Part 3—In search of a pulse: By all accounts, the New York Times’ Elisabeth Rosenthal is on her way to a Pulitzer Prize in April 2013.
She’s doing this without blowing cover, and without a discernible pulse.
Rosenthal has published three lengthy, front-page reports about the massive looting which characterizes American health care. But with the exception of Terry Gross, no one in the far-flung press corps has said a word about this, not even the fiery, corporate-paid “progressives” on The One True Liberal Channel.
Rosenthal’s topic lies at the heart of various top-shelf progressive concerns. The massive looting she is discussing helps explain the rise in income inequality. This looting also helps explain the nation’s stagnating wages; the inability of many people to afford health insurance; and the nation’s ballyhooed problems with debt and deficits, which affect the government’s ability to finance progressive projects.
For the record, Rosenthal is describing a major act of looting, in which Americans spend two to three times as much per person on health care as citizens in every other large developed nation. But Rachel hasn’t mentioned her name. Neither have Lawrence, Al or The Puppy.
For that matter, neither has anyone else except Gross! As Rosenthal cruises toward her prize, silence has invaded the (upper-end) suburbs where all good pundits dwell. This morning, Lady Collins has returned to her steady diet of weiner while promoting the need for “summertime” columns. Monday night, on The One True Channel, Lawrence interviewed a man who was troubled by the antics of a state fair rodeo clown. (For background, click here.)
Let’s assume these are sensible topics. What explains the total silence surrounding Rosenthal’s work?
In part, the silence reflects an upper-end group agreement which holds that massive looting of this type simply will not be discussed. Indeed, Rosenthal herself seems to be trying not to notice the phenomenon she is describing. There is one statistic she constantly mentions—the $2.7 trillion Americans spend on health care each year. But in the course of three long reports about the mammoth size of American spending, she has never mentioned statistics like these:
Per person spending on health care, 2009:Someone else will have to update those data. We’re tired of wasting our time presenting information here. But in that fairly recent year, the United States was spending two to three times as much, per person, as citizens of those other countries, while registering mediocre health outcomes.
United States: $7960
United Kingdom: $3487
Presumably, anyone with eyes and command of the language can spot the presumptive “looting” which screeches out from those remarkable data. Last September, the editors of Rosenthal’s paper even cited another (somewhat faulty) statistic which briefly made the rounds:
NEW YORK TIMES EDITORIAL (9/11/12): Waste in the Health Care SystemAs we noted at the time, this panel of experts seems to have missed a major chunk of the waste. The experts said that 30 percent of our health care spending was wasted. This takes us only partway down to the level of spending found everywhere else in the world—in France, let’s say, which spends half as much as we spend per person while registering equivalent outcomes.
A new report from a panel of experts convened by the Institute of Medicine estimated that roughly 30 percent of health care spending in 2009—around $750 billion—was wasted on unnecessary or poorly delivered services and other needless costs. Lack of coordination at every point in the health care system is a big culprit.
As she pretends to report on the high cost of health care, Rosenthal keeps failing to cite statistics like these. She keeps citing the total amount of American health care spending, a figure which has no meaning to anyone. (She might as well convert the amount into drachmas.) She omits the types of statistics which help us see the size of the looting which explains why our total spending came to $2.7 trillion last year, rather than (let’s say) $1.35 trillion, the amount of money we would have spent if we spent money like France.
That leaves $1.35 trillion we wasted. Just last year!
The $1.35 trillion we wasted could have been put to many uses. It could have gone into citizens’ pockets. It could have funded useful projects.
But Rosenthal keeps steering our eyes away from such data, and the kids on The One True Channel keep chasing Governor Ultrasound’s Rolex and that rodeo clown. As they do, they cluck like chickens, three times, and display their townie accents.
People, the news can be good solid fun, especially when the news is a scam!
This is the shape of corporate liberalism on this corporate news channel. By the way—the children themselves have excellent health care, and they are stuffing tons of bucks into their own fancy pants.
Meanwhile, Rosenthal keeps staying away from the big societal picture. Instead, she offers human interest.
On August 4, Michael Shopenn was the human in whom we were asked to take interest. With a dateline of Warsaw, Indiana, this is the way Rosenthal started her 3800-word report:
ROSENTHAL (8/4/13): WARSAW, Ind.—Michael Shopenn's artificial hip was made by a company based in this remote town, a global center of joint manufacturing. But he had to fly to Europe to have it installed.Because he knew a guy, Shopenn could have purchased a hip implant for $13,000. without any mark-up. But he couldn’t install it himself. The whole deal would run him $78,000, not counting the surgeon’s fee!
Mr. Shopenn, 67, an architectural photographer and avid snowboarder, had been in such pain from arthritis that he could not stand long enough to make coffee, let alone work. He had health insurance, but it would not cover a joint replacement because his degenerative disease was related to an old sports injury, thus considered a pre-existing condition.
Desperate to find an affordable solution, he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the ''list price'' of $13,000, with no markup. But when the hospital's finance office estimated that the hospital charges would run another $65,000, not including the surgeon's fee, he knew he had to think outside the box, and outside the country.
''That was a third of my savings at the time,'' Mr. Shopenn said recently from the living room of his condo in Boulder, Colo. ''It wasn't happening.''
As she continued, Rosenthal explained what happened next. At this point, a reader may think that he or she has already been gobsmacked:
ROSENTHAL (continuing directly): ''Very leery'' of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels for $13,660. That price included not only a hip joint, made by Warsaw [Indiana]-based Zimmer Holdings, but also all doctors' fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.Say what? In Brussels, the whole operation, including the surgeon’s fees, cost $13,660! That included the (Indiana-manufactured) hip joint, which by itself was going to cost Shoppen $13,000 in this country, where he was getting list price!
''We have the most expensive health care in the world, but it doesn't necessarily mean it's the best,'' Mr. Shopenn said. ''I'm kind of the poster child for that.''
Can we talk? At this point, we’ve already seen evidence of a serious crime. Rather plainly, someone had tried to conduct a major scam at Shopenn’s expense.
Yet just as Shopenn needed a hip, Rosenthal seems to need a pulse. Quoting Shopenn, she again makes an impressive bid for an Absurd Understatement Award.
Shopenn is quoted saying that our health care is “most expensive in the world.” Based upon everything else we've been told, it seems he meant to say that it constitutes some sort of criminal enterprise. And as Rosenthal continued, she convinced us of a basic fact:
Perhaps at the direction of her editors, she seems unwilling to comprehend the size of the offense she’s describing. Please note her additional Vast Understatement bids, along with the very large elephant which has entered the room:
ROSENTHAL (continuing directly): As the United States struggles to rein in its growing $2.7 trillion health care bill, the cost of medical devices like joint implants, pacemakers and artificial urinary valves offers a cautionary tale. Like many medical products or procedures, they cost far more in the United States than in many other developed countries.Do medical devices “cost far more in the United States than in many other developed countries?” Based upon what we’ve just been told, we’d have to say that’s another bid for the Understatement Prize.
Makers of artificial implants—the biggest single cost of most joint replacement surgeries—have proved particularly adept at commanding inflated prices, according to health economists. Multiple intermediaries then mark up the charges. While Mr. Shopenn was offered an implant in the United States for $13,000, many privately insured patients are billed two to nearly three times that amount.
An artificial hip, however, costs only about $350 to manufacture in the United States, according to Dr. Blair Rhode, an orthopedist and entrepreneur whose company is developing generic implants. In Asia, it costs about $150, though some quality control issues could arise there, he said.
But as she continued, Rosenthal’s data brought our analysts out of their chairs, as did her lack of a pulse. Can Rosenthal possibly mean what she said? Can we be reading that right?
Can that possibly be what she meant? Rather plainly, she seems to say that the actual cost of manufacturing that artificial hip in the United States is just $350.
Can that possibly be what she meant? Hadn’t she told us, just moments before, that Shopenn was going to be charged $13,000 for that item—and only because he was going to get it at “list price?”
Others get billed two to three times that much. Isn’t that what she just said?
We’ve read Rosenthal’s piece again and again. We’ve read it again and again today. It seems to us that this is what she said.
It also seems that it can’t be.
No matter how many times we read that piece, it keeps coming out the same way. According to Rosenthal, it costs $350 to manufacture an artificial hip in the U.S.—and Shopenn was going to be charged $13,000 for his.
The hospital fees would have been in addition. That was the price he was going to pay for the device, by itself.
That’s what Rosenthal’s words seem to say. But Rosenthal’s affect says something different. She seems unable to grasp the fact that she seems to be describing a crime. A case of looting has been described. There’s no sign that Rosenthal knows it.
Our inner voice keeps telling us that we must be reading this wrong. “Where’s the outrage,” Bill Bennett used to say. In this case, we add, “Where’s the pulse?”
On cable, Lawrence rails at a rodeo clown and shows us his best townie accent. Rachel clucks like a chicken, three times, and hunts after Ultrasound’s Rolex.
None of these corporate rodeo clowns have said a word about Rosenthal’s series! Is this the way “liberal politics” looks when it’s scripted from on high, from high in the corporate boxes?
Tomorrow: How CNN sounds