid much less attention to the right-wing elites who work to convince these people that such ludicrous claims are truethat Obama is forming death panels, for instance. These powerful people have been quite active in the spread of the current disinformationand their conduct has been disgraceful, vile. We know their names: McCaughey, Palin, Limbaugh, Grassley, Boehner, Hannity, many more. None of these people got mentioned by name in Ricks piece. Generically, their role was cited, but the focus on them was secondary.
The mainstream media: Obviously, those right-wing elites have played the lead role in the spread of the current misconceptions. But some parts of the mainstream press have played a role here too. At the Washington Post, Fred Hiatt went out of his way to publish op-ed columns which, through absurdly tortured reasoning, suggested there really was some merit in those death panel claims. Go aheadreread Ricks piece. His general portrait of the mainstream press corps is extremely soft.
Weve suggested that liberals and progressives should start kicking upshould stop kicking down. In our view, the villains of this episode are clear, and their conduct has been disgraceful. Their names are Grassley, Hannity, Beck, many more. That said, lets send the analysts out of the room for a moment:
Given the current circumstances, I have no idea why someone would want to focus a major article on a bunch of unsophisticated people who have been fed a lot of focus-grouped nonsense by a bunch of very powerful players. The villains of this piece are clear. They need to be named, and reviled directly. Rick should kick up, not down.
(Ideally, he should also stop insulting the millions of people whose votes can still change our politics. Is it really impossible to correct false belief, even absurd false belief, without calling people crazy?)
Well plan to return to that on-line discussion next week. Those questions weve posted are very important. How should progressives confront the world? Over the past several decades, weve been routinely destroyed in these messaging wars, even if our high-powered cable hosts dont seem to know it yet. Checking the data in recent polls, weve gotten our clocks cleaned again this past month. The questioner from Derry framed it perfectly: How is it that we keep getting defeated by ridiculous, blatant falsehoods?
(Related question: When we keep getting defeated that way, are we sure that the other sides stupid?)
Its time to ask some obvious questions: Why does that happen? Why do we lose? What cant we counter ridiculous falsehoods? Ricks interlocutors asked him at least three times. We though his responses were hazy.
In the meantime, we strongly recommend Ricks book. When we read it last summer, we recalled where we were when we saw Minnie Pearl (see THE DAILY HOWLER, 7/24/08). It helps if we dont hate such people. But why dont we face the truth for once? We liberals do love to hate.
We know, we knowyou refuse to believe it. In some degree, thats why we lose.
Special report: Pure madness!
PART 3UNABLE TO FOCUS: On Tuesday evening, August 11, our analysts fell off the hard wooden chairs in their Cable News Viewing Quarters.
They had flipped past a show they dont normally watch. And omigod! When they did, they saw a famous cable TV host, and his long-suffering female assistant, discussing the foreign experience! Discussing health care in Europe! In particular, they saw a rather flattering report about the high-quality, low-cost health care system in Switzerland!
People! In North Korea, and in the U.S., this sort of thing just isnt done! The analysts called us into the room. We observed this closing exchange:
FAMOUS CABLE TV HOST (8/11/09): It'sit's fascinating and its, its interesting. We wanted to do this, to do these series of reports because it's important obviously tofor the body of public knowledge to be expanded on this issue...And also to demonstrate that despite what some congressmen, some senators, and some in the administration have said, the American people are perfectly capable of comprehending some of the complexities of this, and I think we're demonstrating that here. I'm even following some of this
LONG-SUFFERING FEMALE ASSISTANT: No, it'sit's interesting because people, when given enough information, can make very informed choices about their personal interests.
FAMOUS CABLE TV HOST: And we should expect them to do so in this country one would think...Well, we're going to continue with our reports on the health care systems of other nations tomorrow.
It almost sounded like the host, and his suffering assistant, were helping his viewers decide where to emigrate! But heres the shocker: This was Lou Dobbs and the long-suffering Kitty Pilgrim (actual name!), after Pilgrim presented a fact-filled report about the Swiss health system!
In North Koreaand in this countrythis sort of thing just isnt done!
Its too late to make any difference this year. It wont likely affect the publics long-term understanding. But Dobbs and Pilgrimand a few other unhappy assistantshave been hammering away at the foreign experience each night since August 5.
Youd think this would be a wonderful thingbut you wouldnt exactly be right. Make no mistakePilgrims short report on the Swiss system was fascinating, in ways which were sometimes good. But before we limn Pilgrims nightly reports about the various systems of Europe, lets consider the truly weird focus displayed by her main man, Sweet Lou.
Good lord! Pilgrims reports, and those of Brooke Baldwin, have brought an awkward fact to the foreEuropean nations seem to be running successful health systems at a fraction of the American price tag. Some of these systems spend less than half as much as we do, on a per-capita basis! But every night, night after night, Lou fails to focus on that remarkable fact. Instead, a bit like Lady MacBeth, he rubs his hands and considers a correlation for which his focus is truly obsessive. This was Lou on August 7, asking the question which murders his sleep:
DOBBS (8/7/09): As Congress and President Obama consider an overhaul of the health care system in this country, we on this broadcast are asking and answering questions that many in Washington won't even consider. Such as, How satisfied are Americans with the health care system that we have? And is there any correlation between satisfaction and life expectancy in this country?
Eighty-three percent of Americans are satisfied with the quality of the health care we receive. Life expectancy in this country is 78.1 years now, that's below the average of 79 years in many other developed countries. In Denmark, 90 percent of the Danes are satisfied with their publicly funded system. And life expectancy there is just barely higher than ours, 78.4 years.
In Germany 55 percent of the Germans are not satisfied with their health care system. Their life expectancy is higher than ours, 79.8, in fact. Fifty-seven percent of the people in the United Kingdom say their system needs an overhaul. Life expectancy, 78.9 years. In Canada, 70 percent say their system is working well. Life expectancy, 80.7 years.
And 84 percent of the people in France are satisfied with the quality of their health care. Life expectancy, 81 years.
Lou rattled a long string of numbers. But then again, the very next night, he did the same darn thing! As you can see, his wording changed at various points. But he was simply rattling the same string of numbers all over again:
DOBBS (8/10/09): As Congress and President Obama consider an overhaul of the health care system in this country, we're asking and answering the questions that many in Washington aren't considering, including how satisfied are Americans with the health care system we now have and is there any correlation between satisfaction and life expectancy? Eighty-three percent of Americans are satisfied with the quality of the health care they receive.
Life expectancy at thisin this country is 78.1 years. That is actually below the average of 79 years in other developed nations. In Denmark, 90 percent are satisfied with their publicly funded system. Life expectancy there just barely, however, more than that in the United States, 78.4 years.
In Germany, 55 percent there are not satisfied with their health care system, but their life expectancy is 79.8 years. Fifty-seven percent of people in the United Kingdom believe their system needs an overhaul. And their life expectancy, 78.9 years. In Canada, 70 percent like their system, Life expectancy, 80.7 years.
Eighty-four percent of the French satisfied with their health care system. Life expectancy, 81 years. Fewer than half of the people in the Netherlands believe their health care system needs fundamental change. That system in fact ranks at the top of a European survey on health care satisfaction. The life expectancy in the Netherlands is 80 years and people in the Netherlands have to buy health insurance because it is the law. Kitty Pilgrim has our report.
The long-suffering Pilgrim then reported on health care in the Netherlands.
For the record, life expectancy is a significant statistic; so is citizen satisfaction with a nations health system. But Dobbs has been rattling off these statistics each nightall the while, making little attempt to show any kind of significant correlation between them. No matter what Kitty happens to say about the country in question that night, Lou ghoulishly rattles the expectancy numbers for a wide range of nations. On August 11, he was at it again. We really arent making this up:
DOBBS (8/11/09): Eighty-three percent of Americans, as we've reported, are satisfied with the quality of the health care we're receiving. Life expectancy in the United States is 78.1 years. That sounds pretty good. But it's below the average of 79 years throughout developed countries.
In Denmark, 90 percent are satisfied with their publicly funded system, 90 percent. And life expectancy is 78.4 years, slightly higher than in the United States. But in Germany, where 55 percent of the Germans are not satisfied with their health care system, their life expectancy is 79.8 years. Fifty-seven percent of the folks in the United Kingdom say their system needs an overhaul. Life expectancy, 78.9 years in the U.K. In Canada, 70 percent say their system is working well. And life expectancy in Canada is almost 81 years. Eighty-four percent of the French say they're satisfied with their health care system, and they ought to be, it's considered to be one or two in all of Europe.
Life expectancy there is, by the way, 81 years. Forty-six percent of the people in the Netherlands say their system needs change, life expectancy there, 80 years.
Well, on this broadcast we've been reporting on the health care systems, the public health care systems, all around the developed world. Tonight, a special report on Switzerland. Switzerland's health care system is ranked seventh in Europe for patient satisfaction. And life expectancy in Switzerland is almost 82 years, second only to Japan. People in Switzerland are required by law to buy health insurance. Kitty Pilgrim has our report.
This would have made an impressive reportif Dobbs were a third-grader. Rather plainly, he has gotten his hands on two sets of datacitizen satisfaction and life expectancy. Each night, he rattles these data off. Did he switch things around on the 12th? Actually, nonot that much:
DOBBS (8/12/09): Eighty-three percent of Americans, as we've reported, are satisfied with the quality of the American health care system. Life expectancy in this country is 78.1 years, below the average of 79 years in other developed countries. In Denmark, 90 percent satisfied with their publicly funded system, life expectancy there just about the same as in the United States, 78.4 years.
[statistical droning continues]
Well we've been reporting here on health care systems all around the world, and tonight we're going to examine the health care system in Spain. Spain's health care system placed 17th in a consumer satisfaction survey of those 32 nations. Life expectancy in Spain is above average, 81 years, almost three years longer than in America. Their system is publicly funded and doctors work directly for the government. Kitty Pilgrim has our report.
Poor long-suffering Kitty Pilgrim! How about a little doctors care and attention for her?
Lets be fair. Wed like to compliment the Dobbs program for providing these nation-by-nation reports. As weve noted again and again, almost no one in major media has done this sort of reporting over the past many years. Ludicrous GOP disinformation is constantly peddled about Euro health care; as this happens, our biggest news orgs stare off into space, letting the ignorance gather. Thats why our analysts fell off their chairs when they stumbled upon last Tuesdays report. Wed like to be able to compliment Dobbs for breaking this press corps taboo.
But these reports are hard to praise, for a couple of reasons.
Alas! Lou keeps rattling the same set of figures. But something even odder than that afflicts poor Kittys reporting. Night after night, she reports on European and Asian nations which seem to achieve outstanding health care for a fraction of the American cost. But neither she, nor Lou, ever seem to notice the sheer enormity of what shes reporting. (In all these reports, shes using the OECD data for 2007.)
Lets start with the first report we saw, the one about Switzerland. As she finished, Pilgrim said the Swiss system is expensive, the third highest among the OECDs thirty developed nations. But good grief! Look at the data weve highlighted from poor Kittys report:
DOBBS (8/11/09): Kitty Pilgrim has our report.
PILGRIM: Universal health care, state of the art technology, complete free choice of doctors and hospitals. In some ways, the health care system of Switzerland looks ideal. Many lawmakers and academics, including Professor Uwe Reinhardt of Princeton, have studied the Swiss system.
REINHARDT (videotape): It's a first-rate system, virtually universal coverage, with very high quality care.
PILGRIM: Everyone in Switzerland has to buy health insurance on their own. And there are about 60 different insurance companies to choose from. Premiums run between six and $7000 a year for a typical family. The government subsidizes lower-income people for their coverage, about one-third of the population.
For most people, the real choice in the system is what kind of deductible to select. Deductibles run from $300 all the way up to $2000. Insurance funds with large numbers of chronically ill people are compensated through a risk equalization fund. The price for major procedures are below those in the United States because the government enforces price controls.
Nonetheless, the whole system is expensive, the third highest behind the United States and [Norway]. The Swiss spend 11 percent of GDP on health care versus 16 percent in the U.S. Per capita, that works out to $4417 on health care versus $7290 in the U.S. There is one doctor for every 256 people versus in the United States, one doctor for every 416 people. Life expectancy in Switzerland is 81.7 years versus 78 years in the United States.
After describing a near-paradise, Pilgrim called the Swiss system expensive. She then stated a per capita spending figure that was only about 61 percent of U.S. per capita spending! And take a look at that figure for health insurance ($6000-$7000 for a typical family); that would be a very low premium in the United States. Despite these facts, neither Pilgrim nor Dobbs seemed able to draw the obvious conclusion from this report. The Swiss system seemed better than ours in many ways. It has universal coverage, many more doctorseven a longer life expectancy, highly pleasing to Lou. Yet our health system spends a great deal more! Our premiums are much more expensive!
In a rational world, a journalist would focus on that remarkable paradox. But when your nation discusses health care, what results often seems like pure madness. On the Dobbs show, that madness seems to present each night. Lou and Kitty seem unable to focus on the startling facts Kitty keeps reporting each night.
Other nights, the discrepancy in spending has been more glaringbut Lou never seems to notice. It doesnt matter how good the European health system sounds, or how little the country in question may be spending per person. No matter what Kitty or Brooke Baldwin says, Lou seems to care about only one thingthose largely pointless life expectancy figures.
Just look what happened on August 10. Lou finished rattling his expectancy data, then threw to Kitty for a report on the Netherlands. The statements we highlight are quite astounding. But as is so often the case in our culture, no one seemed to notice. Or care:
DOBBS (8/10/09): Fewer than half of the people in the Netherlands believe their health care system needs fundamental change. That system in fact ranks at the top of a European survey on health care satisfaction. The life expectancy in the Netherlands is 80 years and people in the Netherlands have to buy health insurance because it is the law. Kitty Pilgrim has our report.
PILGRIM: The Dutch reformed their health care system in 2006 and now every person is required by law to purchase health insurance from one of a dozen or so companies.
The Dutch government makes sure that industry is regulated and fair. Professor Alain Enthoven of Stanford offered the managed competition model the Dutch have embraced.
ENTHOVEN (videotape): One of the things the Dutch do that we should do is have standardized coverage contracts so there is no tricky exclusion, no confusion.
PILGRIM: Though the system is based on private insurers, the government makes certain that no one is refused coverage based on age, gender or pre-existing conditions.
6.5 percent of income goes to health insurance in the Netherlands. Those who cannot afford that have their insurance cost subsidized by the government. The government, through an insurance pool, also compensates insurance companies for signing up people with poor health records or pre-existing conditions. All of this costs less than U.S. health care. The Dutch spend $3527 a person on health care, while the U.S. spends $7290. It is 9.8 percent of GDP in the Netherlands versus 16 percent in the U.S. There are considerably more doctors per capita in the Netherlands, one for 256, versus 1 for 416 in the United States. A chief strength is the network of family doctors who are deeply familiar with their patients. The commonwealth fund reports in a recent survey 100 percent of people in the Netherlands have a regular doctor. The ultimate selling point, the average Dutch life expectancy is 80 years versus 78 in the United States.
All of this costs less than U.S. health care? Heres what a saner person might have said: Good God! The Dutch have achieved an excellent system while spending less than half as much as we do! Where is all our health spending going? Who is looting our system?
Wake up and smell the coffee, you fucking old goat, a sane person might say to Lou.
On August 13, things got worse. Pilgrim went to Japan:
PILGRIM (8/13/09): Japanese citizens go to the doctor an average of 15 times a year. Insurance covers everyone for everything. After a fractional co-payment, the visits are basically free. Even for the elderly, long-term care in nursing homes, even home care, is covered. The Japanese have a life expectancy of nearly 83 years, compared to 78 in the United States.
Japan spends 8.1 percent of GDP on health care, compared to 16 percent of GDP in the United States, total annual spending, $2581 per capita, compared to $7290 in the United States.
The Japanese spend about one third what we do. To a sentient human, that figure would be astounding. How is that possible, a sane person might ask. Such a person might even insist that Lou put down his life expectancy tables.
Sadly, your culture doesnt seem real sane when it comes to discussion of health care. Lou Dobbs and his long-suffering aide cant seem to focus on what theyre reporting. But when it comes to health care, the mainstream press has been that way for a very long time. So have your Very Serious allegedly liberal leaders.
Night after night on this cable program, Dobbs long-suffering female assistants have been reporting remarkable data. But no one shows the slightest sign of seeing how startling those data are. Sensational health systems are describedsystems which spend one-third what we do. At no point has Dobbs asked the obvious questions:
Where is all our money going? Who is looting this nation?
Lou keeps failing to ask that question. But then, your so-called liberal leaders agree not to ask such things too.
TomorrowPart 4: In search of progressives.
Obsession 2: Lou keeps sifting his expectancy databut he often displays a second obsession. On August 12, for example, Lou reacted the following way when Kitty finished with Spain. Spains health care spending per capita is some $2671 compared to $7290 in the United States, the suffering aide had faithfully. From Lou, that got no reaction:
DOBBS (8/12/09): All right, thank you very much and it's very revealing to look at these varying levels of life expectancy in each of these countries. We should point out that there are other factors that go into determining that number statistically and we're going to get to some of the qualifications in this in the days ahead and also the impact of the economic conditions of each of these countries, their debt levels, their trade deficits and their total social and political environment.
We also looked at the amount of debt as a percentage of GDP for the eight countries that we've reported on and the United States. Based on last year's reports, Denmark's debt amounted to $80.5 billion. That's 22 percent of their GDP.
Spain's debt, $632 billion, 37.5 percent of its GDP. The Netherlands, 391 billion, that's 43 percent of their GDP. Switzerland's debt, almost 217 billion, 44 percent of GDP. And as these debt levels keep rising, the U.K.'s debt, $1.3 trillion, 40 percent of its GDP. The U.S. national debt, just about $9 trillion, that's just about 61 percent of GDP.
Canada's debt is almost $1 trillion, 62 percent of its GDP. Germany's debt amounts to 2.4 trillion. That amounts to just about 63 percent of its economy. France, a $2 trillion debt, a whopping 67 percent of its economy. We continue our comparisons of health care systems around the world. Tomorrow we examine the system in Japan where Japan has the highest life expectancy of any nation on the globe.
Theres nothing wrong with look[ing] at the amount of debt as a percentage of GDP for the eight countries that we've reported on. But as with his life expectancy data, Lou shows no sign of being able to draw any meaningful point from his data. He just rattles the data off every night. Kitty is forced to dream of the day when Lou will hear what shes said.
Dobbs almost seems to be out of his mind as he aimlessly sifts his data. But then, his country is like that now. When this country pretends to discuss health care, it often resembles pure madness.
Those French: Brooke Baldwin cant get Lou to listen either. Heres what happened on August 7, when she discussed the health care system currently run by those French. So youll know, the French spend $3601 per personless than half what we spend:
BALDWIN (8/7/09): Imagine a health care system where 99 percent of the population is covered. There's no hassle in seeing your doctor of choice, and the majority of patients are satisfied with the quality of care. France, a nation of more than 60 million people, provides basic, universal health insurance.
Most of the funding stems from a payroll tax, but employees do pay a small percentage. But unlike traditional single-payer systems, Michael Tanner with the Cato Institute says France is different.
TANNER (videotape): It's a system that relies heavily on consumer cost sharing and market forces to control health care costs.
BALDWIN: According to the Commonwealth Fund, a nonpartisan research group, only 33 percent of the French say their system needs fundamental changes compared to 46 percent in the U.S. They have a higher doctor-to-patient ratio, and the French live longer. However, the French are starting to pay more out-of-pocket costs.
DOBBS: Right now France topping out in Europe as the best of thethe public health care systems, and the highest satisfaction rate. So thanks so much, Brooke. Appreciate it.
BALDWIN: You're welcome.
DOBBS: Brooke Baldwin. We've looked at the health care system this week in altogether five nations, all with a national health care plan, but none has the amount of debt that the United States is carrying nor do any of them have our massive trade deficit. Canada's debt, believe it or not, amounts to $814.3 billion, that's 60 percent of its GDP, its trade deficit, 1.2 billion.
The United Kingdom's debt is $1 trillion, 47 percent of its GDP, trade deficit $22 billion. France $1.4 trillion debt, 67 percent of its GDP, its trade deficit is 27.6 billion. Germany's debt amounts to 1.8 trillion, nearly 63 percent of its GDP. Germany has a trade surplus of 66 billion, Denmark, its debt more than $2 trillion. Now think about this.
Denmark is a nation of 5.5 million people, with that level of debt$2 trillion. It has a $3.7 billion trade surplus, however. Now, the U.S. national debt is staggeringmore than 61 percent of GDPour trade deficit $146 billion. The U.S. budget deficit continues to grow at a rapid rate, the federal deficit soaring to 1.3 trillion in the first 10 months of this year, according to the CBO. That's almost a trillion dollars more than the deficit in the comparable period a year ago, just about the same amount as the past four years, in fact.
Monday we'll have a special report on the health care system in the Netherlands.
Baldwin threw herself on a couch in the green room and wept. Between her sobs, two questions emerged: What does it take to get this big nut case to listen? And what explains the pure madness displayed when our nation pretends to talk health care?