They were great pals with the Birther King!

FRIDAY, JUNE 30, 2017

What does that say about them: In the wake of Joe and Mika's silly op-ed column, we liberals need to get clear on a few basic facts:

Within the political realm, Trumpism got here long before Trump. Many other people were Donald J. Trump before Trump came along.

In 1999 and 2000 (and beyond), Chris Matthews was Trump-before-Trump. Maureen Dowd was also Trump. Because of her dominant role at the Times, no one was willing to say so.

When they spent two years inventing crazy claims by Candidate Gore, the mainstream press corps was Trump-before-Trump. Joe and Mika have been Donald J. Trump pretty much since they went on the air.

We'll grant you this—Trump is even more disordered than these earlier Trumps. In effect, he's the 800-pound, poo-flinging Sasquatch of the Trumpist world.

That said, the others were Trump before Trump. Having established that point, here's the ugly fact about our tribe:

Until the 800-pound Sasquatch arrived, we were simply too lazy and dumb to see the Trumpism around us. They were eating our culture alive. We were too dumb to see this.

(The press corps never said that Gore was bleeding from a face lift. Until the statements get that dumb, we're too dumb to notice.)

Joe and Mika are grasping circus clowns, not unlike Donald J. Trump. Their column today is childish and silly, as their work frequently is.

When Trump announced in 2015, they worked and slaved and pandered and fawned to the greatness of their friend. Trump had already been the nation's Birther King for four gruesome years at that point.

What kinds of people would fawn to Trump four years into that reign? Duh! The kind who wanted their ratings to climb so their fat bloated salaries would follow! Here's what this silly, ridiculous pair has phonily written today:

JOE AND MIKA (6/30/17): We have known Mr. Trump for more than a decade and have some fond memories of our relationship together. But that hasn't stopped us from criticizing his abhorrent behavior or worrying about his fitness. During the height of the 2016 presidential campaign, Joe often listened to Trump staff members complain about their boss's erratic behavior, including a top campaign official who was as close to the Republican candidate as anyone.

Really? The chronology breaks down like this:

They met Trump in maybe 2005. In 2011, he turned himself into the Birther King.

Four years after that, in 2015 and early 2016, they fawned to him as few others did. Apparently, something "stopped [them] from criticizing his abhorrent behavior [and] worrying about his fitness" at that particular time.

It isn't just Joe and Mika. We've rarely seen as much pious hypocrisy as Anderson Cooper displayed last night. Consider this heartfelt exchange with Jeffrey Lord, who had an especially unhelpful night:

LORD (6/29/17): Everything we're talking about tonight has in a sense been litigated already. We had the election. This may be the latest episode, but these episodes have been had many times during the campaign. This discussion was had and he won the election.

COOPER: Right. But that doesn't make it right.

LORD: I'm not saying it's right.

COOPER: I mean, when somebody says something disgusting, you know, I think it is incumbent on decent people to stand up, point it out and say, "You know what, this is not normal."

Inspiring! Unfortunately, Cooper did serial interviews with Candidate Trump in which he basically functioned as Donald Trump's caddie and pool boy. Now that the nation is reaping the whirlwind, he's decided to stand up and be decent.

What was he doing back then?

The press corps is crawling with people who have chosen to profit off Trump's disordered behavior. The tabloids made money off him back in the 1980s. In 1990, Diane Sawyer scored the interview with Marla Maples and asked her if sex with the Donald was the best she'd ever had.

Starting in 2004, NBC scored off his goony entertainment show. When he finally threw his hat in the ring, our biggest stars threw their withered souls away in pursuit of the ratings gains which occurred when he went on their programs.

Joe and Mika were among the worst. They're among the worst today, even after they've flipped.

Our tribe was too dumb to see what was happening within our discourse until the 800-pound Sasquatch arrived. In particular, we were too dumb to see the way our leaders were conning us as they accepted all the Trumps who arrived on the scene before Trump.

Matthews was Trump; Dowd was Trump. Chait and Marshall and Robinson simply weren't willing to tell you.

Rachel Maddow even tried to sell us Greta Van Susteren! For all those years, Greta had been Fox's designated enabler of the deranged Birther King. She and Rachel were drinking pals!

Our tribe has been conned for decades now. We've been played by the likes of Mika and Joe. It seems we're too dumb for this game.

A final point about Trump: Donald J. Trump seems to be highly disordered. We would assume that he is some form of "mentally ill."

If so, that's a terrible problem. But it's also a very serious matter.

It should be discussed in a serious way. Yesterday, Joe and Mika, but especially Mika, were just throwing their noise all around.

(By the way, was Donald J. Trump abused as a child? Is that a possible explanation for his disordered behavior? As caring, empathetic liberals, would we know how to tell? How to care? How to stop berating him on a moral basis once we've said he's mentally ill?)

Joe and Mika aren't super-serious people. Mika is very poorly suited to be a political pundit—unlike, for example, Kirsten Powers, who was especially sharp on Cooper's program last night.

(Much sharper than Ryan Lizza, who is, to our surprise, being pushed beyond his depth by his reactions to Donald J. Trump and to those who defend him.)

As is the case with Comey the God, Joe and Mika only seem serious when they're compared to the very large beast who's currently thrashing around. Did you catch them back in their "Bickersons" days? They were a version of Donald J. Trump years before Trump came along.

They were great pals with the Birther King. What does that say about them?

MANUFACTURED THEFT: A change in tone!

FRIDAY, JUNE 30, 2017

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, 2015
United States: $9451
Canada: $4608
France: $4407
Japan: $4150
United Kingdom: $4003

Why 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!

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.

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.

Ow ow ow ow ow ow ow ow! Is she allowed to say that?

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, 2015
United States: $9451
France: $4407

Five thousand dollars, per person per year, disappears in our health system! You aren't encouraged to know.

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).

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.

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.

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?

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.

"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.

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.

It's a good day for some comic relief!

THURSDAY, JUNE 29, 2017

We turn to our greatest newspaper: It's a good day for some comic relief. For that reason, we turn to the world-class foppistry of the New York Times.

On the reimagined page A3, the foofaw comes early and often. That said, the Here to Help section may be Timesiest of all:

How to Help
HOW TO TACKLE CLEANING THE BATHROOM

We sh*t you not. That's what it actually says.

Gonzo! The Times called in Jolie Kerr, a "cleaning expert," to give us a handful of tips. These are her five subheads, and no, we aren't making them up:

Scrub the shower and/or tub, sink and toilet
Clean tile and grout
How to remove soap scum
Pick up loose hairs
Keep bathroom floors clear

No, really. "Keep bathroom floors clean!" That's what the Times expert says!

(Beneath each heading, Kerr explains how to accomplish the task.)

Little on today's reimagined page is much better than this. In the feature called The Conversation, we learned about the mental horizons of (some of) the newspaper's readers:

The Conversation
FOUR OF THE MOST READ, SHARED AND DISCUSSED POSTS FROM ACROSS NYTIMES.COM

1. We Taste-Tested 10 Hot Dogs. Here Are the Best.
A hot-dog show-down by The Times's Julia Moskin, Sam Silton and Melissa Clark—all native New Yorkers—landed atop Wednesday's most-read list...

At least they didn't fly the journalists in so they could taste-test the dogs. Meanwhile, those hot dogs made Times readers lose control! We'll permit ourselves an invidious guess—these are the people who constantly say how dumb The Others are.

Each day, the Spotlight feature presents "additional reportage and repartee from our journalists." Today, the repartee is built around comments by Kirsten Dunst and Sofia Coppola concerning what it's like to work together. In our view, it's not their fault that the New York Times asked.

Page A3 is always there to offer comic relief. Meanwhile, atop page one of ThursdayStyles, we encountered this blurb:

2 UNBUTTONED
Judging 50 authors by their clothes. BY VANESSA FRIEDMAN

Judging authors by their clothes? We're keeping that one for the weekend!

The culture of the New York Times is extremely foppish. Branding says this can't be true. Problematically, though, it is.

Important point: You have to buy the hard-copy Times to receive this comic relief.

This whole press corps is out of order!

THURSDAY, JUNE 29, 2017

Donald J. Trump, always worst: What can you say about Donald J. Trump's latest attack on his critics?

For what it's worth, we'll say this:

When we left for the coffee joint this morning, we had just watched the Morning Joe segment in question. We were struck, as we've often been in the past, by how poorly suited Mika is for the role of political pundit.

As we left our sprawling campus, we were shaking our head over the comments which later sent J-Trump off. Inevitably, after Trump went off, Mika responded with a tweet about the gentleman's little hands. Along the way, Paul Farhi reports, Joe has chimed in like this:

FARHI (6/29/17): Last August, their feud moved from nasty to nuclear.

After the “Morning Joe” hosts criticized Trump’s immigration proposals, Trump called the show “unwatchable” in a tweet, adding “@morningmika is off the wall, a neurotic and not very bright mess!”

Scarborough, who is engaged to Brzezinski, came to her aid in, of all things, a music video. Backed by a country-music beat, he sang and semi-rapped about “a soft and flaccid man” who was liable to grant amnesty to undocumented aliens despite his campaign promises to the contrary. The song went on to suggest that Trump suffered from “psychiatric abnormalities” and was “a sociopath [and] a psychopath.”

Who's maybe 9 years old now? Meanwhile, is this whole press corps out of order? Just like Pacino said?

Several things are worth reviewing here. One involves The Morning Joe Two. The other involves the occasionally selective reactions of our career liberal world.

Regarding Joe and Mika, it's hard to forget the way they fawned to Candidate Trump through February 2016. Their conduct was gruesome, unforgivable, plainly among the worst.

Let's hope their ratings went up! Apparently, Joe and Mika and Donald J. Trump had been friends for years.

(It seemed to us that they turned on a dime, and never went back, when Trump refused to criticize David Duke and the Klan. That said, it's hard to research Morning Joe because the program doesn't produce transcripts.)

Concerning the way our own liberal team has responded to Trump's latest burst:

At the Washington Post, Callum Borchers has noticed that sexism seems to be involved in Trump's latest burst.

(Borchers: "The hosts of Morning Joe on MSNBC criticized President Trump's Twitter habit Thursday...and then, as if succumbing to involuntary spasms, Trump's thumbs tapped out whatever nasty, sexist thought popped into his head.")

At moments like this, we tend to recall how permissive we liberals have often been when sexism and misogyny have come from those on our team.

We think of Chris Matthews' grisly behavior right up through Campaign 2008. Career liberals wanted to get on his show. For that reason, tout was permis!

We also think of the ugly attacks on Naomi Wolf during Campaign 2000, many of which came from our favorite liberal pundits. We recall a protest from William Kristol, but none from anyone else.

Most recently, we think of Keith Olbermann's ugly behavior when he was still the king of MSNBC. He and his smutty pal, Michael Musto, would really stink up the joint with their unvarnished misogyny. For years, we wondered if we could possibly be the only people who were offended by their appalling behavior, after which KO would often throw directly to Rachel Maddow.

(This would force her to pretend that she hadn't heard.)

Finally, we got our answer. When the JournoList emails got hacked and released, it turned out that major liberals had been complaining about Olbermann's "misogyny," but they'd only done so only in private! Do you ever see or read [Name Withheld] without remembering this?

This is no criticism of Borchers, who's from the new generation. But down through the years, we liberals have been very good about dropping our bombs when the misconduct occurs Over There. When it occurs among Our Own, our leaders have often been silent.

Regarding this latest incident, Donald J. Trump is and will always be deeply disordered. He will always go one step beyond—but the press corps, including some of our top liberal stars, has provided few walks in the park.

History lesson: Matthew was quite influential as of Campaign 2000. His misogyny was quite widespread. Until the spring of 2008, nobody said a word.

Are people dead all over the world because he was given free rein at that time? Campaign 2000 was decided by maybe six votes. We'll have to go with a yes.

MANUFACTURED THEFT: Rosenthal abandoned, ignored!

THURSDAY, JUNE 29, 2017

Part 4—Manufactured consent in action: Elisabeth Rosenthal is no pajama-clad blogger.

She wasn't in her parents' basement when she wrote her new book, An American Sickness. At least in theory, she wrote the book as a lifetime denizen of our highest elites.

According to the leading authority on her life, Rosenthal is 61, not 16. Way back when, she graduated from Stanford, then received a master's degree in English from Cambridge University, a well-known school Over There where the speaking of English is good.

At that point, the foolishness ended. In 1986, she graduated from Harvard Medical School with an M.D. degree. For the next eight years, she worked as a physician in the maws of our health care system.

In 1994, she went to work at the New York Times, where she spent the next 22 years, largely but not exclusively as a science and health care reporter. Today, she's editor in chief of Kaiser Health News, a fully respectable outfit.

Rosenthal isn't a hippie; her pedigree involves Harvard Med and the New York Times. From June 2013 through December 2014, she published an 11-part series in the Times, Paying Till It Hurts, which focused on the amazingly high prices charged for American health care.

Perhaps instructively, the series wasn't nominated for a Pulitzer Prize. It did win the 2014 Victor Cohn Prize for Medical Science Reporting, which helps explain why Paying Till It Hurts is sometimes described as an award-winning series.

When Rosenthal wrote An American Sickness, she was working within a long, distinguished career involving our highest-ranking institutions. In all that follows, let's keep this context in mind.

On April 9 of this year, Jacob Hacker reviewed Rosenthal's book in the New York Times Sunday Book Review. He penned a slightly wonky rave review of the book. But as he ended his review, we would be inclined to say he made an inaccurate statement:

HACKER (4/9/17): Without a clear view of the political economy of health care, it’s easy to see the problem as Justice Scalia did. If we could just start treating health care like broccoli, the market would solve the problem. But as Rosenthal’s important book makes clear, the health care market really is different. Speaking of her Times series in 2014, Rosenthal told an interviewer her goal was to “start a very loud conversation” that will be “difficult politically to ignore.” We need such a conversation—not just about how the market fails, but about how we can change the political realities that stand in the way of fixing it.

According to Hacker, An American Sickness is an "important book." In our view, it's important to see why that statement is wrong.

Don't get us wrong! Hacker, a professor at Yale, may be perfectly right on the merits.

For ourselves, we'd lodge some complaints about Rosenthal's book. But as we've already noted, the street-fighting tone she adopts as she starts is extremely rare.

Right in her opening pages, Rosenthal employs the language of corporate crime as she describes the workings of our "extractive" health care industries. It seems to us that this tone, which is very rare, is very much on point.

This may be an important book if it's judged on the merits. But will it be an "important book" in the end?

No, it actually won't! It will be a book which is widely ignored, even by the most-adored stars of our own corporate liberal world.

Indeed, Rosenthal's book is already being widely ignored. Right on page 3, it asks the question which lies at the heart of modern American governance, a question which virtually never gets asked.

"Where is all that money going?" Rosenthal asks, referring the $5000 per person per year which disappears, unexplained and unexamined, into the maws of the "slow-moving heist" which she sees as our medical system.

Where is all that money going? An answer to that foundational question would help explain why our country, along among developed nations, can't seem to find a way to provide universal health care.

As economist Dean Baker has often noted, it would also help explain a second definitive conundrum. It would help explain why we can't seem to get our federal deficits under control.

Where is all that money going? On page 3, Rosenthal asks the question which lies at the heart of our clown-like American governance. But how odd:

Despite the pedigree she provides; despite the centrality of her topic; Rosenthal has largely been ignored by our journalistic elites since her book appeared.

Her book was reviewed in the Sunday Times, but not in the newspaper's weekday editions. (Major books—about apricot cocktails, let's say—tend to rate dual reviews.)

The book was reviewed in the Washington Post in weirdly desultory fashion. Juliet Eilperin is very experienced and no dope, but you'd have a hard time knowing such things from her 1100-word, review-by-the-numbers review. In our view, Eilperin glossed the street-fighting vigor of Rosenthal's critique while offering complains such as this:

EILPERIN (5/21/17): While Rosenthal does her best to squeeze in a few jokes (mostly lighthearted references at pathologists' expense), the subject matter makes for dense reading at times. This is a thorough book, but it's hard to envision a casual reader picking it up and whiling away the weekend with it. And on occasion her obvious immersion in the medical field slows the writing down a bit, as when she decries the disappearance of two anti-nausea generic drugs. "Not having prochlorperazine available in an emergency room is like not having acetaminophen (Tylenol) in a drugstore." I couldn't help wondering why the book's editor hadn't just struck "acetaminophen" and left "Tylenol" in its place.

Slave to the establishment, please! Just consider:

We've voiced a complaint about Rosenthal's style. We think she fails to convey, in a fully effective way, the massive overall size of the "heist" she chronicles in her pages.

By way of contrast, Eilperin thinks Rosenthal should have omitted "acetaminophen" in one annoying sentence! For what it's worth, that blindingly narrow critique is correct. But apostle of trivia, please!

Around the country, it's amazing to note a larger fact. In one arena after another, Rosenthal's book hasn't been reviewed or discussed, or even so much as mentioned.

It's always dangerous to report that a particular item hasn't appeared within the work of some news org. But we find no sign that Rosenthal's book has been reviewed, or even mentioned, in an array of major newspapers or in other well-lit locales.

Has the book been reviewed in the Boston Globe or the Los Angeles Times? Maybe, but Google and Nexis seem to say no.

Has it been reviewed in USA Today? Our answer would be the same. You can search on if you like.

We were surprised to see that major newspapers are scrimping on reviews of this book, which has emerged from the upper ends of our fully respectable class. We were amazed to see the near-total silence the book has met everywhere else.

Has Rosenthal's "important book" been reviewed, or even mentioned, in The New Yorker or in The Atlantic? Our search last weekend turned up no cites.

Has it been mentioned in Slate or Salon? In The Nation or in Mother Jones? Has the book been mentioned by Vox? Searching, we found no such cites.

This brings us to our broadcast orgs. Of these news orgs, we'll only say this:

The avoidance, how it burns!

Let's start with a few bright lights. Rosenthal's book was released on April 10. That day, she did a 36-minute interview segment on Fresh Air with Terry Gross.

Earlier that morning, she'd done a short interview on Good Morning America. The next day, she was subjected to a brief, entirely pointless drive-by on Morning Joe.

On April 27, she was interviewed on the PBS NewsHour. That seems to be where this part of our story ends.

As our nation has pretended to discuss health care in the past few months, where else has Rosenthal's "important book" taken her?

We find so sign that she, or her important book, have so much as been mentioned on any of the five Sunday shows, our journalistic equivalent to Don Corleone's "five families."

We find no sign that her name has been mentioned on any of the daily shows which anchor the NPR schedule. All Things Considered? Apparently not! Nor can we find a record of the book—sorry, of the important book—being mentioned on Morning Edition.

Has she sat with Charlie Rose for his nightly PBS program? The official site for the (slightly self-)important show records no such appearance. This seems amazingly strange to us. But people, there it is.

At some point, we must mention "cable news." When we do, we come face to face with the shape of our corporate world.

Rosenthal has written an "important book" about the looting of the American public by a range of corporate elites. On page 3, she poses the question which lies at the heart of our clown-like American governance.

That said, cable news is itself a corporate realm, and it's the province of clowns. This may explain what we found when we continued our search.

Using Nexis, we find no sign that Rosenthal's name has ever been mentioned on CNN since her book appeared. And uh-oh! We find no sign that her name has been mentioned on the prime-time shows broadcast by MSNBC.

Judging from the Nexis archive, Rachel hasn't so much as mentioned Rosenthal's name. Neither has Lawrence, or any of the other fiery progressives who serve us our porridge each night.

In truth, Rachel would jump off the Golden Gate Bridge before she'd discuss such a topic. Rosenthal's book includes no Republican pol we can try to lock up!

Tomorrow, we'll begin with this part of this problem. We'll proceed to one final semi-complaint about Rosenthal herself.

That said:

On page 3 of her new book, Rosenthal asks a deeply foundational question about our clownish governance. As she proceeds, she uses the language of corporate crime as she describes the looting which lies at the heart of our health care system.

In part for this reason, Hacker said she'd written an "important book." He may be completely correct on the merits. But no book which goes undiscussed can live up to such a description.

Are we observing a case of "manufactured consent" as we note the silence surrounding this book? Tomorrow, we'll return to Chomsky's decades-old phrase, and to the possibility that our American health care system represents a rolling case of "manufactured theft."

Tomorrow: The author seems to bail!

Medicaid cuts versus slower growth!

WEDNESDAY, JUNE 28, 2017

The New York Times tries to explain: Is human life a vale of tears? A mere entertainment arranged by the gods?

We ask for a very good reason. In this morning's hard-copy editions, the New York Times tried to explain the endless debate about those "Medicaid cuts."

The key word there is "tried."

Do journalists at our biggest news organs have any skills at all? You'd think the answer would have to be "yes."

The gods who rule this vale of tears may have a better idea.

The analysis piece to which we refer was written by Alan Rappeport—and no, he isn't a kid.

He graduated from Emory in 2001. One year later, he got a master's degree from the Columbia School of Journalism.

In 2006, he got a master's degree in economic history from the London School of Economics. After spending five years at the Financial Times, he started at the New York Times in April 2014.

Rappeport has a gauzy resume. He didn't have the slightest idea how to settle the endless dispute he'd been asked to resolve.

The scribe had been asked to settle a question. The basic question was this:

Does the Senate GOP health care bill involve cuts in the Medicaid program, as Democrats say? Or are Republicans simply slowing the rate at which the program will grow?

It's stunningly easy to explain this matter. Unless you work for the New York Times, in which case it can't be done.

Before we look at Rappeport's piece, let's settle this tiresome question. As a courtesy, we'll start with the rather silly but technically accurate claim the Republicans have been making. From there, we'll move to the Democrats.

When Republicans say there are no cuts, this is what they mean: They mean that total spending in the Medicaid program would continue to rise from its current level under their proposal.

(We can't swear that that is true. But that is what they claim and that is what they mean.)

X number of years from now, the federal government would be spending more dollars on Medicaid than it is spending this year. That's what the Republicans mean when they say they aren't imposing a "cut."

When Democrats say there very large cuts, this is what they mean: Among other things, they mean that spending won't rise quickly enough to keep up with inflation, or even to come close. More dollars will be spent as compared to this year, but those dollars will pay for fewer services.

In the case pf the GOP plan, it seems that those dollars will pay for far fewer services. But it isn't entirely easy to get clear on such facts, given the staggering lack of skill within our upper-end press corps.

Does the GOP plan involve Medicaid cuts? Or are they simply slowing the rate of growth? Rappeport was asked to untangle this endless conundrum. This is the way he began:

RAPPEPORT (6/28/17): Republicans, under fire for proposing health care legislation that would reduce Medicaid funding by hundreds of billions of dollars, have embraced an old argument that taking money from a program is not a “cut.”

At first glance, the new pitch to make their strategy more palatable seems at odds with the numbers. The Congressional Budget Office said on Monday that the “Better Care Reconciliation Act” would reduce Medicaid spending by $772 billion over a decade. By 2026, Medicaid enrollment would drop by 16 percent among people under the age of 65.

So, are there cuts or not?

Sigh. Right in his opening sentence, Rappeport has assumed the answer to his question. Republicans would say they aren't "taking money from [the Medicaid] program." Right from the start, Rappeport treats it as a given that they actually are.

Republicans would say they aren't "taking money from [the Medicaid] program?" Absolutely! They would say that they're spending more money, in future years, than was spent in the program this year!

On that basis, they would say that their proposal adds money to the Medicaid program. They'd also say, with obvious justice, they aren't "embracing" the claim that Rappeport puts in their mouths.

In his second paragraph, Rappeport again blows past the basic Republican claim, silly though it may be. Did the CBO really say that the Republican proposal "would reduce Medicaid spending by $772 billion over a decade?"

Sad! Rappeport provide no quotation of any such CBO statement. He also provides no link to any such CBO statement. But if the CBO made some such statement, they would have been comparing the amount of spending the Republicans propose to the amount of future spending which would occur under current law.

Should a person refer to some such proposal as a "cut," a "reduction?" We're sorry, but that's a semantic question to which there's no ultimate answer.

How should a journalist deal with a semantic dispute of this type? He should simply explain the facts of the case! Here goes:

Under the GOP plan, spending would rise by a small amount as compared to this year. But it wouldn't come close to keeping up with the rate of inflation, thereby causing significant cuts in nationwide Medicaid services.

Dollar spending would rise by a small amount. The number of Medicaid recipients would have to be substantially cut. Those are the basic facts of the case. How hard was that to explain?

For the nation's upper-end journalists, this amazingly elementary matter is much too hard to explain. It isn't just Rappeport who gets tangled today. On the next page in the hard-copy Times, Margot Sanger-Katz (Yale 2002, CSJ 2003)bungles the very same question:

SANGER-KATZ (6/28/17): Contrary to statements by Kellyanne Conway and other Trump advisers that the bill contains no overall cuts to Medicaid, the budget office offered a chart highlighting the spending reductions for the program. It says explicitly that “states would not have substantial additional flexibility” under the bill’s Medicaid reforms, a typical selling point for a plan that would push more fiscal risk to state governments. It says that a waiver program for state insurance regulations would increase the deficit and would not reduce the uninsured rate in every state. In addition, the analysts wrote, “waivers would probably cause market instability in some areas.”

Sad. Sanger-Katz doesn't link to the chart to which she refers, nor does she actually quote any statement by the CBO. That said, the "spending reductions" to which she refers will qualify as "reductions" only if she compares future spending under the GOP plan to future spending which would occur under current law. In the end, she is simply adopting the semantic framework preferred by one of these sides.

Unless you're an upper-end journalist, it isn't hard to explain the basic facts of this case. Year by year, spending will rise by a small amount under the GOP bill. But because those small increases won't come close to keeping up with inflation, major cuts in Medicaid services will be required.

Spending will rise a small amount. There will be large cuts in Medicaid services. It's amazingly easy to state those facts. They leave the semantic confusion behind.

A journalist should know how to do that. But over the years, we've come to see that our journalists have almost no skills.

They know how to stick to a story-line; that tends to be where the skill set ends. Perhaps the gods find this amusing.

We know of no way to tell.

Meanwhile, for extra credit: Emory, Yale, CSJ, LSE? What are they teaching these kids?

MANUFACTURED THEFT: The $1.5 trillion question!

WEDNESDAY, JUNE 28, 2017

Part 3—Amazingly, Rosenthal asks: Right at the start of her widely-ignored new book, Elisabeth Rosenthal asks the question which virtually never gets asked.

She starts by describing the crazy way Americans get billed for medical procedures. "In no other industry do prices for a product vary by a factor of ten depending on where it is purchased, as is the case for bills I’ve seen for echocardiograms, MRI scans, and blood tests to gauge thyroid function or vitamin D levels," Rosenthal writes.

The passage appears on page 2 of her new book, An American Sickness.

"The price of a Prius at a dealership in Princeton, New Jersey, is not five times higher than what you would pay for a Prius in Hackensack," Rosenthal writes as she continues. "The price of that car at the very same dealer doesn’t depend on your employer, or if you’re self-employed or unemployed. Why does it matter for health care?"

At this point, we're still on page 2 of this book. On page 3, Rosenthal starts to resort to the language of corporate crime as she describes these peculiar billing practices.

As she does, she asks a fundamental, foundational question. It's a question which never gets asked:

ROSENTHAL (page 3): We live in an age of medical wonders—transplants, gene therapy, lifesaving drugs and preventive strategies—but the health care system remains fantastically expensive, inefficient, bewildering, and inequitable. Faced with disease, we are all potential victims of medical extortion. The alarming statistics are incontrovertible and well known: the United States spends nearly one-fifth of its gross domestic product on health care, more than $3 trillion a year, about equivalent to the entire economy of France. For that, the U.S. health system generally delivers worse health outcomes than any other developed country, all of which spend on average about half what we do per person.

Who among us hasn’t opened a medical bill or an explanation of benefits statement and stared in disbelief at terrifying numbers? Who hasn’t puzzled over an insurance policy’s rules of co-payments, deductibles, “in-network” and “out-of-network” payments—only to surrender in frustration and write a check, perhaps under threat of collection? Who hasn’t wondered over, say, a $500 bill for a basic blood test, a $5,000 bill for three stitches in an emergency room, a $50,000 bill for minor outpatient foot surgery, or a $500,000 bill for three days in the hospital after a heart attack?

Where is all that money going?

"Where is all that money going?" At this site, we've been asking that foundational question for years.

Already, on page 3, Rosenthal has asked that foundational question. Truth to tell, it's the most basic question in all of American governance.

That question lies at the heart of the basic problems our federal government can't seem to resolve. It's a question which, by common agreement, essentially never gets asked.

Warning! We're not saying that Rosenthal asks this question in the most skillful way. For our money, she presents that foundational question in a way which is hopelessly murky.

Speaking the language of corporate crime, she has already suggested that our health care systems is built on a foundation of "medical extortion." But she offers a clumsy account of the vast sum which is disappearing into the maws of this system every year.

Is our health care system really based on acts of "extortion?" As a doctor's kid, as a doctor herself and as a health care reporter, has Rosenthal really "had a lifetime front-row seat to a slow-moving heist," as she declares on page 4?

Do American hospitals constitute "an extractive industry" (page 24), whose behavior can be compared to that of bank robbers?
According to Rosenthal, that's where all that money is going! But on page 3, she does a fairly lousy job establishing her basic foundational question.

Where is all that money going? In the following passage, Rosenthal describes the money to which she refers—the money which is being looted out of our health care system. In our view, this is very murky work:

"The alarming statistics are incontrovertible and well known: the United States spends nearly one-fifth of its gross domestic product on health care, more than $3 trillion a year, about equivalent to the entire economy of France."

It would be hard to establish her basic question in a less compelling way. Let's note a few problems:

First, those alarming statistics are not well known among the American public. Go ahead! Stop a hundred pedestrians today. Ask them what portion of our "gross domestic product" is spent on health care each year.

Ask them how many dollars our nation spends on health care each year. Ask them to compare that amount to the entire economy of France!

You're going to get a lot of stares if you start posing those questions. Rosenthal does a terrible job describing the amount of money which is getting looted in the course of the "slow-moving heist" she admirably describes.

Rosenthal asks the foundational question: "Where is all that money going?" It seems to us that this would be a much better way establish the size of the problem:

Per capita spending, health care, 2015
United States: $9451
Canada: $4608
France: $4407
Japan: $4150
United Kingdom: $4003

Good God! Five thousand dollars per person per year is disappearing into the maws of that slow-moving heist! That's the mountain of missing money to which Rosenthal's question refers.

Those numbers dramatize Rosenthal's rather bureaucratic claim (see above): other nations' health systems "all...spend on average about half what we do per person." In the course of a 400-page book, Rosenthal never presents them.

At any rate, those remarkable data help us see why our nation has so much trouble providing health care to all its citizens. Because of all that looting, a year of health care costs more than twice as much in this country as it does everywhere else!

In our view, Rosenthal does a very poor job establishing the size of this looting. On the other hand, she aggressively asks the foundational question, the question which never gets asked:

Where's all that money going?

That is our government's foundational question. That question underlies our endless health care debacle and our federal deficit problems.

Rachel and Lawrence know not to ask it. Rosenthal asks the question straight out, right on page 3 of her book!

Having asked the foundational question, Rosenthal proceeds to an anecdotal answer. Her story starts on page 11, at the start of her Chapter 1.

Her story involves Jeffrey Kivi, a high school chemistry teacher in New York City with a potentially disabling condition called psoriatic arthritis. Absent treatment, the condition could leave Kivi "unable to work and even walk."

Enter our "extractive" health care system! Rosenthal starts her story in the fairly recent past:

ROSENTHAL (page 11): About fifteen years ago, important new arthritis drugs hit the market. His rheumatologist, Dr. Paula Rackoff, said he was a good candidate. The medicine worked wonders: every six weeks, a drug called Remicade was infused into his veins in an outpatient clinic at Beth Israel Hospital, where Dr. Rackoff practiced. The treatment cost $19,000 each visit, but Mr. Kivi, as a New York City civil servant, has excellent insurance under EmblemHealth. He paid nothing himself.

"The results were transformative," Rosenthal writes. Kivi was able to continue his life and his career.

For ourselves, we were already wondering, at this point, why a one-day, outpatient treatment would cost anything like that much. As it turns out, that shows how clueless we are.

In 2013, Dr. Rackoff moved her practice about fifteen blocks to NYU Langone Medical Center. Kivi began going there for the exact same treatments. Only one thing had changed:

ROSENTHAL (page 12): At first, [Kivi] was impressed by the Langone Center for Musculoskeletal Care, where services were distinctly more upmarket...

But the charges that started posting on his insurance Web site, as submitted by NYU, shocked him: the first three-hour infusion at the new hospital, in may, was billed at $98,579.98, the second in June at $110,410.82, and from July on they were billed at $132,791.04. It was the same dose as always, in the same form, prescribed by the same doctor.

Where was all that money going? Rosenthal describes what happened when she and Kivi tried to find out.

Why was a $19,000 treatment now being billed at $132,000? According to Rosenthal, "When Mr. Kivi complained to the NYU billing office, a patient-care representative offered a range of nonexplanations." She quotes Kivi describing the curious things he was told, then reports her own experience:

ROSENTHAL (page 13): When I tried to pick up the investigation where Mr. Kivi left off, the explanations got even less convincing. The public affairs department told me Mr. Kivi was an "outlier" because he was getting aggressive treatment and he is large. Remicade is dosed according to weight and, at over six feet and nearly four hundred pounds, Mr. Kivi does get a relatively large dose. But even so, the wholesale price of Mr. Kivi's dose of Remicade should have been about $1,200, a drug researcher at another hospital told me.

As we slid down the rabbit hole of medical pricing, things only got darker and darker...

The treatment had cost $19,000 fifteen blocks down the street. Fifteen blocks to the north, the billing price jumped to $132,000. The insurance company ended up paying $99,593.27 for each treatment.

According to Rosenthal, these are the types of "heists" which occur within our own homegrown "extractive industry." Presumably, she featured this heist because it's especially dramatic.

That said, when heist is piled upon heist, $5000 per person per year disappears within our health care system. As a result, our nation, alone among its peers, becomes a pitiful helpless giant.

We become a clownish society locked in clownish "health care debates" of the type we're currently experiencing. Clownishly, we can't provide universal health care, and we can't seem to get control of our federal budgets!

Despite their fiercely progressive views, Rachel and Lawrence won't talk about this on their popular "cable news" programs. Instead, they entertain us with a succession of chases, for example against a governor who once said that he enjoyed touching his girl friend's breasts.

Our darling Rachel won't talk about this. Does anyone understand why?

Tomorrow: Rosenthal ignored, disappeared