The triumph of The Interests: In this mornings column, Paul Krugman asks a very good question. Even if health reform passes, how well will health reform work?
We think thats an excellent question. But we think Krugmans columnhis answer is yesalmost seems to represent the triumph of The Interests.
Krugman uses the Massachusetts plan as a predictor. Under that plan, only 2.6 percent of [Massachusetts] residents remain uninsured, Krugman writes. And the Massachusetts reform remains highly popular. Only 11 percent of Massachusetts residents think it should be repealed.
Thats a reasonable standard for success. In Massachusetts, coverage is nearly universaland people support the reform. But health reform was supposed to be about two major thingsuniversal coverage and lower costs. And when it comes to that second objective, Krugmans upbeat column seems to us to represent a triumph of The Interests. Lets go back to 2005, when Krugman wrote a series of columns about the state of our health care. On April 15, he discussed the amazing state of American health care spending:
KRUGMAN (4/15/05): Britain isn't the country we want to look at, because its health care system is run on the cheap, with total spending per person only 40 percent as high as ours.
The countries that have something to teach us are the nations that don't pinch pennies to the same extentlike France, Germany or Canadabut still spend far less than we do...
Let me rattle off some numbers.
In 2002, the latest year for which comparable data are available, the United States spent $5,267 on health care for each man, woman and child in the population. Of this, $2,364, or 45 percent, was government spending, mainly on Medicare and Medicaid. Canada spent $2,931 per person, of which $2,048 came from the government. France spent $2,736 per person, of which $2,080 was government spending.
Amazing, isn't it? U.S. health care is so expensive that our government spends more on health care than the governments of other advanced countries, even though the private sector pays a far higher share of the bills than anywhere else.
What do we get for all that money? Not much.
[N]ow is a good time to ask why other advanced countries manage to spend so much less than we do, while getting better results, Krugman said.
In 2005, Krugman called our health care spending amazingand he noted that the Brits spent only 40 percent as we spend, per person. But uh-oh! As of 2007, the United States was spending two to three times as much, per person, as all large European nations, including the countries Krugman praised above Britain. France was spending $3601 per person. We were spending $7290. (Great Britain: $2992. On-line, Krugman recently said that all these countries get relatively similar health outcomes.)
Those facts are beyond amazing. But this astonishing situation has disappeared in Krugmans current column. Throughout todays column, Krugman adopts a very weak standard for evaluating the effects of reform on health care spending: Health reform should contain rising costs, he says or implies throughout. But an obvious question obtains: If were spending two to three times as much as other nationsother nations with similar outcomeswhy should our costs be rising at all? Why wouldnt successful reforman overhaul, evenreduce what we spend on health care? In 2008, Candidate Obama was talking about reducing the costs of insurance premiumsby $2500, he said. (He no longer talks about that.) Why should it be the goal of Massachusettsor of national reformto permit the continuing rise of costs which are amazing?
There may be an answer to that questiona question which is, of course, never asked. But until someone supplies the answer, lets stick with the obvious: In part, Massachusetts citizens are happy with their reforms because they simply dont understand how much extra theyor their employers; or their state governmentare spending on their health care. To use a phrase from Krugmans column, there hasnt been a huge popular backlash, in Massachusetts or anywhere else, in part because the public simply doesnt know how much they are getting ripped off.
Why dont citizens know about that? In large part, due to the triumph of The Interests. Americas massive over-spending has disappeared from the health care discussion. Democrats simply dont discuss it; as a matter of fact, they never have. (Go ahead. Name an exception.) Neither do big mainstream news orgs, like the New York Times.
And as of today, neither does Krugman, the Last Best Hope of mainstream journalism. As he finishes todays column, he adopts a rather cynical standard of success for reform:
KRUGMAN (10/26/09): So national reform's chances will be better if it contains elements lacking in Massachusettsin particular, a real public option to keep insurers honest (and fend off charges that the individual mandate is just an insurance-industry profit grab). We can only hope that reports that the Obama administration is trying to block a public option are overblown.
Still, if the Massachusetts experience is any guide, health care reform will have broad public support once it's in place and the scare stories are proved false. The new health care system will be criticized; people will demand changes and improvements; but only a small minority will want reform reversed.
This thing is going to work.
Apparently, this thing is going to work if it has broad public support. And it will have broad public support if it doesnt look like an insurance-industry profit grab. But what if it really is such a grabjust not as ginormous a profit grab as the industry might have preferred? Apparently, that would be OKas long as the people dont realize.
Maybe we are being unfair. So go ahead: Do you see a single place in todays column where Krugman addresses, in any way, the amazing state of our health care spending? Would a reader have any idea how amazing our costs really are?
Here at THE HOWLER, we have never seen a more managed, or more inane, discussion than this years discussion of health care. Until someone shows different, it seems clear that American citizens are being ripped off in their health care spending. They (or their employers; or their various governments) spend two to three times what others spendwhile getting similar outcomes. Presumably, large amounts of that over-spending go straight into industry pockets. Duh! A profit grab has been under way for a very long time, enabled by both political parties and by the mainstream press corps. (And by our polite liberal journals, the land of Serious Youngsters.)
In 2005, this situation was amazing. Today, it has disappeared.
In our view, its amazing to think that reform has worked if our astonishing costs continue to rise, even in contained fashionif we continue to spend twice as much as the French. In 2005, Krugman said we should learn from the French. Today, he seems to say that reform will have worked if the voters ne comprehend pas.
JOAN WALSH FOR PRESIDENT: On Friday, Joan Walsh finished her blog review of Taylor Branchs new book, The Clinton Tapes. In the process, she told the truth about the Clinton/Gore era in ways which basically havent been done that high up in the press corps.
Foser and Boehlert constantly do it. Lyons and Conason wrote two books in real time! (Not that any career liberals noticed.) But Walsh is editor of Salon, and shes a regular guest on big cable. In her review of Branchs book, she tells the truth about the Clinton/Gore yearstruth which the career liberal world has worked long and hard to avoid.
Plainly, you cant tell this story in one paragraph. But the following paragraph is a doozy. It states the plain, hidden truth:
WALSH (10/23/09): "The Clinton Tapes" makes clear that from start to finish, President Clinton was besieged by a vicious just-say-no GOP abetted by the perversely, inexplicably, cruelly anti-Clinton leaders of the so-called liberal mediafrom the New York Times' lame crusades against Whitewater and Chinese donors and Wen Ho Lee, to the integrity-free opinion journalism by Maureen Dowd and, sadly, Frank Rich, to a whole host of other liberal media characters who couldn't shake their feeling that Clinton was a fraud, a poseur, a hillbilly, a cynic. Their trashy eight-year oeuvre will likely go down in history as the most spectacularly malevolent and misguided White House coverage ever and politically costly, since it also encompassed Vice President Al Gore and probably made George W. Bush president in 2000.
Darlings, it simply isnt done! It isnt done to name Frank Rich. It isnt done to say that the mainstream press corps coverage of Clinton will likely go down in history as the most spectacularly malevolent and misguided White House coverage ever. (Were not sure who will be writing any such history, but Joans larger point is clear.) It isnt done to say that this malevolent coverage was authored by a host of liberal media characters. And its really not done to state the obvious: When this malevolent treatment was transferred to Candidate Gore, the mainstream press corpsand a whole bunch of liberalssent George Bush to the White House. Joan throws a probably in to be safe, but few assessments could be much more clear.
At the same time, few assessments have been avoided for so long by so manyavoided by the people who played active roles in that travesty, or enabled those who did.
Obviously, the conduct of Rich and Dowdand many otherssent George Bush to the White House. But so what? The career liberal world has spent ten years pretending not to know any such thing. In this way, they defend themselves and defend their ownand treat you like dish rags, like play-toys.
Joan names other names in her review. One of these names belonged to the late Tim Russert. This is what happens when the liberal world sits around diddling itself as a corporate mogul (Jack Welch) hires strings of weak-willed stooges, at millions per year, to promote the corporate interest:
WALSH (continuing directly): But I did find a nugget from the second half of the book that perfectly captures the whole poisonous, deluded, clubby Beltway mentality of the mainstream media circa 2000. It stars the late Tim Russert.
Branch recounts being the lone Clinton defender on one of the last "Meet the Press" shows of Clinton's term, when all the other guests were still obsessed with the president's sex life. It was bad enough on camera, but during commercial breaks Russert and his friends gossiped about alleged new Clinton girlfriends and sang the 2000 one-hit wonder "Who let the dogs out?" tapping their pencil along to the woof-woof chorus. (I don't believe in hell, but I think Russert spent some time in a way station in Purgatory being grilled on his poor political judgment during the Clinton-Gore years, before being welcomed to heaven by a God more forgiving than the Beltway mediocrities who sat in judgment on Clinton.)
In fact, that January 14, 2001 Meet the Press wasnt quite as one-sided as Branch recallsbut it came close. (The other guests: Gergen, Maraniss, William Bennett.) Reading the transcript after all these years, the most ludicrous moment was authored by Russert, who pretended to speak for the black community, voicing his deep concern about the way the deeply vile Clinton had challenged Sister Souljah, nine years before. Nine years later, Russert played tape of Clintons statementthough not of Sister Souljahs, of course, since almost no one in America, black or white, would have found much to agree with in her attitude or her pronouncement. (She had suggested that we devote a special day to killing only white people.) But how amazing! After speaking for black America, Russert sat and clowned off-air, singing satirical songs about Clintons imagined girl friends. Does anything ever change? In The Making of the President, 1960, Teddy White described the Kennedy press corps singing satirical songs about Candidate Nixon (along with Kennedy staffers) as they flew about the country on Candidate Kennedys plane. Forty years later, Branch sat and watched Russerts gang in song. The inanity of this group remainedbut their party alignment had changed now.
Thats what happens when the liberal world twiddles and diddles as corporate moguls make multimillionaires of compliant ethnic home-boys like Russertand Matthews and Williams. And lets be clear: Right to this day, the career liberal world has refused to tell the truth about this because they long to be TV stars too. Because they share the big-money culture and values which produced that spectacularly malevolent coverage.
Tim Russert got bought many years ago, By now, David Corn strikes us as bought too.
Continuing to do what mustnt be done, Walsh names a few more names from that astonishing era. Dowd was always top fool, of course. But to his credit, Branch even names the name of a neighbor and friend, right here in Baltimore:
WALSH: Against this historical backdrop of childish media snickering, the sharp, accomplished Branch comes off as a naif and even a rube in some of his stories, consistently flummoxed by the enmity among Washington media players, some of them his friends, as they savaged Clinton beyond proportion. He writes, bewildered, about a spate of vicious headlines at the end of 1996: The Times' Abe Rosenthal accused the Clintons of "giving militant Islam its first beachhead in Bosnia," while Maureen Dowd dubbed Clinton the trivia-obsessed "President Pothole" and the "Limbo President," sinking ever lower. For good measure she added: We pretty much know the Clintons did something wrong in Whitewater, when in fact, 12 years later, we know no such thing. Wen Ho Lee at least got an apology from the Times; the Clintons are still waiting. (Clark Hoyt, is it too late to take that factual error up with Dowd?)
But it wasn't just the Times: Branch also lays out Washington Post embarrassments; an Op-Ed by Andrew Sullivan headlined "The Clintons: Not a Flicker of Moral Life"; a declaration by liberal book critic Jonathan Yardleya friend and neighbor of Branch'sthat he wouldn't vote for Clinton in 1996 because he was a "buffoon" with a monstrous fault "at the core of his being...He is a man who does not believe in anything." One of my favorite sections of the book features Hillary Clinton sitting in her kitchen explaining why, no, thank you, she is never going to invite the vicious Sally Quinn into her houseand why should she, given Quinn's multiple treacherous, class-based takedowns of the Clintons as neighbors, leaders, parents, Americans?
For the record, those remarkable columns by Sullivan and Yardley appeared on the Sunday and Monday before the 1996 election. (On the Sunday before the 2000 election, Dowd opened her column with Gore looking in a mirror, singing I Feel Pretty. Can anyone tell us why this broken-souled, simnpering nincompoop still has a job?) Each fellow declared that a bad man like Clinton should be denied an electoral landslide. Apparently, this was one of the childish Group Stories to which all Serious People subscribed at that time. By 1996, one Hard Pundit Law was already clear: All Serious People Must Say The Same ThingsMust Always Recite The Same Stories.
You find yourself wishing and hoping Branch could find some Washington pooh-bahs who'd realize they'd been played by the Republicans, Walsh says. In fairness, that wasnt Branchs purpose in writing his bookand well disagree with Joans implied analysis a tad:
For the most part, these pooh-bahs werent played by Republicans. To a much larger degree, they had simply been bought by the prevailing culture of wealth and power. Russert was bought by Welch in the 1980s; the rest of Establishment Washington was bought by Russert (and by Matthews) in the years after that. They wanted the money; they wanted the fame; in the case of the silent children at the liberal journals, they wanted to make their mommies proud. They wanted to get their own simpering mugs on TV. They bowed to Inside Washington power. And the 1990s was a time of rising corporate/conservative /big-money power inside Establishment Washington.
Just a guess: Most of these people didnt get played, and they didnt get fooled. They knew what they were doing.
To this day, the liberal world has pretended that none of this ever happened. In the next week or so (we knowweve already missed a deadline), we ourselves will start posting a book about one part of this long, buried history. But your favorite liberal stars have always kept their traps shut about this stunningly gruesome era. So sure enough! Joan Walsh for president, the analysts cried, as she broke every rule in the book. In just the first paragraph we have quoted, Joan does what is simply never done. Joan Walsh tells the basic truth about a disgraceful, disappeared eraan era in which conservative/corporate/big money power squashed Democratic Party/progressive interests. By the way: Americans will never understand their countrys current power relations until actual liberals and progressives help them understand what happened in the 1990san era when conservative/big-money power purchased Establishment Washington.
Including the liberals, of course.
Your favorite liberals have never tattled about what happened during this era. May they join Russert in Joans described heaven, where Jesus will lecture them every day about the money-changers.
That said, Joans first quoted graf tells the truth. Dearest darlings! It just isnt done!