The Times hides the spending data again: In Mondays column, Paul Krugman correctly wrote that corporate donations to politicians of both major parties fuels debates that otherwise seem incomprehensible.
Thats true. But the discussions found in our upper-end press often seem incomprehensible too. Consider what happened last Thursday morning, when the New York Times deigned to discuss the health care system of another developed nationJapan.
The report appeared in a small boxed format at the bottom of page A12. (It appeared beneath this headline: HOW THEY DO IT OVER THERE.) In some ways, the piece reads like a parody of reporting on foreign health care. Principally, the piece is the fault of Sarah Arnquist, described as a contributor to the New York Times. We cant find the piece on-line in its hard-copy format.
Arnquists editors have to share the blame for this gong-show too.
What was so bad about Arnquists report? The familiar way it disguised the groaning difference between American and Japanese spending on health care. Throughout the press corps, big news organs seem to work hard to keep us clueless about our vast spending. Unless she simply has very bad judgment, Arnquist seems to have worked hard to keep us in the dark too.
Arnquists presentation began with a small chart, comparing the United States and Japan in five basic categories. Life expectancy was the first category. For the United States, its 78 years. For Japan, its 83.
So far, so good. But when she got to her third category, Arnquist addressed the issue of spending. Except she chose to present this comparison in the murkiest way possible. Heres how she chose to present it:
Health spending as percentage of G.D.P.
United States: 15
Question: Could a reporter present this comparison in a way which is less accessible to the typical reader? Thats a presentation for policy nerdsfor geeks, for professors, for eggheads. Heres a more accessible way to make the comparison. Data from the OECD:
Total spending on health care, per person, 2007:
United States: $7290
Good God. The difference in health care spending is vast! Heres our question: If you could present just one comparison, in a mass publication, why on earth would you present the comparison in the way Arnquist chose? Why wouldnt you let your readers gaze on those more startling, more accessible data?
Sorry, but it often seems that major newspapers are trying to keep the public clueless about our vast health spending. And as she continued on Thursday morn, Arnquist only fed this conspiracy theory. Below her five-category chart, she presented one lonely Q-and-A between herself and a health care expert. This was her hapless question:
Q: How does the Japanese system provide health care at lower cost than the American system?
At lower cost than the American system? In fact, the Japanese system provides health care at vastly lower cost! Per capita, the Japanese spends barely one-third what we Americans do! But last Thursday, readers of the New York Times didnt wonder why that is. Arnquist seemed to work rather hard to keep that fact from their view.
On a per capita basis, the United States spends vastly more than other developed nations. Again and again, weve marveled at the way the mainstream press seems to keep hiding this fact. The spending data are simply stunningand readers are constantly shielded from them.
North Koreans get their news this way. So do Times subscribers.
We have no idea why the New York Times reports health spending this way. But the spending data on are simply stunningand the suppression of these data is so routine, its hard to believe its an accident. We understand why politicians may want to create debates which are incomprehensible. But why do newspapers follow suit? We have no real ideabut its hard to believe its just dumbness.
Arnquists answer: If you read to the end of Arnquists lone Q-and-A, you finally got a tiny hint of the startling contrast in per-person spending. But it was only a hint.
Arnquists answer came from John Creighton Campbell, co-author of the 1998 book, The Art of Balance in Health Policy: Maintaining Japans Low-Cost, Egalitarian System. This is his answer, as it appeared in our hard-copy New York Times. If you read all the way to the end, you get a hint of the startling facts the press seems to want to suppress:
Q: How does the Japanese system provide health care at lower cost than the American system?
A: Japan has about the lowest per capita health care costs among the advanced nations of the world, and its population is the healthiest. That is largely due to lifestyle factors, such as low rates of obesity and violence, but the widespread availability of high-quality health care is also important.
Everyone in Japan is covered by insurance for medical and dental care and drugs. People pay premiums proportional to their income to join the insurance pool determined by their place of work or residence. Insurers do not compete, and they all cover the same services and drugs for the same price, so the paperwork is minimal.
Patients freely choose their providers, and doctors freely choose the procedures, tests and medications for their patients. Reimbursement rates to doctors and hospitals are negotiated and set every two years. The fees are quite low, often one-third to one-half of prices in the United States.
In North Korea, they probably wouldnt have printed that answer at all. But Arnquist seemed to work rather hard to keep you in the dark too.
Final point: Patients fees arent the same thing as per-person spending. Our per-person spending is simply vasta clear suggestion that Americans are being looted in their health spending. We understand why some politicians may not want to tell you that. As Krugman noted in yesterdays column, theyre on the take from the looters.
But what is up with the North Korean approach of our biggest newspapers? Yes, our big papers are frequently dumb. But no ones so dumb that theyd cover this story this way. Theyd have to have a reason.
The Times has busted its keister, for years, to keep you from knowing that youre being looted. Their discussion seems incomprehensible too! Pols have a motive to play it dumb. Whats up with our biggest newspapers?
Arnquist on-line: This is Arnquists piece as it appeared on-line. This is not the format which appeared in the hard-copy Times.
Special report: Message: We dont care!
PART 1THE REAGAN RULES: Why are liberals so easily beaten?
In an August 18 on-line discussion, readers of the Washington Post asked versions of that critical question. (To read the full discussion, click here.) They spoke with liberal historian Rick Perlsteinand their questions cut to the heart of our broken progressive politics.
Weve posted some of those questions before. At least two should be looked at again:
Boston, Mass.: Why do you suppose are 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?
Derry, N.H.: I thoroughly appreciate your article... 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 air time and greater credence with some. If you could suggest one way to take on this foolishness, what would it be?
Why are Democrats so bad at messaging? So bad at pushing back? How can it be that liberal proposals keep getting destroyed by ridiculous, blatant falsehoods? By outright foolishness? As health reform sinks beneath the waves (again), defeated (again) by ludicrous claims (the death panels this time!), those readers were asking superlative questions.
Why are liberals so easily beaten? Last Monday, we thought our smartest player showed little sign of understanding how this game plays.
That smartest player was Paul Krugman, the most important upper-end journalist (by far) over the past ten years. Currently, Krugman holds the Nobel Prize in economics. We shudder to think how little we all would know about various issues if he hadnt been writing his New York Times column over these past ten years.
Thats why we were so struck by last Mondays column.
Why are Democrats (and liberals) so bad at messaging? Why are Dems so easy to beat? Well be discussing those questions all week. But at the start of last Mondays column, Krugman seemed to marvel at an equal-but-opposite phenomenon. Why are Republicans so good at messaging? That too is a very important question. But to our ear, our smartest, most important player seemed to be strangely unclear:
KRUGMAN (8/24/09): The debate over the public option in health care has been dismaying in many ways. Perhaps the most depressing aspect for progressives, however, has been the extent to which opponents of greater choice in health care have gained tractionin Congress, if not with the broader publicsimply by repeating, over and over again, that the public option would be, horrors, a government program.
Washington, it seems, is still ruled by Reaganismby an ideology that says government intervention is always bad, and leaving the private sector to its own devices is always good.
Call me naive, but I actually hoped that the failure of Reaganism in practice would kill it. It turns out, however, to be a zombie doctrine: even though it should be dead, it keeps on coming.
Well have to accept that invitation. In this case, well have to call our best player naive.
As Krugmans column continues, he explains, quite cogently, why Reaganism should be dead. He describes the failures caused by its tenets over the past many years. But that pertains to the merits of Reaganism, not to the powerful messaging which has kept this ideologythis zombie doctrineriding so high in the saddle.
Government intervention is always bad? This hoary claim lies at the heart of the GOPs powerful messaging. It explains why conservatives have just kept saying that Obamas health planforget the public optionwould be, horrors, a government program. And by the way: This particular bit of messaging has powerfully affected the broader public, despite Krugmans odd statement in paragraph one. Opponents of Obamas proposed health reform have kept describing the plan as big government. This messaging has helped kill off the publics supportjust as it always has.
It doesnt matter if it seems dumb. That message remains very potent.
Its true. Youd have to be a bit naive to be surprised by the force of that message. But as he continued in last Mondays column, Krugman seemed to have little idea why the tide has dramatically turned in the drive for health reform. Professor, say it isnt so! Before long, he was saying this:
KRUGMAN: We have always known that heedless self-interest was bad morals, said Franklin Delano Roosevelt in 1937. We know now that it is bad economics. And last year we learned that lesson all over again.
Or did we? The astonishing thing about the current political scene is the extent to which nothing has changed.
The debate over the public option has, as I said, been depressing in its inanity.
Krugman is certainly right on one score. Nothing has changed in the current debate. As we tried to detail last week, the downward spiral of the Obama health plan closely parallels that of the Clinton health plan, observed some fifteen years earlier. And the current debate is indeed depressing in its inanityjust like that miserable debate in 1994.
But why should any of this seem astonishing? Because the tenets of Reaganism seem to have failed? American politics doesnt turn on such rational assessments. And the same factors which allowed the inanity then have driven the inanity now.
One such factor is the powerful messaging that helped drive Reagans ascent.
At the end of his column, Krugman asked an important question: Why wont these zombie ideas die? The zombie ideas to which he refers are the central tenets of Reaganismthe notion that big government never did anything right, that governments the problem/not the solution. Because these tenets have failed in practice, Krugman finds it astonishing that they rule our debate. Well accept that invite for the third time: That reactions naive.
Why are liberals so easy to beat? One part of the answer is simple. Their side has messagingand our side doesnt! Potent, perhaps simple-minded messaging continues to rule the American discourse. Those potent claims about big government seem to win every damn time.
Why is our side so bad at this game? The Boston reader asked Rick Perlstein the worlds most important political question. Last Monday, Krugman didnt seem to know the answer. But in that way, our long-term smartest, most valuable player reflects the whole liberal world.
We liberals call the other side dumbeven as they clean our clocks with strings of blatant, ridiculous falsehoods! But then, their side has been smart enough to build powerful messaging over the course of the past forty years. Our side has been too self-impressedtoo lazy; too unaware; too stupidto build such frameworks of our own.
Obvious message: We dont care! Tomorrow, a look at their messaging.