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MESSAGE: WE DON’T CARE! Our smartest player seemed perplexed by the force of the GOP’s messaging: // link // print // previous // next //
TUESDAY, SEPTEMBER 1, 2009

The Times hides the spending data again: In Monday’s column, Paul Krugman correctly wrote that corporate donations to politicians of both major parties “fuels debates that otherwise seem incomprehensible.”

That’s 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 nation—Japan.

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 can’t find the piece on-line in its hard-copy format.

Arnquist’s editors have to share the blame for this gong-show too.

What was so bad about Arnquist’s 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.

Arnquist’s 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, it’s 78 years. For Japan, it’s 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. Here’s how she chose to present it:

Health spending as percentage of G.D.P.
United States: 15
Japan: 8

Question: Could a reporter present this comparison in a way which is less accessible to the typical reader? That’s a presentation for policy nerds—for geeks, for professors, for eggheads. Here’s a more accessible way to make the comparison. Data from the OECD:

Total spending on health care, per person, 2007:
United States: $7290
Japan: $2581

Good God. The difference in health care spending is vast! Here’s 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 wouldn’t 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 didn’t 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, we’ve marveled at the way the mainstream press seems to keep hiding this fact. The spending data are simply stunning—and 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 stunning—and the suppression of these data is so routine, it’s hard to believe it’s an accident. We understand why politicians may want to create debates which are “incomprehensible.” But why do newspapers follow suit? We have no real idea—but it’s hard to believe it’s just dumbness.

Arnquist’s answer: If you read to the end of Arnquist’s lone Q-and-A, you finally got a tiny hint of the startling contrast in per-person spending. But it was only a hint.

Arnquist’s answer came from John Creighton Campbell, co-author of the 1998 book, The Art of Balance in Health Policy: Maintaining Japan’s 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 wouldn’t have printed that answer at all. But Arnquist seemed to work rather hard to keep you in the dark too.

Final point: Patients fees aren’t the same thing as per-person spending. Our per-person spending is simply vast—a 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 yesterday’s column, they’re 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 one’s so dumb that they’d cover this story this way. They’d have to have a reason.

The Times has busted its keister, for years, to keep you from knowing that you’re being looted. Their discussion “seems incomprehensible” too! Pols have a motive to play it dumb. What’s up with our biggest “newspapers?”

Arnquist on-line: This is Arnquist’s piece as it appeared on-line. This is not the format which appeared in the hard-copy Times.

Special report: Message: We don’t care!

PART 1—THE 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 Perlstein—and their questions cut to the heart of our broken progressive politics.

We’ve 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 hadn’t been writing his New York Times column over these past ten years.

That’s why we were so struck by last Monday’s column.

Why are Democrats (and liberals) so bad at “messaging?” Why are Dems so easy to beat? We’ll be discussing those questions all week. But at the start of last Monday’s 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 traction—in Congress, if not with the broader public—simply by repeating, over and over again, that the public option would be, horrors, a government program.

Washington, it seems, is still ruled by Reaganism—by 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.

We’ll have to accept that invitation. In this case, we’ll have to call our best player naive.

As Krugman’s 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 “ideology”—this “zombie doctrine”—riding so high in the saddle.

“Government intervention is always bad?” This hoary claim lies at the heart of the GOP’s powerful “messaging.” It explains why conservatives have just kept saying that Obama’s health plan—forget the public option—“would be, horrors, a government program.” And by the way: This particular bit of messaging has powerfully affected “the broader public,” despite Krugman’s odd statement in paragraph one. Opponents of Obama’s proposed health reform have kept describing the plan as “big government.” This messaging has helped kill off the public’s support—just as it always has.

It doesn’t matter if it seems dumb. That message remains very potent.

It’s true. You’d have to be a bit “naive” to be surprised by the force of that message. But as he continued in last Monday’s column, Krugman seemed to have little idea why the tide has dramatically turned in the drive for health reform. Professor, say it isn’t 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 inanity”—just 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 doesn’t 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 Reagan’s ascent.

At the end of his column, Krugman asked an important question: “Why won’t these zombie ideas die?” The “zombie ideas” to which he refers are the central tenets of Reaganism—the notion that “big government never did anything right,” that “government’s the problem/not the solution.” Because these tenets have failed in practice, Krugman finds it “astonishing” that they rule our debate. We’ll accept that invite for the third time: That reaction’s naive.

Why are liberals so easy to beat? One part of the answer is simple. Their side has “messaging”—and our side doesn’t! 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 world’s most important political question. Last Monday, Krugman didn’t 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 dumb—even 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-impressed—too lazy; too unaware; too stupid—to build such frameworks of our own.

Obvious message: We don’t care! Tomorrow, a look at their messaging.