If the current effort to reform American healthcare ends in frustration, much of the blame rests on our political culture's empowerment of deception and ignorance. Fake erudition is revered, every hoax is deemed brilliant, and prejudice is presented as knowledge -- while actual expertise is disregarded or devalued.
The glaring evidence may be found in media and online everywhere today – but most blatantly, perhaps, in the nation's rapt attention to the fraudulent pronouncements of William Kristol and Betsy McCaughey, the right-wing celebrities who worked so hard to kill the Clinton reform plan. Knowing what we have since learned about him and her, it is hard to believe that anyone believes anything they say. But once again it is their words -- brimming with falsehood, stupidity and possibly both -- that inspire the opposition and confuse the public.
It appears that McCaughey is the source of the "elderly euthanasia" hoax now circulating on the Internet, talk radio and in right-wing media, which claims that Democratic health bills will force old, ill Medicare recipients into making plans for their own deaths. Two weeks ago, on former Sen. Fred Thompson's radio program, she warned that "the healthcare reform bill would make it mandatory — absolutely require -- that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner." The nonpartisan Politifact.com Web site described this claim as a "ridiculous falsehood."
Over the past several years, McCaughey had lapsed into a hard-earned obscurity, following her embarrassing stint as New York's lieutenant governor and spectacularly unsuccessful gubernatorial candidate, and then an even more embarrassing, somewhat bizarre divorce from Wilbur Ross, one of America's wealthiest investors. Her dizzying career had begun with "No Exit," the New Republic cover story that was responsible for blowing the first big political hole in the Clinton health plan.
Although she was then working at a conservative think tank in Manhattan, McCaughey posed as a kind of intellectual ingénue, the only independent analyst with the grit and moxie to read the whole damn plan. She had found the damning details that proved Clintoncare would mean the end of fee-for-service medical care in America and the mandatory enrollment of every citizen in managed care plans -- with criminal penalties for those who disobeyed. Her wild accusations were not only publicized by the New Republic (whose then-editor Andrew Sullivan still claimed to be proud of publishing her essay as recently as two years ago), and in the right-wing media, but quickly gained traction in the mainstream thanks to George Will and other conservative pundits.
This was a bravura performance, except for the fact that none of McCaughey's troubling accusations about the Clinton plan were true -- as James Fallows and many other critics later demonstrated. When Franklin Foer took over as the New Republic's editor, he publicly disowned her work and apologized on behalf of the magazine. Yet by then the damage had long since been done -- in part because McCaughey's accusations were picked up and amplified by Bill Kristol, a neoconservative strategist and former aide to Dan Quayle, who then ran an operation called the Project for the Republican Future.
Over the years, Kristol has earned a reputation as a writer impervious to facts. Whether in his magazine, on the opinion pages of the New York Times or the Washington Post, on Fox News Channel or any of his other myriad media appearances, the man's sloppy mental habits regularly lead him to utter strident statements and confident predictions that turn out to be laughably wrong. As other critics have noted, those intellectual pratfalls only seem to have elevated him to higher and higher levels of respect and remuneration among the Washington press corps.
Demonstrably bereft of any expertise on the subject of Iraq, to take the most notorious and ruinous example, Kristol was nevertheless capable of driving the United States to launch the invasion that turned into a bloody, trillion-dollar fiasco of historical proportions. He admittedly knew nothing about the decades of U.S. government collusion with Saddam Hussein, including the episodes that occurred while he was working in the first Bush White House. He clearly knew little about the seething and bloody resentments between the Shia and Sunni in Iraq, a problem he described as a mere figment of "pop sociology." He assured us that the weapons of mass destruction would be found, that the invasion would bring us respect in the Arab world and enhance our global prestige, and that the effects of war on the Mideast would be "terrific" and "healthy."
The catalog of Kristol's inaccurate pronouncements on that fateful topic is lengthy and widely available -- as are lists of his careless errors, large and small, on a variety of other subjects. Until his disastrous triumph on Iraq, however, his greatest political achievement was his effort to kill the Clinton healthcare plan, an offensive he launched as head of an outfit called the Project for the Republican Future. From there he sent forth the memos and scripts that persuaded Republican officials, including Senate leader Bob Dole, to say there was no crisis in healthcare -- and to bet their own political future on defeating Clinton's proposals.
Fifteen years later, millions more Americans lack health insurance and decent care, while costs continue to rise out of control -- yet Kristol nevertheless urges congressional Republicans to "go for the kill" and confront President Obama rather than compromise in the national interest. What is amazing is that he can still masquerade as knowledgeable and even expert in this field -- much as he did during the debate on Iraq.
With Kristol, it is not easy to tell where ideological philistinism gives way to plain deception. Either way, whatever he says on the subject of healthcare is almost certain to be precisely the opposite of what is actually true.
During his most recent appearance on "The Daily Show," Kristol found himself trapped by host Jon Stewart into agreeing that the government provides "first-class" healthcare to American soldiers -- a self-refutation of his own prejudice against the public sector. When he tried to rescue himself, Kristol displayed how little he really knows.
Bringing up the Veterans Administration, which used to have a poor reputation, he said, "I'm not sure the V.A., which is another government agency, has the best healthcare." But as Philip Longman demonstrated in his excellent 2007 book, "Best Care Anywhere," the V.A. has developed one of the finest, most technologically advanced, and least costly healthcare operations in the world. For several years now, the V.A. has "received the highest consumer satisfaction ratings of any public or private sector healthcare system," followed closely by Medicare. Its implementation of advanced information technology and medical records has saved thousands of lives and improved medical practice across the country -- and the V.A. has done all this in service to a population that suffers more from age and illness than the average.
Of course, experts, meaning people with current and competent understanding of health systems, are well aware of the advances made by the V.A. over the past 10 years. They would never resort to the dated stereotype used by Kristol to take a cheap shot -- before he quickly moved on to denigrate Medicare.
"I'm not sure Medicaid or Medicare, which are government-run programs, provide the absolute best healthcare, either," he said, before explaining why we cannot afford the "public option" or "single-payer" solutions. "One reason the price of healthcare is going up so fast is because of government programs. The price of Medicare and Medicaid have gone up faster than private insurance. The more government, the faster prices are gonna go up -- that's pretty well documented over the last 20 or 30 years."
Sure, and the WMD are just around the corner and the Shia and the Sunni will lie down in green pastures together. Except that the actuarial data compiled by the Center for Medicare and Medicaid Services, and many other studies, show that Kristol is dead wrong, as usual.
This month, the nation is celebrating the 44th birthday of the Medicare system -- and the statistics of the past four decades show clearly that the cost of private insurance has risen slightly faster than the cost of Medicare. Nobody, not even the most sedulous insurance lobbyist, tries to argue otherwise (except, perhaps, when addressing an especially gullible audience).
Indeed, the greatest scandal in healthcare costs over the past several years has been the so-called Medicare Advantage program, which subsidizes private insurers to provide care to seniors eligible for regular Medicare. Originally, the insurance companies insisted that their efficiency would allow them to profit from caring for the elderly even at the same cost per patient as Medicare. They promised to save money for the government. But now those same companies get an additional $1,000 -- or 12 percent -- more per beneficiary annually than traditional Medicare, and they want still more. It is the clearest possible proof that private insurance is more costly and wasteful than the public option.
So while Medicare's costs are rising too fast, that isn't the underlying cause of medical inflation. And Kristol, once more, doesn't know what he's talking about. He only knows what he wants to kill -- and once more he has dear Betsy wielding the rhetorical hatchet.