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Context of 'Mid-January - February 4, 1994: Lawyer Lambasts Clinton Health Care Reform Proposal'

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Betsy McCaughey.Betsy McCaughey. [Source: Newsday / Gawker (.com)]Elizabeth “Betsy” McCaughey (R-NY), a lawyer and future lieutenant governor of New York, writes a scathing analysis of the Clinton administration’s health care reform plan. The article, “No Exit,” is published in the New Republic, and sparks not only a detailed rebuttal from the Clinton administration, but numerous editorials and responses praising the article and joining in the attack. Echoing McCaughey’s arguments, Newsweek writes, “The plan would reduce the quantity and quality of health care and medical technologies by vastly expanding government’s coercive role.” McCaughey and Newsweek question the proposed creation of a seven-member “National Health Board” which will, she claims, “guess the nation’s health care needs and decree how much the nation may spend meeting them.” According to Newsweek: “Everyone would be locked into one system of low-budget health plans picked by the government. Fifteen presidential appointees, the National Quality Management Council, not you and your doctor, would define the ‘medically necessary’ and ‘appropriate’ care a doctor could give you. Escaping government control to choose your doctor or buy other care would be virtually impossible. Doctors could be paid only by the government-approved plans, at rates set by the government. It would be illegal for doctors to accept money directly from patients, and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem ‘necessary.’ Government would define a minimum level of care and herd people in particular regions into dependence on the lowest-cost organization able to deliver that level. Doctors would be driven into organizations in which they would be punished financially for giving more treatment than the organizations’ budget targets permit. The primary care physician assigned to you would be, McCaughey notes, a gatekeeper with an incentive to limit your access to specialists and high-tech medicine. The premise of the Clintons’ plan is not just that government knows best, but that government knows everything relevant, including how many specialists there should be no more than 45 percent of all doctors [sic]. McCaughey says many medical students will be told that the specialties they prefer are closed, or closed to them because they are not the right race or ethnicity. Yes, the plan subordinates medical values to ‘diversity.’” Prescription drug prices would be controlled through the Department of Health and Human Services, and, McCaughey and Newsweek claim, would “certainly suppress research” that might benefit patients of incurable diseases and disorders. [Newsweek, 2/7/1994]
Refuting McCaughey - The Clinton administration details the “numerous factual inaccuracies and misleading statements” contained in McCaughey’s article. The administration’s response says that doctors and patients, not “government bureaucrats” or a board of governors, will decide what treatments are “necessary and appropriate.” The government will not decide what treatments are, and are not, provided: “If anything, the ‘necessary and appropriate’ care provision in the bill delegates authority to the medical profession—rather than imposing further government bureaucracy between the patient and the doctor.” The plan will not block Americans from opting into private health care plans just as they do now, nor will it block doctors and hospitals from accepting payments from “non-approved” health care plans. Nor does the plan require doctors and hospitals “to report your visit to a national data bank containing the medical histories of all Americans,” as McCaughey writes. And the so-called “National Health Board” will not “decide how much the nation can spend on health care beginning in 1996,” as McCaughey claims. The plan will not seek to reduce quality of care in the interest of saving money, and it does not contain price controls. [White House, 1/31/1994] A year later, author and columnist James Fallows will call the article “a triumph of misinformation,” and refutes McCaughey’s (and others’) claims point by point. [Atlantic Monthly, 1/1995]
Instrumental in Derailing Reform - The article will later be cited by House Speaker Newt Gingrich (R-GA) as “the first decisive breaking point” in the plan’s initial support; the plan will never be implemented. The article itself will spark tremendous controversy, winning the National Magazine Award while being attacked for being fundamentally inaccurate. (In 2006, the new editor of the New Republic, Franklin Foer, will apologize for his magazine having run the article.) In 2009 McCaughey will be a fellow at the conservative Manhattan Institute and will soon join the equally conservative Hudson Institute. Both are heavily funded by health care corporations. [Daily Beast, 5/15/2009]

Entity Tags: Newt Gingrich, Franklin Foer, Elizabeth (“Betsy”) McCaughey, Clinton administration, James Fallows, US Department of Health and Human Services, Hudson Institute, Manhattan Institute

Timeline Tags: US Health Care, Domestic Propaganda

Betsy McCaughey (R-NY), the former lieutenant governor of New York and a fellow at the conservative Hudson Institute, writes that health care provisions in the Obama administration’s economic stimulus plan will affect “every individual in the United States.” McCaughey writes: “Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.” McCaughey says the provisions are similar to suggestions in the book Critical: What We Can Do About the Health Care Crisis, by former Senate Majority Leader Tom Daschle (D-SD), until recently Obama’s pick to head the Department of Health and Human Services. McCaughey writes that hospitals and doctors who do not use the system will be punished, by a federal oversight board to be called the Federal Coordinating Council for Comparative Effectiveness Research. Perhaps most worrisome is McCaughey’s claim that elderly Americans will be given reduced health care based on their age and expected productivity. “Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council,” she writes. “The Federal Council is modeled after a UK board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. In 2006, a UK health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.… If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the US will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined.” [Bloomberg News, 2/9/2009] McCaughey’s claims are very similar to the ones she made against the Clinton administration’s attempt to reform health care in 1994 (see Mid-January - February 4, 1994). They will be proven false (see July 23, 2009).

Entity Tags: Hudson Institute, Elizabeth (“Betsy”) McCaughey, US Department of Health and Human Services, Tom Daschle, Obama administration

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Slate reporter and columnist Christopher Beam coins a new term, “deathers,” to label conservatives who are spreading the debunked rumors that President Barack Obama’s health care proposals would kill old people (see July 16, 2009 and July 23, 2009). Beam publishes his article on the same day that Representative Virginia Foxx (R-NC) claims that under Obama’s reforms, seniors would be “put to death” (see July 28, 2009), and that Obama holds a “town hall” meeting where he debunks this and other rumors surrounding his proposals (see July 28, 2009). The claim apparently originated with lobbyist and lawyer Betsy McCaughey (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 16, 2009, and July 23-24, 2009), who used similarly questionable claims to derail the 1994 reform proposals by the Clinton administration (see Mid-January - February 4, 1994). Others have made similar assertions; Representative Paul Broun (R-GA) recently warned that Obama’s reform proposals would “kill people” (see July 10, 2009), and conservative commentator and author Charlotte Allen says: “Obama’s not going to say, ‘Let’s kill them.’ But he seems to be perfectly comfortable with the idea that a lot more old people are going to die a lot sooner.”
End-of-Life Consultations - Beam shows that the language of the bill, as it stands in Congress at this time, provides for “end-of-life consultations” between patients and doctors, if the patients wish them. In those consultations, doctors would explain what kind of services are available to those patients—palliative care and hospices, in-home care, more intensive treatments in a hospital, etc.—but would not tell patients that they had to restrict themselves to less intensive treatments that would shorten their lives. Some “deathers” have also insisted that the bill provides for the withholding of “artificially administered nutrition and hydration.” McCaughey is a vocal proponent of this claim. However, such a choice would have to be made by the patient and/or the family, specifically not a doctor.
Shared Decision-Making - Opponents of health care reform such as McCaughey claim that the House bill would “coerce” seniors into taking part in a program that forces them into making decisions about “trade-offs among treatment options,” or takes the final decision-making power away from them and places it in the hands of doctors or government officials. In reality, the bill would provide an informational tool for patients and families to make informed decisions. No coercion could legally be applied.
Obama Staffers Cause Concern - Some of Obama’s staffers have said and written things that cause consternation among reform opponents (see July 23-24, 2009). One of Obama’s senior health care advisers, Ezekiel Emanuel, who serves as health policy adviser at the White House’s Office of Management and Budget (OMB), wrote in 2008 that doctors too often interpret the Hippocratic oath “as an imperative to do everything for the patient regardless of the cost or effects on others,” leading some to wonder if Emanuel would put cost concerns over patients’ needs; others have gone farther, comparing Emanuel to Nazi doctors and of advocating “eugenics.” In 1977, Obama’s “science czar,” John Holdren, joined two other authors in writing about possible methods of population control, including a speculative bit about sterilizing people by introducing chemicals into the water supply. (ABC News later reports that the controversial passage was from a textbook in which various methods of population control were considered and rejected. Holdren recently released a statement saying that population control is not the government’s job; his statements on the matter passed muster in the Senate Commerce Committee, whose Republican members joined Democrats in unanimously approving his nomination as the director of the White House’s Office of Science and Technology Policy.) And some worry that the proposed Independent Medicare Advisory Council, which would oversee cost containment for Medicare, would be staffed, in Allen’s words, with “a certain class of secularized intellectuals” who might put cost concerns over quality of life. [Slate, 7/28/2009; ABC News, 7/28/2009]

Entity Tags: John Holdren, Charlotte Allen, Barack Obama, Christopher Beam, Ezekiel Emanuel, Senate Commerce Committee, Elizabeth (“Betsy”) McCaughey, Office of Science and Technology Policy, Medicare, Virginia Foxx, Paul Broun

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Progressive author and columnist Joe Conason writes that if the Democrats’ attempt to reform health care fails, “much of the blame rests on our political culture’s empowerment of deception and ignorance. Fake erudition is revered, every hoax is deemed brilliant, and prejudice is presented as knowledge—while actual expertise is disregarded or devalued.” Conason points to two conservative commentators as primary founts of destructive misinformation: neoconservative publisher and cable news pundit William Kristol, and health industry lobbyist Betsy McCaughey (see January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, July 16, 2009, and July 23-24, 2009), whom Conason names as “the right-wing celebrities who worked so hard to kill the Clinton reform plan” in 1994 (see Mid-January - February 4, 1994). Conason labels McCaughey as “the source of the ‘elderly euthanasia’ hoax now circulating on the Internet, talk radio, and in right-wing media, which claims that Democratic health bills will force old, ill Medicare recipients into making plans for their own deaths” (see July 28, 2009). A thorough debunking of her claims by a variety of Congressional and media sources (see July 23, 2009, July 23, 2009, and Late July, 2009) has done little to derail the impact on the media, and on the citizenry, that McCaughey’s claims are having. McCaughey’s falsehoods are being heavily, and effectively, promoted by Kristol and other conservative pundits (see July 17, 2009) on Fox News and other media outlets. Conason notes that Kristol, interviewed by Jon Stewart of The Daily Show, admitted that the government provides “first-class” healthcare to American soldiers and senior citizens (in the form of the Veterans Administration and Medicare) before trying, and failing, to back away from the admission. [Salon, 7/31/2009]

Entity Tags: Joe Conason, Clinton administration, Jon Stewart, Elizabeth (“Betsy”) McCaughey, William Kristol, Fox News

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Former health insurance executive Wendell Potter (see July 10, 2009), who formerly headed the PR division at Cigna, says that the skyrocketing profits of health care corporations and their executives are directly driving the industry’s opposition to health care reform. According to filings with the Securities and Exchange Commission, the profits of the US’s 10 largest health insurance companies rose 428 percent between 2000 and 2007. In 2000, those 10 companies made a combined profit of $2.4 billion. In 2007, those numbers had risen to $12.9 billion. During that seven-year period, the number of Americans without health insurance rose 19 percent. The CEOs of those 10 firms made an average of $11.9 million in 2007 alone. MSNBC’s Rachel Maddow notes that the health insurance industry “bankrolled efforts to kill the last effort at health care reform” in 1994 (see Mid-January - February 4, 1994). In an interview with Maddow, Potter blames the insurance industry for much of the recent spate of “town hall” disruptions that have helped derail debate over health care reform (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, August 5, 2009, August 5, 2009, August 6, 2009, August 6, 2009, August 6-8, 2009, August 8, 2009, and August 10, 2009) “and a lot of the deception that’s going on in terms of disinformation that many Americans apparently are believing.” Potter goes on to note that health insurance firms are making tremendous profits on the steady erosion of paid premiums going to fund medical claims. In 1993, the industry paid out roughly 95 percent of the premiums they took in to claims. In 2007, that number had dropped to 80 percent. Insurance firms also routinely “kick sick people off the rolls when they do get sick or when people get injured.… [A]nd also, they’re paying fewer claims.” The health insurance industry is dead set against the so-called “public option,” Potter says, for the simple reason that a publicly run alternative to private insurance would cost its members profits. [MSNBC, 8/11/2009]

Entity Tags: Wendell Potter, Rachel Maddow

Timeline Tags: US Health Care

Former President Bill Clinton accuses Republicans of trying to terrify Americans into opposing health care reform, and says the GOP is using those tactics because it lacks the political clout to fight it. Clinton, whose own health care reform efforts were derailed in 1994 (see December 2, 1993 and Mid-January - February 4, 1994), says the big difference between then and now is that Democrats have a filibuster-proof majority in the Senate as well as control of the House of Representatives. He calls allegations that the Democrats’ reform proposals include so-called “death panels” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 6, 2009, August 7, 2009, August 10, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, August 11, 2009, August 12, 2009, August 12, 2009, August 12, 2009, August 13, 2009, August 12-13, 2009, and August 13, 2009) “crazy.” [Associated Press, 8/13/2009]

Entity Tags: William Jefferson (“Bill”) Clinton

Timeline Tags: US Health Care, Domestic Propaganda

Betsy McCaughey is interviewed by Jon Stewart of ‘The Daily Show.’Betsy McCaughey is interviewed by Jon Stewart of ‘The Daily Show.’ [Source: Media Matters]Health care reform opponent Betsy McCaughey (see February 9, 2009, July 16, 2009, July 23, 2009, and July 23-24, 2009) appears on Comedy Central’s satirical news/comedy broadcast, The Daily Show. Host Jon Stewart devotes twice the usual amount of air time to interviewing McCaughey, and even then the interview is not broadcast in its entirety; Comedy Central posts the entire interview on its Web site. Stewart’s main interview tactic is to challenge McCaughey to prove one claim or another, such as her assertion that the health care reform legislation pending in the House would mandate “death panels” or “end-of-life” review committees; McCaughey then tries and fails to find language in the bill itself, and Stewart chastises her for spreading falsehoods. Late in the interview, Stewart calls McCaughey’s rhetoric “hyperbolic” and “dangerous.” [Comedy Central, 8/20/2009; Comedy Central, 8/20/2009; Media Matters, 8/21/2009; Huffington Post, 8/21/2009] He concludes by telling her, “I like you—but I don’t understand how your brain works.” [Salon, 8/21/2009] In an analysis of the interview, The Atlantic’s James Fallows, who lambasted McCaughey’s 1994 arguments against the Clinton administration’s health care reform efforts (see Mid-January - February 4, 1994), says he realizes after watching the interview that “I have been far too soft on Betsy McCaughey. Even when conferring on her the title of ‘most destructive effect on public discourse by a single person’ for the 1990s. She is way less responsible and tethered to the world of ‘normal’ facts and discourse than I had imagined.” Fallows writes that McCaughey succeeds as well as she does in the interview by ignoring Stewart’s points and rebuttals, and echoing her assertions even after Stewart effectively rebuts or mocks them. [Atlantic Monthly, 8/21/2009] Days later, McCaughey will be removed from her position as a director of Cantel Medical Corporation, in part apparently due to her performance on Stewart’s show (see August 20-21, 2009).

Entity Tags: Comedy Central, Jon Stewart, Elizabeth (“Betsy”) McCaughey, Cantel Medical Corporation, James Fallows

Timeline Tags: US Health Care, Domestic Propaganda

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