You can’t appeal to independents with a non-existent healthcare plan

October 29, 2007

Maybe it was just me, but I thought this WaPo article, which ran on page A2 yesterday, was a good example of what’s wrong with most campaign coverage.

Independents will make all the difference in New Hampshire.

That bloc, which encompasses more than 40 percent of registered voters in the state, exercises huge influence in the presidential primary process, as unaffiliated individuals can cast a ballot in either the Democratic or Republican primary.

While Sen. Barack Obama (D-Ill.) has drawn perhaps the most attention for his attempts to woo New Hampshire’s independents, former New York mayor Rudolph W. Giuliani (R) is set to begin a direct-mail and radio campaign of his own aimed at persuading unaligned voters to back his candidacy.

Both the radio ad, which will begin airing tomorrow, and the direct-mail piece, which will land in Granite State mailboxes over the next few days, are centered on Giuliani’s health-care plan.

The radio ad notes Giuliani talking about his battle with prostate cancer, while emphasizing America’s 82% survival rate, as compared to England’s 44%.”You and I should be making the decisions about what kind of health care we get with our doctors, not with a government bureaucrat,” Giuliani says in the ad.

The Post article suggested this message may help Giuliani “close the deal” with independent voters in New Hampshire.

There wasn’t even a hint of fact-checking, which in this specific case, is a real problem.

First, PM Carpenter noted that the one statistic Giuliani cites is wrong.

[D]eploying my vast research skills, I Googled “England prostate cancer survival rate,” and up popped the Web site of “Cancer Research UK,” the “leading funder of cancer research” in the Queen’s realm. Want to know what I found?

I shall quote: “The relative five-year survival rate for men diagnosed in England in 2000–01 was 71%,” which indicates that Rudy’s flat figure of 44 was creatively arrived at, statistically speaking. Not only that, for mates in Rudy’s current age group, 60-69, the survival rate is 83 percent — one uptick higher than his vaunted statistic for us ruggedly male, American individualists.

The WaPo piece simply passes along the claim as if it were true, and then inserts the ad into the horserace narrative.

Second, for the Post to even reference “Giuliani’s health-care plan” is itself unhelpful. In reality, Giuliani may have some kind of proposal, but it’s a stretch to call it a “health-care plan.” As Ezra reported back in August:

I’m supposed to be writing about Rudy Giuliani’s health care plan today. And I would, if Rudy Giuliani had a health care plan. But Rudy Giuliani doesn’t have a health care plan. What he has is a pretext with which to attack the Democrats. Indeed, just about all you need to know about Giuliani’s thoughtfulness on the issue can be summed up by the following: In the speech introducing and detailing his new health care proposal, Giuliani refers to the “Democrats” six times. “Single-payer” is said eight times. “Socialized medicine,” or some variant thereof, makes nine appearances. “Uninsured” is never uttered — not once….

[I]t’s worth wondering why anyone is even crediting Giuliani with a health care plan. The New York Times headlined their story “Giuliani Seeks to Transform U.S. Health Care Coverage,” before telling us, in the tenth paragraph, that “Mr. Giuliani’s speech offered very little in the way of specifics. He said his goal was to outline his ‘vision,’ with more details to come in the fall.” I guess the headline “Giuliani Seeks to Transform One-Seventh of Economy, Couldn’t Be Bothered to Offer Details on How” wasn’t snappy enough?

Failure of the press aside, let’s examine this “vision.” What Giuliani offered is this: A tax exclusion of up to $15,000 for families, and $7,500 for individuals, to help pay for health care. What Giuliani is relying on is people reading those numbers — $15,000 and $7,500 — without noticing that they don’t denote the amount of money he’s offering them, but the amount of money he’s not taxing them on. And when we plug it into my magical Rudy Translation Machine (constructed with the help of friendly neighborhood economist, Dean Baker), we can watch how $15,000 can easily become … zero.

The Post article, of course, doesn’t even hint at any of this. The reader is told Giuliani has a healthcare plan, that the candidate is touting it, that it’s different from England’s system, and that it’s likely to appeal to New Hampshire independents.

This really isn’t helpful.

But…buh buh but…NINE ELEVEN!

  • Since when do facts get checked? The media don’t need no stinking facts, and anyone who says they’re important is a party pooper.

    We are the TV nation. Reality is only what we say it is. It doesn’t matter if our leaders are dumb and dangerous, as long as the people who sell us TV think they’re good looking and tough sounding. We would be safer in a car driven by drunken teenagers.

    Ronald Reagan is the poster child for the TV nation. Even Gerry Ford, loyal dumbass extrordinaire, thought Reagan was a stupid show pony*. And Reagan is revered by half the nation, even though he committed treason.

    * This is what President Ford said about Ronald Reagan to Tom DeFrank who he knew and trusted for 33 years. Ford’s sole condition of speaking honestly was that he wanted his words to be kept secret till after his death.

    “A superficial, disengaged, intellectually-lazy showman who didn’t do his homework and clung to a naive, unrealistic, and essentially dangerous worldview. Foreign leaders have said they were appalled by Reagan’s lack of knowledge of the issues.”

    http://www.huffingtonpost.com/martin-lewis/reagan-without-the-ros_b_70143.html

  • The reader is told Giuliani has a healthcare plan, that the candidate is touting it, that it’s different from England’s system, and that it’s likely to appeal to New Hampshire independents.

    twice as good, actually

  • But if the media were to actually check facts, then they’d be called liberal. And they can’t have that.

    I propose we all do something from here on out: Instead of calling it “the media” or referring to these clowns as “journalists,” let’s just be more accurate and it “The Mirror” and call them “stenographers.”

    I have no clue what happened to journalism in this country, but … no offense to CB or any other blogger, it’s just a damn shame we have to rely on individuals working out of their homes to get the truth, rather than on an entire industry designed to do it.

    Thank gawd you all are here — I’d hate to think how bad it would be otherwise.

  • “The Post article suggested this message may help Giuliani ‘close the deal’ with independent voters in New Hampshire.”

    The question is, why do we expect the Post to bother its beautiful mind (or pretty little head) with facts?

    They’ve told us all they need to know — which is all *we* need to know: Giuliani’s empty slogans and arguments (“HillaryCare! Rawr!”) can help fool independent voters in NH because the Post won’t tell them anything else.

    (I’m trying to figure out what the pun on “horse-race coverage” substituting the word “whore” into the “horse” part of the phrase would be, but I’m drawing a blank…)

  • What Mark D said, though he’s far more mature than I am; I’m partial to slurs involving oral sex, since much of the media seems content to figuratively (or, in the apparent case of Jeff Gannon and maybe others, literally) suck off any conservative who demands service.

    Also, since so many of these “journalists” were so indignant about Bill Clinton’s peccadilloes and are so indifferent to the Bush-Cheney Administration’s sins, it seems especially apt to use such crude analogies, because their fixation on civility and politeness is especially obscene, given what it enables…

  • Just think about how these TV ads would affect voters if the competing party (Dems, in this case) was allowed to have fifteen seconds at the end of every Republican ad (and vice-versa), with another 15 after that for the original ad maker to counter any lies in the rebuttal. Gross lies like this would be impossible to get away with. But then that would be in a world where the media isn’t controlled by a few Republican-friendly megacorporations, I suppose…

    And what is with the WaPo? One day they’ll have an incisive, analytical, revelatory article, and then they’ll follow it up with days and days of total bullshit that couldn’t make it into a high school paper. What a way to run a paper.

  • Journalism and business are the degrees of choice for those who couldn’t pass most courses.

  • ”You and I should be making the decisions about what kind of health care we get with our doctors, not with a government bureaucrat,”

    The insurance company decides what kind of health care I get with my doctor. Past that my choice is limited to the size of my wallet.
    I had full health care when I lived in the UK with no worry about bankruptcy should I fall seriously ill…..even with pre existing conditions. I was fully free to discuss the options with my doctor and decide how I wished to proceed.

    The problem here in the US isn’t with the standard of treatment, it’s being able to afford it

  • Journalism and business are the degrees of choice for those who couldn’t pass most courses. -Jen Flowers

    Apparently statistics is the easy ‘A’ for flunkies in Iowa.

    Me, I picked psychology. A lot of good that did me. I’m still crazy.

  • All of the Republican “plans” are likely to look a lot like Rudy’s: tax credits and Health Savings Accounts, and lots of misinformation and scary buzz words.

    The people who have no health insurance because they cannot afford it are not suddenly going to have the whole medical world open up to them because they got a tax credit. See, people like Rudy – people who are awash in money and investments and disposable income – think that not subjecting some amount of income to tax is the same as that money now being in your pocket. They don’t understand that whatever small amount of tax one does not have to pay on that $15,000 or $7,500 is not going to buy anyone decent health insurance.

    If people want to understand what life would be like with a single-payer plan, they should talk to people who are on Medicare – those people make all their own decisions about health care – for the most part, they see the doctors they want to see, and there is no HMO-style gatekeeper that is trying to lay out as little as possible so as to keep profits and dividends high. And, Medicare has extremely low administrative costs, making it a very efficient program.

    I don’t believe the “universal health care” being proposed on the Democratic side is anything like the Canadian or British systems, where, if you have National Health Service coverage, you see only NHS providers – who are government employees. Nothing prevents the Canadians or the Brits from paying out-of-pocket for health care with non-NHS providers, however, so there is still a two-tier system even in countries with “government-run” health care.

    What we also will hear is the same baloney we heard on S-CHIP: any plan that has “government” in it will encourage people to drop their private plans, and that I think is what this is all about. The insurance companies are in a panic that they are going to get left behind in any Democratic plan, but I find it hard to feel much sympathy for a business which has always had the ability to make its product more affordable to more people, and still keep profits reasonable – but chose not to. So, instead of being content to be pigs getting fed on a regular basis, they opted to be hogs…and they end up being slaughtered. Oh, well.

  • One point I never see made is that among the nation’s nearly 50 million uninsureds are a sizable number of freeloaders. They’re not all victims of our atrocious system. Many opt out of the system voluntarily, because they’re in good health, like young people, and have nothing to gain by paying health insurance premiums. If they get sick or injured, they have little or no assets to cover their medical costs, and the rest of us wind up paying for them. That’s why automobile insurance is mandatory on the liability side. Yet these same people are quite capable of paying premiums for health coverage. They just don’t, and so drive up costs for the rest.

    It’s important to understand that a viable, fair and effective national health insurance system requires everyone to participate and contribute to the extent they can afford it.

    Unfortunately, we’re not likely to get such a system. The Republicans are concerned only with keeping the revenues and profits in the private sector. They don’t give a damn about people or their health.

    That last statement sounds like a Stark. So be it. They don’t give a damn.

  • Note to Chris @#10 “Fellating Stenographers” would be a great name for a punk rock band.

  • The most likely solution to the health-care disaster is to implement a small payroll-deducted premium—a flat rate based upon annual income—and then take the whole lump sum to buy an across-the-board health plan for every citizen in the country. This could easily be extended to provide equal coverage for legal immigrants and foreign students in the US on legitimate student visas. Each program “participant” would be provided with a healthcheck identity number which could be used as an alternative to SS numbers, and it’s ONLY for the health program. What’s someone going to do—steal free healthcare?

    A single-payer program would immediately lift the gross-cost burden from employers, who could take the reduced cost and apply it directly to employee wages—and keep the balance in their company bank accounts.

    A single-payer program would eliminate a great deal of the billing time experienced by doctors, as their support staff would no longer have to maintain account contact protocols for thirty or forty different insurance plans.

    And—a single-payer program would immediately eliminate those insurance providers who—having no medical experience whatsoever, feel that they have the legal right to refuse to pay for services rendered, or override the decision of the attending physician based on “cost analysis.”

    The private insurance companies have raped the People long enough. It is time for them to go the way of the dinosaurs….

  • No matter how you dice it, the US has higher cancer survival rates than Europe.

    medscape.com (subscription)

    August 22, 2007 — New reports from EUROCARE suggest that cancer care in Europe is improving and that the gaps between countries are narrowing. However, comparisons with US statistics suggest that cancer survival in Europe is still lagging behind the United States. The reports are published online August 21 in Lancet Oncology and scheduled for the September issue.
    One of the main messages from both reports is that in Europe, “for most cancers, survival has increased and between-country survival differences have decreased over time,” notes an accompanying commentary by Mike Richards, CBE, from the United Kingdom’s Department of Health. However, the differences between countries are not trivial, and “many more lives could be saved if the outcomes of all countries were brought up to the standards of the best” (ie, Norway, Sweden, and Finland), he comments. The United Kingdom in particular comes out badly in the tables, showing cancer survival rates that are among the worst in Europe. The findings suggest that the national cancer plan for England, which began in 2000, is not working, a second editorial comments.

    Survival Rates Significantly Higher in United States Than in Europe

    One of the reports compares the statistics from Europe with those from the United States and shows that for most solid tumors, survival rates were significantly higher in US patients than in European patients. This analysis, headed by Arduino Verdecchia, PhD, from the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, Italy, was based on the most recent data available. It involved about 6.7 million patients from 21 countries, who were diagnosed with cancer between 2000 and 2002.

    The age-adjusted 5-year survival rates for all cancers combined was 47.3% for men and 55.8% for women, which is significantly lower than the estimates of 66.3% for men and 62.9% for women from the US Surveillance, Epidemiology, and End Results (SEER) program (P

  • (continued)
    Survival was significantly higher in the United States for all solid tumors, except testicular, stomach, and soft-tissue cancer, the authors report. The greatest differences were seen in the major cancer sites: colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate cancer (77.5% vs 99.3%), and this “probably represents differences in the timeliness of diagnosis,” they comment. That in turn stems from the more intensive screening for cancer carried out in the United States, where a reported 70% of women aged 50 to 70 years have undergone a mammogram in the past 2 years, one-third of people have had sigmoidoscopy or colonoscopy in the past 5 years, and more than 80% of men aged 65 years or more have had a prostate-specific antigen (PSA) test. In fact, it is this PSA testing that probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment.

    Further analysis of these figures shows that, in the case of men, more than half of the difference in survival between Europe and United States can be attributed to prostate cancer. When prostate cancer is excluded, the survival rates decreased to 38.1% in Europe and 46.9% in the United States. For women, the survival rate of 62.9% for all cancers in the United States is comparable to that seen in the wealthiest European countries (eg, 61.7% in Sweden, 59.7% in Europe), and the slightly higher survival in the United States was largely due to better survival for colorectal and breast cancer, the authors comment.

    The differences in survival are due to a variety of reasons, Dr. Verdecchia and colleagues write. They include factors related to cancer services — for example, organization, training, and skills of healthcare professionals; application of evidence-based guidelines; and investment in diagnostic and treatment facilities — as well as clinical factors, such as tumor stage and biology.

    For hematological malignancies, except for non-Hodgkin’s lymphoma, the survival rates in Europe and the United States were comparable. The authors suggest that the reason may be that “these malignancies are usually referred to specialist centers for treatment, in accordance with evidence-based guidelines, and they are frequently included in international clinical trials.”

    Wide Variations Across Europe Are Narrowing

    Dr. Verdecchia and colleagues comment that their analysis of the most recent cancer survival data available in Europe suggests that the wide variations across countries, which have persisted for many years, “might be on the verge of decreasing.”

    The authors of the other report, which considered earlier data, from 1995–1999 (the EUROCARE-4 study), are more positive in their conclusions. Franco Berrino, MD, from the Fondazione Istituto Nazionale dei Tumori, in Milan, Italy, and colleagues say their findings show that “the gap in cancer survival in Europe is narrowing . . . and suggests substantial improvement in cancer care in countries with poor survival.”

    Nevertheless, both reports show that survival is worst in Eastern Europe and best in Western and Northern countries. Dr. Berrino et al comment that a consistent finding of all of the EUROCARE studies is that between-country survival differences are small for relatively uncommon treatable cancers, such as testicular cancer and Hodgkin’s disease, and also for cancers with a very poor prognosis. By contrast, for cancers with an intermediate prognosis — for which early diagnosis is typically an important determinant of outcome — the survival rates “still differ markedly, and probably unacceptably, between countries in Europe.”

    “Understanding the reasons for these persistent (but diminishing) differences is important for the public health response to cancer in Europe,” Dr. Berrino and colleagues write. The EUROCARE approach to disentangling these possible determinants of survival includes high-resolution studies, which use information accessed from clinical records. So far, these studies suggest that most of the survival differences for breast and colorectal cancer are attributable to differences in disease stage at diagnosis, while survival differences for testicular cancers seem to be due mostly to differences in access to appropriate treatment.

    Lancet Oncol. Published online August 21, 2007.

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