Arranges to hide the big picture: On the front page of today’s New York Times, the paper has done it again.
Elisabeth Rosenthal writes her latest lengthy report concerning the outlandish costs of American health care. In the process, she hides the big picture—“buries the lede”—in familiar, remarkable fashion.
In today’s report, Rosenthal focuses on the wildly varying cost of a certain medical procedure. Headline included, this is the way she starts:
ROSENTHAL (12/16/14): The Odd Math of Medical Tests: One Scan, Two Prices, Both HighThe more elaborate echocardiogram was billed at $1400. Earlier, at a community hospital, the patient had been charged four times as much for the same procedure.
Len Charlap, a retired math professor, has had two outpatient echocardiograms in the past three years that scanned the valves of his heart. The first, performed by a technician at a community hospital near his home here in central New Jersey, lasted less than 30 minutes. The next, at a premier academic medical center in Boston, took three times as long and involved a cardiologist.
And yet, when he saw the charges, the numbers seemed backward: The community hospital had charged about $5,500, while the Harvard teaching hospital had billed $1,400 for the much more elaborate test. “Why would that be?” Mr. Charlap asked. “It really bothered me.”
On its face, that’s a remarkable difference. Rosenthal devotes 2357 words to questions about the way this procedure gets billed.
Along the way, very much in passing, she drops a genuine bombshell. This tiny paragraph passes so fast that a reader might not grasp its truly remarkable content:
ROSENTHAL: In other countries, regulators set what are deemed fair charges, which include built-in profit. In Belgium, the allowable charge for an echocardiogram is $80, and in Germany, it is $115. In Japan, the price ranges from $50 for an older version to $88 for the newest, Dr. Ikegami said.Say what? Elsewhere in the developed world, this procedure costs $115 or less, Rosenthal mentions in passing. Those prices include a built-in profit!
In Belgium, the procedure costs $80. That is stunning fact. Rosenthal includes that fact, but it passes by so quickly, with so little hype, that readers may barely notice. Much later, in paragraph 27 (of 42), Rosenthal briefly expands this startling international comparison:
ROSENTHAL: Claims data shows that Japanese patients received 6.6 million echocardiograms last year, about five times the rate per capita in Britain.It isn’t just that Americans may pay vastly more for that one procedure. In paragraph 27 of a lengthy report, readers are finally told, very much in passing, that Americans spend vastly more per person for their overall health care than people in Japan.
Despite Japan's fondness for testing, its health spending is about $4,000 a year a person, or 9.6 percent of gross domestic product. By contrast, the United States spends more than $9,000 per person annually, more than 17 percent of G.D.P., although some studies indicate that health care spending is leveling off.
The difference is in part because Japan decides the value of each test and medicine, sets a price and demands that it decrease over time.
Good grief! Americans spend $9000 per person per year on health care; the Japanese spend only $4000. This is a much larger, much more important story than the narrow tales about health care spending Rosenthal has presented in the past two years.
Rosenthal has done a series of front-page reports about the costs of American health care. Persistently, she focuses on the cost of some particular procedure.
In the process, she completely ignores the overall cost of our health care. Or she cites this matter in passing, in paragraph 27.
As we’ve noted for years, Americans are massively looted in the costs of health care. This looting affects liberals and conservatives alike. Correctly understood and explained, it could provide the basis for political agreement across our current tribal lines.
Americans spent vastly more per person on health care than people in any other nation. But so what? You never see that remarkable fact explained in the New York Times. You never see it discussed on MSNBC.
In these ways, the American middle class gets looted—and the health industries thrive. This morning's front-page report is just the latest example of the way the “journalism” works.
Why does the Times report this topic this way? We can't tell you that. But liberal heroes on corporate TV are never going to ask.