The New Landscape

In 1994 when Betsy McCaughey wrote her piece in The New Republic full of lies abut the Clinton health care reform bill, the DC establishment accepted it uncritically because, well, she was in The New Republic, and nobody liked these Clinton outsiders anyway, and there was virtually no countervailing opinion independent of the White House that offered any refutation of her claims. The Village was the one and true arbiter of her story, and their acceptance of it colored the entire health care debate from that point forward.

Fast forward to 2009, and another fallacious McCaughey claim based on a clear misreading of legislative language makes the rounds of conservative media. Her claim that health information technology and comparative effectiveness research would cause rationing and give big gubmint a veto over your medical care is ridiculous. Only this time, a mainstream reporter actually chronicled how that conservative media puke funnel reinforces itself and creates opinion where there are only lies. And then a cable news show thoroughly debunks the lie in a long segment. And a series of blog posts reveal that McCaughey is on the board of directors of a medical device company and therefore has a conflict of interest over stopping comparative effectiveness studies, or that she received stock options from that company days before writing her flase op-ed in Bloomberg, or that the think tank she works at is funded by drug companies. As Ezra Klein says, this is a very new age:

Will Olbermann's segment on McCaughey end her relevance? Probably not. But it -- along with the blog posts, and inevitable columns -- will be part of what any CNN producer sees if he wants to run a segment on McCaughey the next morning. It will be part of what an NPR editor reads when she's researching a show. None of this progressive infrastructure existed in 1994. She published her smear job in an influential journal of putatively liberal opinion that was being edited by a self-professed conservative and it quickly become the conventional wisdom. This time, such arguments will not go unchallenged. That doesn't mean they will disappear. McCaughey's arguments are already taking root in the fertile swamp of talk radio. But it will be much harder for such bits of disingenuous nonsense to cement themselves in the center. And by the same token, it will be much easier for liberals to make, and disseminate, their own arguments.

I don't know if that's entirely true - there's nothing the Village likes more than to be willingly blind, and they'll probably opt for a "teach the controversy" approach - but that's better than the 1994 landscape.

Sometimes I definitely feel like I'm spitting into the wind out in the lonely blogosphere, and yet letting smears go unchallenged and letting progressive ideas get sandbagged is no longer an option. There is a progressive infrastructure now that can at least get a piece of the spotlight through relentless effort. It ought to actually be funded (greetings, liberal angels!), but even today it does have an impact.

Zombie Liars And The Right-Wing Puke Funnel

Media Matters chronicles the evolution of a wingnut talking point, where Rush reads something, distorts it, bounces it to Drudge and the Wall Street Journal editorial board and Fox, and then Rush cites the chatter as an "example" of how the talking point is growing. It's all so depressingly familiar.

Wall Street Journal senior economic writer Stephen Moore and Fox News anchors Bill Hemmer and Megyn Kelly promoted on February 10 the falsehood that the economic recovery bill includes a provision that would, in Moore's words, "hav[e] the government essentially dictate treatments." Former New York Lt. Gov. Betsy McCaughey apparently originated the false claim in a February 9 Bloomberg "commentary," which Rush Limbaugh and Matt Drudge touted that day. Indeed, Moore credited Limbaugh, saying of the provision, "I just learned of this myself yesterday. In fact, Rush Limbaugh made a big deal out of it on his radio show and it just -- it caused all sorts of calls into congressional offices." Limbaugh later took credit for spreading this story, saying during the February 10 edition of his radio show: "Betsy McCaughey writing at Bloomberg, I found it. I detailed it for you, and now it's all over mainstream media. Well, it's -- it headlined Drudge for a while last night and today. Fox News is talking about it."

The name "Betsy McCaughey" may not be totally familiar to you, but it may interest you to know that perhaps nobody is more responsible for the fact that America is the only industrialized nation on Earth without a universal health care system than her. The latest distortion, that because of the health IT provisions in the stimulus - backed by every side of the ideological spectrum from Barack Obama to Newt Gingrich - a National Coordinator of Health Information Technology will

...monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions.

Now, I can't think of anyone who should be more worried about electronic medical records being made public than Rush Limbaugh, but McCaughey is predictably peddling nonsense here. It talks about doctors having "complete, accurate information" to guide patients' care, but nothing about a federal bureaucracy having any authority to do the same. It's a deliberate lie, a misreading of the language of the bill.

But McCaughey, a Hudson Institute Senior Fellow, has a long history of distorting legislation to scare Americans about "socialized medicine." She was the writer of the long New Republic piece, allowed into the magazine by then-editor Andrew Sullivan, that slandered the Clinton health care plan with one lie after another. James Fallows provides the history, with a telling reminder of how the Village worked to screw health care reform in the 1990s:

Much of the problem for the plan seemed, at least in Washington, to come not even from mandatory alliances but from an article by Elizabeth McCaughey, then of the Manhattan Institute, published in The New Republic last February. The article's working premise was that McCaughey, with no ax to grind and no preconceptions about health care, sat down for a careful reading of the whole Clinton bill. Appalled at the hidden provisions she found, she felt it her duty to warn people about what the bill might mean. The title of her article was "No Exit," and the message was that Bill and Hillary Clinton had proposed a system that would lock people in to government-run care. "The law will prevent you from going outside the system to buy basic health coverage you think is better," McCaughey wrote in the first paragraph. "The doctor can be paid only by the plan, not by you."

George Will immediately picked up this warning, writing in Newsweek that "it would be illegal for doctors to accept money directly from patients, and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem 'necessary.'" The "doctors in jail" concept soon turned up on talk shows and was echoed for the rest of the year.

These claims, McCaughey's and Will's, were simply false. McCaughey's pose of impartiality was undermined by her campaign as the Republican nominee for lieutenant governor of New York soon after her article was published. I was less impressed with her scholarly precision after I compared her article with the text of the Clinton bill. Her shocked claim that coverage would be available only for "necessary" and "appropriate" treatment suggested that she had not looked at any of today's insurance policies. In claiming that the bill would make it impossible to go outside the health plan or pay doctors on one's own, she had apparently skipped past practically the first provision of the bill (Sec. 1003), which said,

"Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services."

It didn't matter. The White House issued a point-by-point rebuttal, which The New Republic did not run. Instead it published a long piece by McCaughey attacking the White House statement. The idea of health policemen stuck.

Plus ca change, plus ca la meme chose, n'est-ce pas? Gary Wills has more on McCaughey's lies.

This is how the conventional wisdom often gets set in Washington - an article that "the right people" read builds among the chattering class and then is distilled out to the people, no matter its veracity. While zombies like McCaughey are still churning out the lies, there's a whole new set - Rush, Drudge, Fox - of opinion leaders that get to set the agenda on these matters. Drudge still rules their world.

Health Care "This Year"

In between fielding another pointless round of questions on Rod Blagojevich, Barack Obama used today's press conference to introduce Tom Daschle as the next Health and Human Services Secretary and to signal that he would move early in his term to reform health care.

"Some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question -- I ask how we can afford not to....If we want to overcome our economic challenges, we must also finally address our health care challenge [...] This has to be interwoven into our economic recovery program. This can't be put off because we're in an emergency. This is the emergency!"

It's a very important way to look at the health care crisis, which is destroying both American families and American business with its twin outrages of soaring costs and reduced care. The key point, as Ezra Klein notes, is that Obama said he would seek to reform the system "in my first year." That suggests he is determined to move quickly on health care, which is exactly what is needed to secure passage. There are going to be a lot of neo-Hooverists out there calling for delay, but if Obama sticks with his solid rhetoric, he should parry those calls pretty easily. It's amazing what you can accomplish if you take the long view of the subject. If health care costs continue to expand at their current rate, today's recession will look like a small bump in the road.

Nobody really knew what Obama would spend his political capital on early in his term. If it's health care, I'm very pleased.

By the way, Daschle wasn't the only appointee on stage.

He also introduced Jeanne Lambrew's appointment as Daschle's deputy. Lambrew is an incredibly talented and knowledgeable health wonk, and her involvement should cheer liberals. Unlike during the campaign, when Obama's health care team seemed heavy on relatively cautious academics, Lambrew has long White House and executive branch experience, and comes to health care as a crusade as much as a topic of study. As Jon Cohn says, the importance of her presence "goes beyond the fact that she happens to know a heck of a lot about health care. She, too, has a strong commitment to what you might call the 'social justice' side of the debate."

More from Jon Cohn and Robert Pear at the NYT.

...as a side note, one of Obama's core ideas to lower health care costs is electronic medical records. Ezra spells that out pretty nicely here. You wouldn't think that you could achieve as much savings just by putting health records online, but it turns out that the Veteran's Health Administration has gone electronic, and they save $33,000 a year per nurse practitioner, according to this study. That's pretty amazing. And we're finally at a moment where we can swallow the up-front costs:

But the problem is the upfront costs are quite high. Around $50,000 per physician. And that's not to include the time it takes to learn the system, or a doctor's preference for the way he's always done things. Which is why fewer than 20 percent of physicians have adopted the technology. At this point, it's clear you'd need some coordinating authority to help pay some of the upfront cost, and ensure standards and interoperability among systems. An authority like...the government. Even Kevin MD, as free market as they comes, agrees. "The ball is in the government's court. If universal electronic records are the happen, they have the ability to make it so." And now the government, under Obama, is planning to make it so, including real money for health information technology in the stimulus package. This is how the stimulus should be used: To make necessary and needed investments that will have lasting beneifts.

Fantastic.