Editore"s Note
Tilting at Windmills

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September 29, 2009

DEPRESSING DEBATE.... As advertised, the Senate Finance Committee has spent the morning and early afternoon debating heath care reform, and for the first time, getting into the details of a public option. The problem isn't that the debate is going poorly -- it's long been expected that the provision would fall short at this stage -- it's that the arguments against the public option have been ridiculous.

Sen. Chuck Grassley (R-Iowa) has been repeating Lewin Group data that was debunked months ago. Sen. Orrin Hatch (R-Utah) has argued that socialized medicine costs less, which is a bad thing. Sen. Jim Bunning (R-Ken.) called a public option a "major step toward universal health care coverage." He meant it as criticism.

This is not the debate you want to watch if you're looking to be inspired by the grandeur of the American political system in action.

But Sen. John Ensign (R-Nev.) was especially interesting when he said the status quo in the United States does quite well on medical treatment, as compared to other countries, just so long as we don't count those injured by guns or car accidents.

"Are you aware that if you take out gun accidents and auto accidents, that the United States actually is better than those other countries?" Ensign said. Sen. Kent Conrad (D-ND) had been citing the health care systems of France, Germany, Japan and Canada as more effective, but with lower costs.

Conrad responded that one can bend statistics in all sorts of ways.

"But that doesn't have anything to do with health care. Auto accidents don't have anything to do with h--," Ensign said, cutting himself off. "I mean we're just a much more mobile society. ... We drive our cars a lot more, they do public transportation. So you have to compare health care system with health care system."

A few thoughts here. First, Ensign seemed to be making the case for gun control and expanded investment in public transportation. He actually opposes both.

Second, Ensign also said the U.S. does better than European countries on cancer survival rates. That's not true.

And third, unless Ensign has a plan to eliminate shootings and car accidents, I'm not sure what he hopes to prove with his observation.

Update: And fourth, in case it wasn't clear, Ensign's wrong on the substance. As Matt Yglesias noted, "What Ensign is saying here -- that gun accidents and car accidents fully account for the life expectancy gap between the US and other countries -- isn't true."

Steve Benen 2:15 PM Permalink | Trackbacks | Comments (39)

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I have the right to die in a firearm-related auto accident with no insurance, and you can't stop me! GOD BLESS AMERICA...

Posted by: Conservatroll on September 29, 2009 at 2:19 PM | PERMALINK

Yea, I got depressed and angry watching it, so I turned on BBC America's daylong Dr Who marathon.

Which is a hell of a lot more fun, and just as likely to be as realistic as getting a real public option in this country. OY.

Posted by: Dee Loralei on September 29, 2009 at 2:21 PM | PERMALINK

Please! You have to understand him! John Ensign is one of the five dumbest people on the planet. He has no clue what he is saying. They put it in front of him and he says it. He doesn't know what it means. He is only concerned about how he looks on TV.

If you look up "Empty Suit" in the dictionary, you will see John Ensign's picture. He is a disgrace to the species.

Posted by: Wayne Lively on September 29, 2009 at 2:23 PM | PERMALINK

Do politicians in France, Germany, Japan and Canada get away with paying off their mistresses?

Posted by: Tea Bagger Jones on September 29, 2009 at 2:23 PM | PERMALINK

Wow, I had no idea our high infant mortality was due to auto accidents and gun accidents. Those pregnant women need to be more careful.

Posted by: calling all toasters on September 29, 2009 at 2:29 PM | PERMALINK

I have no idea whether Ensign is using statistics accurately, but it is legitimate argument to question the differences in US and other societies as a possible reason that US outcomes are so far down the list of industrialized countries despite the much higher cost per capita. Of course as noted that does not address the uninsured who may be denied health care in at least some circumstances, the insured who may be denied health care by their insurers or the bankruptcies caused both individuals and businesses alike by the costs of health care or health care insurance.

Posted by: terry on September 29, 2009 at 2:34 PM | PERMALINK

That this stupidity is not called out by sitting Senators indicates to me that the whole lot of them is disturbed and should be eliminated by any means possible: I guess by gunshot while driving. Seems that is what is acceptable to this lot. Where are Boxer, Kucinich, Feingold? Biden? I don't get it. Are we the wisest people in the U.S. and get no say in this debate?

I am disgusted and may not even be making any sense. I hope they all get caught in their own web and die slowly and painfully, or have to watch their loved ones suffer at the hands of the best health care system in the world.

Fuck them all!

Posted by: Pissed and not holding back on September 29, 2009 at 2:35 PM | PERMALINK

The great thing is that we can instantly fact check these lying bags of putrid gas and call them on their bullshit. You know that in the good ole USA we really are experts at spreading good old american bullshit. It's the biggest political achievement these days.

Posted by: Gandalf on September 29, 2009 at 2:45 PM | PERMALINK

I don't know why you're depressed. The public is paying attention to this and I actually still have faith that the non-wingnut population will recognize the stupidity and which side is spewing it. Besides, Rocky and others are putting up a good fight for our position.

Posted by: Bill From PA on September 29, 2009 at 2:48 PM | PERMALINK

Snickering...

This is not the debate you want to watch if you're looking to be inspired by the grandeur of the American political system in action.

Wait until these folks try to solve global warming...
Hopefully I won't be all snickered out by then...

Posted by: koreyel on September 29, 2009 at 2:49 PM | PERMALINK

"Sen. Jim Bunning (R-Ken.) called a public option a 'major step toward universal health care coverage'. He meant it as criticism."

There are Orangutans smarter than this slug.

Posted by: Joe Friday on September 29, 2009 at 2:56 PM | PERMALINK

Actually, I think its the perfect debate to watch. Its pretty obvious that the Republican's "got nothin." Fun to watch, and also important to see which Dems really show their support for the healthcare industry over healthcare. Thank god for CSPAN.

Posted by: Scott F. on September 29, 2009 at 2:59 PM | PERMALINK

America has great politicians, as long as you don't count Republicans.

Posted by: hells littlest angel on September 29, 2009 at 2:59 PM | PERMALINK

i first saw this talking point pop up from a conservative on a comment thread the other day but haven't seen anything that links to the source...wonder who came up with these numbers..the same folks who made up cap n trade figures?

Posted by: dj spellchecka on September 29, 2009 at 3:03 PM | PERMALINK

Do politicians in France, Germany, Japan and Canada get away with paying off their mistresses?

Don't know about Japan and Canada. But at least in most of Europe they rarely need to, as sexual affairs of politicians are not that big a deal, unless there's some seriously aggravating factor. The roman-catholic countries may still be a bit more old-fashioned in this regard, but as Berlusconi's example in recent months has shown, even they have come a long way.

But then again, family values are no longer that great a barn burner either.

Posted by: SRW1 on September 29, 2009 at 3:04 PM | PERMALINK

Basically, Ensign's argument is that the US health care system is great, provided we don't count deaths from car accidents + gunshots. Makes sense to me, since he + most Republicans think that the Bush administration was wildly successful, provided we don't count 9/11, Iraq, or the Great Recession.

Give him points for consistency, if nothing else,
-Z

Posted by: Zorro on September 29, 2009 at 3:36 PM | PERMALINK

@terry: "it is legitimate argument to question the differences in US and other societies as a possible reason that US outcomes are so far down the list of industrialized countries despite the much higher cost per capita."

I completely agree. IF, in fact, you were somehow able to remove uniquely American factors from the statistics and eliminate uniquely European factors from the statistics, you would have a much better set of facts to debate.

However, there are four major problems with Ensign's argument:

1. Ensign is a buffoon, and anyone who follows politics well enough to hear his argument will immediately discard it because of this. Let's try to ignore this one for now, though.

2. Ensign picks two uniquely American factors (traffic accidents and gunshot wounds) with negative outcomes, but does not likewise discard uniquely American factors with positive outcomes (ex, dog bites or Wii-sprains, I don't know).

3. Ensign neglects to likewise discard the two most negative uniquely European factors (I'd guess cigarette smoking to be the top factor there just based on the recent US movement to discourage it severely).

4. He says "better" as though healthcare systems could be graded on a curve and lined up from best to worst. What single metric is he looking at which comes up "better" when you unfairly skew the statistics by removing two major causes of death in the US? I mean, he could mean anything from "everyone lives 10 years longer" to "insurance company execs are more satisfied with their bonuses" ... I'd bet his version of "better" is more likely the latter than the former.

Aside from that, a VALID and SCIENTIFIC attempt to "even the playing field" before comparing outcomes might be useful. On the other hand, we already HAVE "even playing field" comparisons of various countries before and after adopting various flavors of centralized healthcare, so one might make the argument that we already know the effect of centralized healthcare, at least at an aggregate level. The problem with that, of course, is that those known comparisons don't go Ensign's way.

Posted by: Tom Dibble on September 29, 2009 at 3:38 PM | PERMALINK

Senator Ensign wants to take away our guns!!!!

That's clearly what he's getting at here, isn't it? Alert the NRA! Call Rush and Beck! Ensign is trying to make guns look like a danger and a key cost to our health care system, so that he can then eliminate them!!

Posted by: biggerbox on September 29, 2009 at 3:48 PM | PERMALINK

@ biggerbox
Yea, and he wants to take away our cars too!!!

Posted by: cwolf on September 29, 2009 at 3:55 PM | PERMALINK

I wonder if it is even true - does Mr. Esteemed Senator mean that if you ALSO take out gunshots and car accidents from comparator countries that the US still does pretty well?

I assume Mr. Brilliant Senator is comparing along one variable - probably life expectancy. Assume it's true: is it okay that our health care system delivers the same ballpark outcome while paying 25%-100% more than other modern industrialized countries? While also leaving huge inequalities - some 18% are uninsured, the majority of bankruptcies are health care related (the majority of which actually had insurance).

Personally, I think that talking about having lower life expectancies than other countries is the weaker argument politically (for reasons like these). The main drivers of differential life expectancy outcomes, within the US and with international comparisons, are *lifestyle* issues. Ensign is creeping close to the common conservative observation that is you *take out* African Americans and Spanish-speaking immigrants, life expectancy in the US is very near other industrialized European countries. Of course, Ensign can't really say that. But broadly defined lifestyle issues do account for the majority of the variation.

(Even then, *choices* like an unhealthy diet, obesity and a lack of exercise lead to strokes and heart attacks, for instance, but those events are ALSO impacted by lack of health care - less well-controlled blood pressure and diabetes, etc. - which complicates making distinctions about which variations in outcomes are *health care* related and which are lifestyle/choices).

Posted by: flubber on September 29, 2009 at 3:55 PM | PERMALINK

The fact that we are even having a debate about whether outcomes in the US are better or worse than in Europe tells us that it is, in any case, a close call. What is not a close call, however, is the amount of money that we spend compared to other western industrialized countries,or the proportion of our citizens uninsured or underinsured. In addition, given the long term fiscal implications of healh care cost inflation, defending the status quo is recklessly irresponsible. One would think especially so if you were a conservative.

Posted by: Jason on September 29, 2009 at 4:03 PM | PERMALINK

Watching this repartee between Kyl & Roberts is like seeing a double backwards reach around two butt circle jerk.

Posted by: cwolf on September 29, 2009 at 4:09 PM | PERMALINK

Calling it insurance is kind of an anachronism is it not?

Posted by: jedediah Redman on September 29, 2009 at 4:15 PM | PERMALINK

To illustrate:

Californians live much longer than Arizonans, if you eliminate all traffic accidents on CA highways and US interstates 50, 80, and 5, surfing-related accidents, and heart attacks while breathing non-desert air.

While true (I'm guessing; haven't actually run those numbers) it's meaningless due to the cherry-picking involved.

Posted by: Tom Dibble on September 29, 2009 at 4:17 PM | PERMALINK

That debunked Lewin Group study said that the public option at Medicare rates would cost $2500 per year less for a family plan than a private plan with identical coverage. Why do Republicans and some Democrats want us to pay $2500 more per year for the same coverage?

Posted by: Th on September 29, 2009 at 4:18 PM | PERMALINK

Are you aware that if you take out the affairs he's had, John Ensign is as faithful as the most faithful American husband?

Posted by: shortstop on September 29, 2009 at 4:20 PM | PERMALINK

The fact that we are even having a debate about whether outcomes in the US are better or worse than in Europe tells us that it is, in any case, a close call.

I have to argue there. We have been having "debate" after "debate" in this country this year, but that doesn't mean that both sides had good points. If nothing else has been proven without a doubt in recent history, at least we have shown conclusively that the Republican Party doesn't need a valid argument or even the ability to convey a cohesive idea in order to engage in "debate".

The presence of "debate" does not prove the rough equivalence of the sides of that debate. Taking the scare quotes off "debate" requires actually judging the quality of the arguments on both sides, and so the presence of debate (no scare quotes) proves nothing but does require the assessment of the arguments.

To the larger point, though, I completely agree. Whether or not we have as-good results, we certainly pay a hell of a lot more, both in financial costs and in human costs of a disproportionate number of uninsured and the lack of security for those who are currently insured (until they come down with something drastic and the insurance company notes they neglected to dot the 'i' in their signature on a form three years previous).

Posted by: Tom Dibble on September 29, 2009 at 4:27 PM | PERMALINK

The American system is broken. Systemically, originally, broken. It can't be fixed without some truly major changes, and this system will not allow any changes. America will disintegrate.

This system is too corrupt to handle what's coming. I'd wager we give way to riots and political assassinations over the economy alone within 5 years. The government response to that will likely trigger a great deal of domestic terrorism. This country ended the day they decided to treat corporations like living people.

Posted by: soullite on September 29, 2009 at 4:32 PM | PERMALINK

Actually, it sounds like the superficial kind of argument that is just plausible enough to get on news shows. To summarize Ensign: "The problem is not health care. Take out gun accidents (are suicides included here?) and auto accidents, which do reduce longevity but don't have anything to do with health care and we are as good as they are." Another way to put it might be to say using longevity to compare the effectiveness of health care systems is invalid because so many irrelevant factors go into longevity. I know there has to be a good, pithy response to this, but I can't think of it at the moment. Any ideas?

Posted by: amorphous on September 29, 2009 at 4:53 PM | PERMALINK

This country ended the day they decided to treat corporations like living people.

Seeing as that decisions establishing corporate personhood date from as far back as the early 19th century, + I'd say this country did pretty well for most of the 20th century, your assessment is a bit harsh.

-Z

Posted by: Zorro on September 29, 2009 at 5:27 PM | PERMALINK

"What Ensign is saying here -- that gun accidents and car accidents fully account for the life expectancy gap between the US and other countries -- isn't true."

What a shocker.

Posted by: Joe Friday on September 29, 2009 at 5:43 PM | PERMALINK

Do you think that Ensign even knows that neither gunshot deaths nor fatal car accidents make it into the top 10 causes of death in the United States?

Yeah, me neither.

Posted by: Mnemosyne on September 29, 2009 at 7:22 PM | PERMALINK

I'm finding this "discussion" so stupid that I end up yelling "You lie!" or "Go to H*ll!" at the Rs on the teevee. It helps relieve stress, but not enough that I can stop taking my blood pressure meds.

Posted by: Hannah on September 29, 2009 at 7:29 PM | PERMALINK

Maybe I am misreading something, but when I clicked on the link about cancer survival, it did say the US had higher survival rates. Doesn't mean that Ensign has a point, but he is factually correct on the matter

Posted by: Hoss on September 29, 2009 at 7:50 PM | PERMALINK

"Are you aware that if you take out gun accidents and auto accidents, that the United States actually is better than those other countries?" Ensign said.

Well, if you take out all the sick people our health care system the numbers look even better.

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