THE RATIONAL ANIMAL'S GUARDIANS: Guardians abandon their posts!

MONDAY, FEBRUARY 24, 2020

The $8000 tax:
Long ago and far away, the Washington Post published a front-page report which was, in theory, important.

Actually, Heather Long's front-page report appeared early last month. It graced the front page of the Washington Post.

Long's report started as shown below. As a theoretical matter, her topic was very important:
LONG (1/8/20): America’s sky-high health-care costs are so far above what people pay in other countries that they are the equivalent of a hefty tax, Princeton University economists Anne Case and Angus Deaton say. They are surprised Americans aren’t revolting against these taxes.

“A few people are getting very rich at the expense of the rest of us,” Case said at conference in San Diego on Saturday. The U.S. health-care system is “like a tribute to a foreign power, but we’re doing it to ourselves.”

The U.S. health-care system is the most expensive in the world, costing about $1 trillion more per year than the next-most-expensive system—Switzerland’s. That means U.S. households pay an extra $8,000 per year, compared with what Swiss families pay. Case and Deaton view this extra cost as a “poll tax,” meaning it is levied on every individual regardless of their ability to pay.
In recent years, Case and Deaton have become major high-profile economists. In 2015, Deaton won a Nobel Prize in the field.

Now, the pair were saying that the typical American household is paying the equivalent on an $8000 tax due to our nation's very high health costs.

Indeed, the typical family is paying this extra $8000 every single year. And, as Long's report continued, the news got even worse:
LONG (continuing directly): Despite paying $8,000 more a year than anyone else, American families do not have better health outcomes, the economists argue. Life expectancy in the United States is lower than in Europe.

“We can brag we have the most expensive health care. We can also now brag that it delivers the worst health of any rich country,” Case said.
Oof! American families are paying an extra $8000 per year. In return, our system is "delivering the worst health [outcomes] of any rich country," according to Case.

Case and Deaton had delivered this analysis at the annual meeting of the American Economic Association. Their analysis went right to the front page of the Washington Post—and, completely predictably, that's where the matter died.

The Post's report appeared in early January. We've waited to mention the front-page report in order to make a key point:

Our public discourse involves no serious discussion of any significant issue. In journalism and in the academy, the guardians have walked off their posts.

Before proceeding, let's note one key fact about Case and Deaton's analysis. By comparing American health care spending to that of Switzerland, the economists were making their point in the softest possible terms.

Switzerland is a small higher-income nation. Its per capita health care spending falls well short of our own, but it far exceeds that of all other major developed nations.

If Case and Deaton had compared our health care spending to that of Canada, France, the U.K. or Japan, the "poll tax" paid by the typical family would have been much larger.

Those larger developed nations all spend much less, per capita, than Switzerland does. For the relevant data, click here.

In that sense, the typical American family is paying a hidden "tax" of substantially more than $8000 per year. In return for all that extra spending, they're getting the worst health outcomes in the developed world, or so say Case and Deaton.

You'd almost think a front-page report like the one in the Post would trigger wide public discussion. That's especially true because health care has become the central driving topic in the nation's recent political discussion.

Health care lies at the heart of the current Democratic White House campaign. The Post was reporting that the typical family was paying an extra $8000 for its health care every single year—and, as a handful of journalists may even know, the real number is substantially higher!

You'd almost think a report like that would generate public discussion. But this front-page report in the Post had a predictable lifespan:

It appeared on page one of the Washington Post, and that's where the matter died.

Exactly as anyone might have predicted, that front-page report produced exactly zero wider discussion. Columnists didn't discuss the report in the Post or the New York Times. No one discussed the report on the liberal world's favorite "cable news" programs.

The silly children on corporate cable are there to entertain and please their tribal viewers. Rachel Maddow wouldn't discuss a report like Long's if her grandmothers' lives were at stake. In fairness, the same can be said for Chris and Chris, and for Lawrence and Brian.

Briefly, let's be fair. Absent the inflammatory language about a "poll tax," there was absolutely nothing new about Case and Deaton's presentation.

Way back in 2005, Paul Krugman devoted a series of columns in the New York Times to this remarkable state of affairs. To read the first column in his series, you can just click this.

Krugman hadn't yet won his own Nobel Prize; that happened in 2008. But he was writing from one of the highest platforms in American journalism, and his columns produced zero discussion. Simply put, topics like this will not be discussed within the mainstream American discourse.

Within the mainstream American discourse, silly children go on TV and hand you the latest polls.

They speculate about what will happen next. They discuss what Trump said ten minutes ago, and they do little else.

They gambol and they play and they cash their extremely large checks. They're trained to know how to make you like them. They do not discuss the kind of topic Case and Deaton aired.

In journalism and in the academy, our guardians have walked off their posts. Our journalists avoid topics like this. Our academics tend to be lost in the weeds of their particular "disciplines."

Krugman's columns produced no reaction. Fifteen years later, Long's report disappeared. Starting next week or the week after that, we plan to say goodbye to most of this, embarking on a different type of award-winning meta-discussion.

This week, though, we plan to review the type of carnage we'll be leaving behind. It's a type of American carnage characterized by endless silence, but also by mountains of foolishness.

Our thought leaders gave up the ghost long ago. Across the nation's upper-end landscape, our guardians have abandoned their posts.

Tomorrow: When guardians attack

31 comments:

  1. "The U.S. health-care system is “like a tribute to a foreign power, but we’re doing it to ourselves.”"

    This is probably the stupidest metaphor I've seen recently. Well, either that one of the "poll tax" thingy. Clearly designed to obscure rather than enlighten.

    Why don't they call it what it is: medical mafia.

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  2. Come to TDH to be told, again, how the “guardians” have abandoned their posts re health care reporting, in a TDH post where the main item is a front-page news report in the Washington Post, traditional information/news guardian, about...health care.

    I do seem to recall an article in the Atlantic (guardian or no?) from last October, by Ronald Brownstein, discussing the “eye-popping” cost of Medicare For All. It was meant as a criticism of Warren and Sanders. Brownstein uncritically quotes figures from the Urban Institute.

    Bob Somerby, without critiquing the article, said “For the record, Brownstein is reporting basic facts.”

    Perhaps that is Somerby’s idea of a healthcare discussion:

    http://dailyhowler.blogspot.com/2019/10/some-numbers-re-medicare-for-all.html

    Just for starters, Oof!

    ReplyDelete
    Replies
    1. I don't understand. Are you saying American health care spending is discussed within the mainstream American political discourse?

      Delete
    2. anon 12:44 - the issue gets mentioned from time to time in the media, but then it's dropped. It should be a very big subject, given that 'health care' is a such a major thing for the Dems this year, and for the country. I bet less than 1% of Americans realize what we pay. I think Sanders tries to get the point across, but his point is more or less ignored by the press. TDH is very right that the media, including "our" side does a terrible job on this issue. If they spent a tenth the time on it that they do on the stupid Russia interference issue it might help.

      Delete
  3. But. But, but, Medicare for all will bankrupt us! Duh!

    ReplyDelete
  4. I don't see the point of a discussion about costs without a discussion about different choices in how health care is administered to people.

    In many European countries, when a doctor decides a patient is terminal, they begin hospice care. There are no "codes" and extreme measures and no attempts to try continued treatments. That patient is written off and the doctors and hospital staff devote their energies to other patients. My point is that this is not the patient's choice but the doctor's decision.

    In many European countries, patients are not free to go off their meds when they are mentally ill. They are required to take them. They are also classified as mentally ill and given a living stipend, but are forbidden to seek a job. This means they are less likely to wind up abandoned by caregivers and homeless, but it also limits their life options. Again, my point is that the patient has no choice about this. In the US, homeless mentally ill people constitute the bulk of chronic emergency room users, constantly in crisis because their health issues are not properly managed outside the hospital.

    There are many other instances where Americans choose freedom and choice over cost control. We pay a higher price for that freedom.

    Somerby wants to focus on the costs but not on the factors that produce higher costs. I never see him willing to discuss what lies behind the numbers (or excoriate those who similarly will not discuss the social differences between Switzerland and the US.

    ReplyDelete
    Replies
    1. I’m tempted to call bullshit on your entire comment, but instead I’ll just ask you to back up your claims about “choosing freedom … over cost.”

      Hospice care is for patients who have terminal diagnoses. In the US that's 6 months or less left to live. That means that the medical judgment is that continued treatment beyond palliative care and pain management is futile. That is, there simply aren’t effective treatments available. It took a few moments in the google to find that in the Netherlands and Germany, patients must apply for hospice.

      It’s true that compulsory psychiatric treatment, including mandatory drug treatment, is easier to enforce in Europe than in the US. But it’s still an option in the US, especially for minors, but just as in Europe, the patient must be deemed a danger to self or others.

      I can find no support for the contention that mentally ill people are forbidden to work, but I’ll have to admit that I didn’t spend a lot of time on the research.

      What are your sources?

      Delete
  5. " Our academics tend to be lost in the weeds of their particular "disciplines."

    In other words, academics are doing their jobs.

    It is not the job of any academic to be a "guardian."

    The job of an academic is to create new knowledge and to disseminate the state-of-the-art to students and, secondarily, the public. The weeds are where the growth takes place. The broad outlines are what the public can absorb without having depth of knowledge in a specific field. When the public asks a specific question, they get weeds because that is what it takes to answer anything but the most superficial questions. Then academics get ridiculed by folks like Somerby, for not speaking plainly enough for people with no background to understand them.

    Our President and most of Congress has decided that it does not wish to make policy decision based on knowledge, but prefers to make such decisions based on political considerations. If you don't consult academics, it isn't their job to force their knowledge on politicians or anyone else, including especially those who refuse to listen.

    Academics are not guardians -- they are a generally untapped resource (except to businesses engaged in emerging fields and technology, who draw freely on academic expertise).

    ReplyDelete
    Replies
    1. "The job of an academic..."

      Zzzzzzzzzzzzzzzzzzzzzzzz.

      Delete
  6. Notice too how Krugman in general has been disappeared?

    ReplyDelete
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  21. My name is JOHN, and I base in USA...My life is back!!! After 5years of Broken marriage, my wife left me with two kids. I felt like my life was about to end i almost committed suicide, i was emotionally down for a very long time. Thanks to a spell caster called drsamuel321@gmail.com, which i met online. On one faithful day, as I was browsing through the internet,I came across allot of testimonies about this particular spell caster. Some people testified that he brought their Ex lover back, some testified that he restores womb,cure cancer,and other sickness, some testified that he can cast a spell to stop divorce and. i also come across one particular testimony,it was about a woman called sharon,she testified about how he brought back her Ex lover in less than 2 days, and at the end of her testimony she dropped DR SAMUEL e-mail address. After reading all these,I decided to give it a try. I contacted him via email and explained my problem to him. In just 48hours, my wife came back to me. We solved our issues, and we are even happier than before drsamuel321@gmail.com, is a man sent by god and i will not stop publishing him because he is a wonderful man... If you have a problem and you are looking for a real and genuine spell caster to solve all your problems for you. Try Newton of drsamuel321@gmail.com anytime, he might be the answer to your problems. Here's his contact: drsamuel321@gmail.com or Whatsapp +1 (364) 202-5427

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