Conclusion—On C-Span, Rosenthal bails: Elisabeth Rosenthal's book, An American Sickness, was released on April 10.
One week later, on April 17, Rosenthal taped an hour-long interview for After Words, the weekly C-Span program. She was interviewed by Dr. David Blumenthal, president of the Commonwealth Fund.
As best we can tell, the program aired for the first time on Sunday, May 14; you can watch it here. Due to an editing error, the C-Span site mistakenly suggests that it runs two hours.
As we'll note at the end of this report, Rosenthal adopts a surprisingly narcotized tone at the start of this hour-long program. But near the end of the session, she states some facts which help explain this data set, the one you'll see nowhere else:
Per capita spending, health care, 2015Why does a year of health care cost twice as much in this country as it does everywhere else? Our results are no better than theirs!
United States: $9451
United Kingdom: $4003
Why does our health care cost so much? That's a deeply foundational question for our clownish American governance. Near the end of her hour on C-Span, Rosenthal partly explains.
At the start of the exchange in question, Blumenthal tees her up. "You have some pretty striking things to say about hospitals as non-profits," he says. "Could you elaborate on that a little bit?"
"I'm probably going to make a few enemies in business here," Rosenthal says as she starts her reply.
This happens near the 50-minute mark. We're going to guess that she may have lost a few friends, based on what she eventually said.
Rosenthal started her response with a bit of soft soap. She said she hates the fund-raising letters she gets after trips to the hospital.
Eventually, though, she took us where the rubber hits the road. Warning! Information ahead:
ROSENTHAL (4/17/17): What are hospitals doing? Do they feel like charities? Do they feel like they're serving a community? I recommend that everyone look at the 990 tax form of their local hospital. Look how much the executives are paid.Ow ow ow ow ow ow ow ow! Is she allowed to say that?
The highest paid executive in most cities is the CEO of the local hospital. And you know, I don't want anyone going broke on health care. I don't think you have to take a vow of poverty. But I don't think most hospitals need the top twenty administrators paid over a million dollars a year.
And when they say, "Oh, health care is really complicated," my immediate answer is, "Yeah, well the Ford Foundation is really complicated too, and it operates in ninety countries, and the CEO of the Ford Foundation doesn't make nearly as much as the 15th administrator at a local hospital in New Jersey." So I think that's a kind of false narrative.
The CEO of the Ford Foundation makes far less money than the fifteenth highest-paid administrator at your local hospital?
Your local hospital may be paying million-dollar salaries to twenty different administrators? Can these claims be true?
We don't know if those claims are true. But that's what Elisabeth Rosenthal said—and when she did, Blumenthal offered no challenge or contradiction.
With those statements, the street-fighting author of the new book, An American Sickness, had returned to the form she displays in her book. Assuming her statements were reasonably accurate, we'd learned about one of the factors which explain the remarkable data we've posted above.
More significantly, we'd been exposed to one of the reasons why we can't provide universal health care in this country. Beyond that, we'd been exposed to one of the reasons why we can't seem to get control of our federal budgets.
We'd been exposed to one of the factors which led the author of An American Sickness to describe our health care system as she does in her book's opening pages—as a "slow-moving heist" performed by an "extractive industry" which exposes patients to "medical extortion."
If you plan to pay salaries like that, you'll have to perform some extortions. According to Rosenthal, the leading extortionist in your community may be that CEO!
For ourselves, we were surprised by what Rosenthal said. We don't think we've ever heard anyone discuss the size of those salaries.
Equally surprising is this:
By apparent common agreement, remarkable facts like those are essentially never discussed by our major news orgs. Despite her fiery progressive views, Rachel Maddow doesn't mention such facts on her corporate "cable news" show, for which she's paid ten million dollars by her corporate owners.
You'll rarely hear such facts discussed in our biggest, most famous newspapers, even when we're all pretending to discuss our American health care.
You won't be exposed to such facts, and you won't be exposed to the data they generate. The New York Times would voluntarily cease to publish before it would show you this:
Per capita spending, health care, 2015Five thousand dollars, per person per year, disappears in our health system! You aren't encouraged to know.
United States: $9451
How does such group silence work? Twelve years ago, in 2005, Paul Krugman tried to put such data in play in a series of columns in the Times. For one of those columns, click here.
Everyone else ignored what he wrote! The topic is AWOL, missing-in-action from our discussions today.
Decades ago, an explanation was offered for this remarkable type of group silence. Chomsky and Herman referred to this type of systemwide silence as a way of generating "manufactured consent."
What is manufactured consent? The leading authority on the topic offers this capsule account. Note the "self-censorship" function:
Manufacturing Consent: The Political Economy of the Mass Media (1988), by Edward S. Herman and Noam Chomsky, proposes that the mass communication media of the U.S. "are effective and powerful ideological institutions that carry out a system-supportive propaganda function, by reliance on market forces, internalized assumptions, and self-censorship, and without overt coercion", by means of the propaganda model of communication. The title derives from the phrase "the manufacture of consent," employed in the book Public Opinion (1922), by Walter Lippmann (1889–1974).Everybody knows that this theory has to be crazy and nuts. And yet, Krugman's attempt to introduce this topic crashed and burned in 2005. Today, the data we've shown you are relentlessly disappeared, despite their obvious centrality to the endemic failures of our clownish federal governance.
Chomsky credits the origin of the book to the impetus of Alex Carey, the Australian social psychologist, to whom he and co-author E. S. Herman dedicated the book. Four years after publication, Manufacturing Consent: The Political Economy of the Mass Media was adapted to the cinema as Manufacturing Consent: Noam Chomsky and the Media (1992), a documentary presentation of the propaganda-model of communication, the politics of the mass-communications business, and a biography of Chomsky.
The data set we've posted is an astonishing data set. It's true that our journalists aren't real bright, but even they can surely see the remarkable strangeness of those data, and the relevance of the fact that so much money—$5000 per person per year!—is disappearing (being extracted) from our health care "system."
That said, Rachel would jump off the Golden Gate Bridge before she'd discuss such a topic. Rosenthal, who wrote this "important book," has never appeared on MSNBC, our allegedly liberal cable.
(You've also never seen education expert Diane Ravitch on your liberal channel. A few years back, she became the liberal rage. But despite their fiery progressive views, people like Rachel don't discuss the experiences of black kids in our public schools. Nor do they discuss the looting of our health care "system," which lines the pockets of people like the corporate bosses who own them.)
Everyone can invent his own reasons for the group silence of which we speak. Why don't our major newspapers present and explore those remarkable data?
We can imagine various reasons. But you are never going to see that obvious question discussed.
Chomsky spoke of manufactured consent, attributing it to a form of propaganda. In this case, we'd say the practice leads to manufactured theft.
The theft comes from our health care system. It explains why we, among all developed nations, are still clownishly unable to provide universal health care.
As we close, let's note an unfortunate point. A very potent group dynamic seems to encourage major players to conform to this silence.
Right out of the gate in her new book, Rosenthal breaks all the rules. Using the language of corporate crime, she describes our health care system as a series of extortions and heists.
We were surprised when we purchased her book and encountered this tone. We were surprised because we'd already seen her on that C-Span program.
Near the end of that hour, Rosenthal gets a snootful and talks about hospital salaries. But at the start of that hour-long program, she and Blumenthal seemed to be speaking the clubby language which manufactures consent in this world.
Before three minutes are gone, Blumenthal lets the viewer know that he and Rosenthal share the old school tie from Harvard Medical School. He proceeds to let Rosenthal explain that her new book won't bore the reader with lots of diagrams and charts.
(Or with a single presentation of that data set!)
Finally, near the nine-minute mark, Blumenthal gets to the serious questions. He asks Rosnethal to explain what the basic problem is. What is "the American sickness?" he asks.
The basic problem is "high prices and unaffordable health care," Rosenthal says. "I don't think anyone—Republican, Democrat independent, libertarian—would disagree with that."
It seems to us that she was already putting a shine on the matter. But Blumenthal proceeded to ask what the source of this problem is.
How did we come to have crazy high prices? Amazingly, this is what Rosenthal said, around the ten-minute mark:
BLUMENTHAL: And how did we get to those high prices? What's the diagnosis?"This is kind of a classic case of the road to Hell is paved with good intentions?" Before we ever looked at her book, that's what we'd heard her say.
ROSENTHAL: Well, this is where the kind of history of present illness, you know, kind of has to spool itself out. And I think what I realized as I was digging into that is, this is kind of a classic case of, you know, the road to Hell is paved with good intentions.
It's very hard to read Rosenthal's book and think that's the story you're hearing. But the C-Span interview goes on at some length in this tapioca vein.
At the 50-minute mark, we finally hear about those seven-figure salaries. Still, we never see the data set which defines the extent of the looting created by the extortions and heists and Rosenthal cites in her book.
"It's nice to be nice," a sage once said. Rosenthal's book isn't "nice." It traffics in a horrible truth, one you won't learn from Rachel or Lawrence or their slippery millionaire pals.
Rosenthal's book isn't "nice" at all. That's why it's going undiscussed. That seems to be why the people we love won't let her new book be important.