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April 27, 2007

The Worst Op-Ed I've Read In A Long Time

There's this wonderful moment in the Simpsons, where Burns goes into the doctor for a check-up, and the doctor explains that the only reason he's alive is that there are so many diseases trying to kill him that none can get through. They're all crowded at the door, struggling to enter. That's sort of describes my reaction to Doug Schoen's health care op-ed. I feel virtually incapable of engaging with it, paralyzed by the infinite expanse of logical holes, self-serving omissions, and political hackery riddling the article. But I shall soldier on.

"According to a Kaiser Family Foundation poll in March," Schoen writes, "after Iraq, healthcare is the single most important issue among American voters today." I've read that poll. And I've read Doug Schoen's op-ed. And the two have nothing to do with each other.

Schoen's op-ed mentions the word "partisan" four times. It tells us that "[Americans] want to see healthcare needs and issues addressed in a spirit of partnership, not partisanship," that [w]hat is clear is that America wants everyone to work together in a constructive manner," that "[h]ealthcare should not become a partisan issue," that Medicare Part D "marked a huge bipartisan step forward" and that "working together, the members of the two parties were able to bring together the best ideas from both sides of the aisle to create a broad-based program that succeeds in achieving many critical goals."

Want to know the final vote tally on Medicare Part D was in the House of Representatives? 216-215. Want to know how long Tom DeLay extended the vote to dragoon and intimidate more members? Three hours. Want to know the Senate margin? 55-44. There was nothing bipartisan about it. It's widely acknowledged to possess huge failings owing entirely to drug company giveaways. George W. Bush is currently threatening to veto an overwhelmingly popular bill that would empower Medicare to bargain down drug prices -- a bill that Democrats made into a core part of their 2006 platform. Schoen mentions none of this. He paints one of the most grotesquely partisan votes in history, a vote that literally led to ethics investigations against DeLay, as a bipartisan triumph. He ignores the overwhelmingly popular reform that Democrats have long been touting. He spins, he misrepresents, and he lies in order to strengthen the Republican bargaining position.

Here's another finding from Kaiser. 52% of voters want "A new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured but would involve a substantial increase in spending," while only 24% support "A new health plan that is more limited and would cover only some groups of the uninsured BUT would involve less new spending." As anybody who's ever picked up a paper knows, the former is the Democratic approach, the latter the Republican way. Schoen not only appears devoid of opinions on which is better, he seems to be counseling Democrats to follow the less popular path.

It's almost a parody of the pernicious Democratic consultant. There's no core convictions, no policy preferences, no belief in Democratic ideas, no thoughts about how to lead public opinion, a fetish for bipartisanship, a willingness to ignore the ongoing sins of the Republicans and abandon popular progressive legislation, and an attempt to convince the Democratic Party that it's actual position is weaker than it is and compromise must start now. That he's not backed up by the facts of the poll nor the facts of Medicare Part D don't stop him in the least. This is very genuinely one of the worst opinion pieces I've ever encountered.

April 27, 2007 in Health Care | Permalink


I know how passionate you are about health care. I have alot at stake with it as having a son who just broke his hip right after we added him back on with him going back to college. And I have medical issues as well.
But, you are focusing so much on it you are barely addressing any other issue. You use to have a good mix up of different things everyday. Now, you blog is pretty much just health care. zzzzzzzzzzzzzzzzzzzzz.

Posted by: vwcat | Apr 27, 2007 12:37:04 PM

It's almost a parody of the pernicious Democratic consultant. There's no core convictions, no policy preferences, no belief in Democratic ideas, no thoughts about how to lead public opinion, a fetish for bipartisanship, a willingness to ignore the ongoing sins of the Republicans and abandon popular progressive legislation, and an attempt to convince the Democratic Party that it's actual position is weaker than it is and compromise must start now.

That's no parody. That's an accurate description.

Posted by: Stephen | Apr 27, 2007 12:38:11 PM

VW: I don't mean this to seem snarky in any way, I really want to know if readers feel that's true. Yesterday I had eight posts. One on Gonzales, one on Lieberman and Iraq, one on Prince Charles, one on monarchies, one on Iraq casualty numbers, one on Matt Taibbi and the press, and one on the uninsured. Does it really feel so imbalanced?

Posted by: Ezra | Apr 27, 2007 12:47:34 PM

A good part of the reason I come here is for the analysis of health care issues. For other issues I go to other blogs.

Posted by: nolo | Apr 27, 2007 12:51:41 PM

"Does it really feel so imbalanced?"

No it doesn't. Keep doing what you're doing.

Posted by: Waingro | Apr 27, 2007 1:04:55 PM

I agree - the healthcare analysis is a HUGE reason I come to the blog - along with Matt Holt you are one of the premiere liberal health policy analysts I have ever read. I do read some of the other (excellent) pieces also but healthcare is #1.

You are so prolific Ezra that I do not have time to read every post.

Readers - I suggest that if you are not interested in the subject of a post - DON'T READ THE ARTICLE!

Keep up the great work!

Posted by: terry | Apr 27, 2007 1:07:42 PM

No, it doesn't seem like an imbalance Ezra - I think you've done a good job making healthcare a primary, but not overwhelming, focus of your blogging (and now that I blog, I understand why new posts can seem to take a while and certain issues become central ones, if only for a while). That said, I'd put vwCat's point another way - not so much why so much health posting, but why this article, which seems like the usual boilerplate hash we're getting lately from pundits who don't know what they hell they're talking about on healthcare. I mean Schoen's so clueless he can't even face that America "may want to choose its own doctor" but has no idea how to actually go about this. Or how about, you can't simply cover everyone and say that everyone will have access to the best care, because these two premises naturally conflict. If we cover more people and more people get access to care (good things, it seems to me), the natural outgrowth of that will be more good care, and somewhat less "best" care being available. These are trade-offas, and no one, certainly not Schoen, seems honest enough to admit the need ofr them. But again, why Schoen? Does Real Cklear Politics really seem to know what they're doing on this topic? I'd say not, and I'd say this thing is really not worth the time and energy of even dismissing. It's just too easy. Fish in a barrel. Or, worse, a sign of just how little good information is really out there. And I don't know that anyone has a good answer for fixing that in the near future - look at some of those lightweight, pointless answers in the South Carolins debate last night.

Posted by: weboy | Apr 27, 2007 1:20:25 PM

the mix: just about right IMO.

There is such an awful amount of misunderstanding of health care issues and facts that your efforts are needed, welcome and make a great contribution.
He spins, he misrepresents, and he lies in order to strengthen the Republican bargaining position.

This is the conservative/GOP/libertarian modus operandi, and has been well before Bush or even Reagan. If there is no substantial electoral penalty or public approval penalty (because of the media 'balance' thingy), why not lie?

It used to be thought that calling a liar a liar (and proving it) was enough to discredit that voice. Now, lies are expected and rarely is the lie called a lie. I've tried to understand how this shift occured. One explanation is that we've adopted an overly legalistic view about what a lie is: a lie is only a lie if the intent was to lie (and who knows what intent lurks within a person's being?).

A lie is a mistruth in the real world. More lies need to be calleld lies, and the penalty for lying should be shunning and dishonor.

Posted by: JimPortlandOR | Apr 27, 2007 1:25:03 PM

Occasionally I find the second or third post on a particular piece of health care minutiae to be a little dreary, but I wouldn't ask you to change your focus, because overall I know way more about health care than I ever would if I didn't read your blog. And anyway, the wonder of blogs is that you can skip the boring posts and even go find some other clever young liberal Jewish guy who's writing about what he thinks. In fact, I gather a whole bunch of your close friends provide this very service.

Posted by: Sam L. | Apr 27, 2007 1:30:18 PM

Ezra: in a word, no. You like healthcare, you're good at it, stick with it. The world doesn't need another damn journalist who doesn't know the difference between Medicare and Medicaid, and thinks "moral hazard" has something to do with free-flowing booze at frat parties.

When you go too long without a healthcare post, I miss it. And healthcare matters.

That said, isn't Schoen a big Hillary supporter? Her entire position is that we should have healthcare reform, but with no new spending. She's gonna reform exactly like it's 1994. No spending was a core principle in 1994.

Posted by: anonymous | Apr 27, 2007 1:32:13 PM

There's this wonderful moment in the Simpsons

No matter what the situation is, there is a Simpsons quote that fits perfectly.

Too much health care? No, not really. It's an important issue that doesn't get nearly enough attention. That looks like it may be starting to change, though. It would be a shame to ease off the pedal now.

Posted by: Jason | Apr 27, 2007 1:35:39 PM

Doug Schoen: The Schoen in "Penn, Schoen & Berland", where Penn is Mark Penn, HRC's leading public opinion adviser.

Posted by: Tony V | Apr 27, 2007 1:36:23 PM

Keep doing what you're doing, Ezra.

Posted by: Wisewon | Apr 27, 2007 1:44:28 PM

In regards to meta-blogging, I feel like the balance of health care vs. other issues is fine. However, this specific post is a good example of another issue: dividing points between this blog and TAPPED.

You've got another, pretty different post up at TAPPED right now about the Doug Schoen op-ed, which I personally enjoyed more. The post here at ezraklein.com focuses on more health care parsing stuff, the on at TAPPED talks about Schoen's relationship to the larger consultant system.

This is starting to become a trend IMO. Is there some directive from on high that personal stuff/policy discussion stays over here while more political/horse race stuff gets pushed over there?

Posted by: Korha | Apr 27, 2007 1:54:48 PM

Not enough basketball blogging; definitely imbalanced.

"That said, isn't Schoen a big Hillary supporter? Her entire position is that we should have healthcare reform, but with no new spending"

That is why I think this is a good & important post. I respect HRC and her supporters, at least to the extent that they know what they are doing. No new spending = no new taxes = opinions & interests of the elites and middle-upper class are the only important ones, since the rest of us are TV sheep that can be bought with corporate profits converted to campaign funds. The lesson of the Shrub years. Lying works.

Or the people can be safely ignored, since liberalism has been so made our entire consciousness that other organizing systems and tactics are unthinkable.

Why do Democratic/Beltway consultants and the MSM act the way they do? Not because they are stupid or lazy. I guess "evil" depends on how much you accept false consciousness.

Posted by: bob mcmanus | Apr 27, 2007 2:01:25 PM

Great post, man. Keep doing what you're doing, and ignore vwcat.

Posted by: Neil the Ethical Werewolf | Apr 27, 2007 2:17:07 PM

The healthcare posts are of the most interest to me. Keep them coming.

Posted by: BC | Apr 27, 2007 2:21:17 PM

The Great Pet Food Scandal ...via Flippy and BitchPhd.

Maybe tangential to topic, but I think tangentially. Everything is connected. The article is really about a hidden consolidation of the wet pet food industry, outsourcing of ingredients to China, and a favorite topic of this blog:

"But even as Menu's business grew exponentially, its margins were reportedly under constant pressure. It was rumoured within the industry that Wal-Mart and Loblaw, eager to maintain their own margins in a competitive pricing environment, kept a lid on prices that squeezed Menu's profits. Specifically, Menu was expected to deliver expensively made foil packs -- now at the centre of the contamination controversy -- at the same price as cans. "They definitely had to eat margins to a point they weren't making any money selling to Wal-Mart"

Wal-Mart killed your cat, folks. Not Menu, not China. I hear Wal-Mart is getting into the health-care business. Are we outsourcing the manufacture of generic drugs to China yet?

Posted by: bob mcmanus | Apr 27, 2007 2:23:57 PM

I just kinda assumed that healthcare was something you seem to know a lot about and that why you write about it. Its also why I come here.

.....back to lurking and reading (maybe some work too)

Posted by: ken | Apr 27, 2007 2:46:20 PM

From the episode entitled "The Mansion". I was thinking of this the other day, but as a metaphor for all the scandals afflicting the Bush presidency...

At the Mayo Clinic, Burns receives the results of his tests.

Burns: Well, doc, I think I did pretty well on my tests. You may shake my hand if you like.
Doctor: Well, under the circumstances, I'd rather not.
Burns: Eh?
Doctor: Mr. Burns, I'm afraid you are the sickest man in the United States. You have everything.
Burns: You mean I have pneumonia?
Doctor: Yes.
Burns: Juvenile diabetes?
Doctor: Yes.
Burns: Hysterical pregnancy?
Doctor: Uh, a little bit, yes. You also have several diseases that have just been discovered -- in you.
Burns: I see. You sure you haven't just made thousands of mistakes?
Doctor: Uh, no, no, I'm afraid not.
Burns: This sounds like bad news.
Doctor: Well, you'd think so, but all of your diseases are in perfect balance. Uh, if you have a moment, I can explain.
Burns: Well ... [looks at his watch]
[the Doctor puts a tiny model house door on his desk]
Doctor: Here's the door to your body, see?
[bring up some small fuzz balls with goofy faces and limbs from under the desk] And these are oversized novelty germs. [points to a different one up as he names each disease] That's influenza, that's bronchitis, [holds up one] and this cute little cuddle-bug is pancreatic cancer. Here's what happens when they all try to get through the door at once. [tries to cram a bunch through the model door. The "germs" get stuck] [Stooge-like] Woo-woo-woo-woo-woo-woo-woo! Move it, chowderhead![normal voice] We call it, "Three Stooges Syndrome."
Burns: So what you're saying is, I'm indestructible!
Doctor: Oh, no, no, in fact, even slight breeze could --
Burns: Indestructible.

Posted by: Jon Moyer | Apr 27, 2007 2:58:15 PM

I read a number of progressive blogs every day, but I'm not sure who this guy Schoen is. Should I care what he has to say about health care?

If his op-eds only appear on RCP then I'm not too concerned.

re: Too many health care posts. Is he kidding? Ezra does a great job of translating health care wonkishness into plain English. Thanks to Ezra, I now start all health care arguments with this: we pay nearly twice as much for "free market" health care as European countries with "socialized" health care, and we get worse results.

I think you're doing a great job. Keep up the health care posts.

Posted by: Colin | Apr 27, 2007 3:16:11 PM

Ezra, I enjoy all your posts but health care is the reason you're worth reading. On everything else, you're just a bright young guy but on health care you're developing real expertise.

Posted by: bloix | Apr 27, 2007 5:18:09 PM

Ezra, the mix is perfect. You quickly became one of my few daily reads.

Re: the post on Schoen, I think you're doing us a service; we need to get rid of that type of consultant.

Posted by: eriks | Apr 27, 2007 5:21:56 PM

You're my go-to healthcare blog, not b/c you post on it a lot, which you do, but b/c you have become a credible expert in the field and I trust what you write. Keep it up.

Posted by: eRobin | Apr 27, 2007 5:23:55 PM

This country should have had single-payer universal health care insurance long ago, yet even today our Democratic candidates are too wimpy to promise it.

And the amount of stupidity and misinformation abounding on the subject is overwhelming in newspapers and TV.

Keep up the good work.

Posted by: Joyful Alternative | Apr 27, 2007 5:35:20 PM

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