Friday, August 7, 2009


Steven Pearlstein (WaPost business reporter): Republicans Propagating Falsehoods in Attacks on Health-Care Reform

As a columnist who regularly dishes out sharp criticism, I try not to question the motives of people with whom I don't agree. Today, I'm going to step over that line.

The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.

There are lots of valid criticisms that can be made against the health reform plans moving through Congress -- I've made a few myself. But there is no credible way to look at what has been proposed by the president or any congressional committee and conclude that these will result in a government takeover of the health-care system. That is a flat-out lie whose only purpose is to scare the public and stop political conversation.

Under any plan likely to emerge from Congress, the vast majority of Americans who are not old or poor will continue to buy health insurance from private companies, continue to get their health care from doctors in private practice and continue to be treated at privately owned hospitals.

The centerpiece of all the plans is a new health insurance exchange set up by the government where individuals, small businesses and eventually larger businesses will be able to purchase insurance from private insurers at lower rates than are now generally available under rules that require insurers to offer coverage to anyone regardless of health condition. Low-income workers buying insurance through the exchange -- along with their employers -- would be eligible for government subsidies. While the government will take a more active role in regulating the insurance market and increase its spending for health care, that hardly amounts to the kind of government-run system that critics conjure up when they trot out that oh-so-clever line about the Department of Motor Vehicles being in charge of your colonoscopy.

There is still a vigorous debate as to whether one of the insurance options offered through those exchanges would be a government-run insurance company of some sort. There are now less-than-even odds that such a public option will survive in the Senate, while even House leaders have agreed that the public plan won't be able to piggy-back on Medicare. So the probability that a public-run insurance plan is about to drive every private insurer out of business -- the Republican nightmare scenario -- is approximately zero.

By now, you've probably also heard that health reform will cost taxpayers at least a trillion dollars. Another lie.

First of all, that's not a trillion every year, as most people assume -- it's a trillion over 10 years, which is the silly way that people in Washington talk about federal budgets. On an annual basis, that translates to about $140 billion, when things are up and running.

Even that, however, grossly overstates the net cost to the government of providing universal coverage. Other parts of the reform plan would result in offsetting savings for Medicare: reductions in unnecessary subsidies to private insurers, in annual increases in payments rates for doctors and in payments to hospitals for providing free care to the uninsured. The net increase in government spending for health care would likely be about $100 billion a year, a one-time increase equal to less than 1 percent of a national income that grows at an average rate of 2.5 percent every year.

The Republican lies about the economics of health reform are also heavily laced with hypocrisy.

While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers -- the only two ways I can think of to credibly bring health spending under control.

When Democrats, for example, propose to fund research to give doctors, patients and health plans better information on what works and what doesn't, Republicans sense a sinister plot to have the government decide what treatments you will get. By the same wacko-logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly.

Government negotiation on drug prices? The end of medical innovation as we know it, according to the GOP's Dr. No. Reduce Medicare payments to overpriced specialists and inefficient hospitals? The first step on the slippery slope toward rationing.

Can there be anyone more two-faced than the Republican leaders who in one breath rail against the evils of government-run health care and in another propose a government-subsidized high-risk pool for people with chronic illness, government-subsidized community health centers for the uninsured, and opening up Medicare to people at age 55?

Health reform is a test of whether this country can function once again as a civil society -- whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done.

If health reform is to be anyone's Waterloo, let it be theirs.

Smooth Like Remy: If You Aren't Watching The Rachel Maddow Show, You're Missing Out

Rachel connects a few more dots to expose the people behind the teabagging protestors that are disrupting the townhalls of Democratic members of Congress. This time she connects some shady former Bush Adminstration officials.

Then she calmly, carefully and politely connected Americans For Prosperity and their President, Tim Phillips, with this astroturfing effort and with catering to the religious right. If you pay attention you will actually see near the end of the interview where realizes that he has said too much and tries to call what she is doing gotcha journalism, but by that point it the cat was already out of the bag. I think he was thrown off because she was so mild mannered when asking him tough questions. So she came off as friendly all the while she was pulling negative information out of him. That's some top notch work righ there! She deserves an award for her reporting on this issue.

Brendan Nyhan: Health care/birther misinformation playbook

Between the birthers who promote the myth that the President was not born in this country and opponents of health care reform who falsely claim the legislation would promote euthanasia, there is a lot of misinformation floating around about the Obama administration. That shouldn't be surprising, though; Obama's honeymoon is ending.

What is striking is the extent to which birthers, led by Orley Taitz, and the health care misinformers, led by Betsy McCaughey, are working from a similar playbook. Here's an outline of how the process works:

1. Take a complicated issue that people don't understand (e.g. presidential citizenship reqirements and Hawaiian birth records or the complex health care reform bills pending in Congress).
2. Advance a disturbing hypothesis about the issue that will appeal to your side of the aisle (e.g. Obama isn't a legitimate president; the health bill will take away your freedom).
3. Misconstrue available evidence to construct arguments supporting your point.
4. Promote these myths widely. If you are successful enough in doing so, the media will feel obligated to report on them. Coverage will then frequently be presented in an artificially balanced "he said," "she said" format, giving further credence to your claims.
5. When your arguments are debunked, claim that the media is trying to silence you to prevent the truth from being revealed.
6. Repeat steps 3-5 until various elites (e.g. John Boehner on health, Lou Dobbs on Obama's birth certificate) start claiming you have raised legitimate questions about the issue of interest.

It's been reasonably well-documented how Taitz and her allies have followed this process in promoting the birth certificate myth, but I'm not sure if most people understand the extent to which McCaughey -- a more mainstream figure -- has used an almost identical approach to promote several falsehoods about health care reform.

Following the model of her infamous 1994 New Republic article on the Clinton health care plan, McCaughey has cycled through steps 3-5 above three times this year. First, Bloomberg published a commentary in which she falsely claimed in February to have discovered a provision in the stimulus bill that would lead to government control of medical treatments. Then, in June, she falsely claimed on CNBC that "the Democratic legislation pushes Americans into low-budget plans" and was given space to make similar claims by the New York Daily News and the Wall Street Journal. Now she's been spending the last few weeks promoting the false claim that the health care legislation in Congress would promote euthanasia, which was again featured in the Wall Street Journal and on former Sen. Fred Thompson's radio show.

Each of these myths was widely disseminated in the news media, but the euthanasia claim has received the most enthusiastic response from sympathetic elites. It's already been parroted by the RNC and various pundits as well as Republican members of Congress like Rep. Virginia Foxx, who suggested on the House floor that the Democratic plan would "put seniors in a position of being put to death by their government." As a result, it is now circulating widely at the grassroots level.

Who's to blame for this problem? I largely fault the media. While the Obama administration's message strategy has hardly been perfect, it's absurd to say, as Cynthia Tucker did on This Week, that Obama "allowed the opposition [to health care reform] to scare people" (my emphasis). In a polarized political system, the McCaughey/Taitz approach to concocting and promoting misinformation probably would have worked no matter what the White House did. As Kevin Drum and Matthew Yglesias recently argued, it's extremely difficult to myth-proof a bill or to effectively counter these claims once they are made. Until the media stops giving airtime and column inches to proponents of misinformation, the playbook is going to keep working.

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