Xblog

So, a couple of the points were selective use of statistics (the one that really blew me away was pointing out that Americans have shorter wait times for elective surgery as some kind of counter claim against them having longer wait times for non-elective surgery… doesn’t that suggest a complete misprioritization of resources?), but there were a number of points there where CNN just got their facts wrong. It’s just sad that within hours, Michael Moore can put up facts and links to back up his claims and demonstrate that CNN is off in left field.

Of course, it would be nice to see a similar list from Dr. Gupta’s piece, but that is not how the television medium works. Hopefully CNN will provide links on their website. I checked, and while there was a great shot of Dr. Gupta right on the front page of CNN’s “Health” section, I couldn’t find mention of any backing information for their story. They do have a written version of the story that reads a lot less ridiculously than the video I saw, although it still reads like he grabbed a few of his facts from a PR guy from the health industry and didn’t bother to check them. In CNN’s defense, I will say that I suspect most of the problems actually come from trying to compress a story down to the very short window that fits the TV format.

One thing this shows: CNN and TV news in general aren’t ready to for the Internet just yet. A 24-hour news service, with the resources that come with that, if really cognizant of Internet would have not even waited for Michael Moore to post his references, but would have immediately gone to the reporter’s notes and the fact checker’s notes (let’s just assume for the moment that CNN is still following those time honored traditions of journalism) and updated the web story to provide links to them. Instead, you will find plenty of links to promote other areas of the CNN site, as well as a number of links to advertisers, a link to a review of the movie, but no links to back up any facts in the article.

Indeed, a truly web-savvy news service would always include links to data that backs up their story, just on the off chance that their viewers were interested in learning more (sure the links would be selective, much as Michael Moore’s are, but like Michael Moore did, if you were smart you would select sources who were entirely credible, and most importantly, people would know where your data came from).

I mentioned in a previous entry that it seems the TV is coming to the Internet, and it perhaps isn’t going to be much better than the original. I guess one thing I am hoping gets better is that when TV news starts really moving to the Internet when a random factoid is bandied about in a story, there might simultaneously be a link to the source for that factoid. It might cut down on that time honored tradition of tossing about statistics without context or worse still, getting the context or stats so wrong that one has a hard time associating anything but deliberate intent to the cause of the problem.

I think it is safe to say that Michael Moore has on occasion done his own bit of misrepresenting things, and he certainly does not have a monopoly on the truth, but it seems that more and more traditional news services have been drawn so far from that hallowed ground by PR reps, a focus on profit over quality, etc., that it sadly non-traditional sources like Mr. Moore are the only ones who actually bothers to get their facts straight.

One parting shot on the health care issue itself. There was a time in American history when health care was often provided by practitioners who were expensive, had a poor track record of patient care, but who had the highest rates of customer satisfaction. These practitioners turned health care in to a confidence game, because they realized that making people feel like they were being taken care of was far cheaper and more profitable than actually taking care of them.

Those practitioners were called frauds and quacks, and it is high time that when someone like Dr. Gupta agrees that the US has significantly higher costs for health care, longer wait times for needed care, fewer people having access to health care, higher infant mortality rates, shorter life expectancies, doesn’t even make the top 30 nations in terms of quality of health care, and then points out that more context is needed because the US ranks highest in patient satisfaction, they ought to name that larger context: fraud and quackery, or at least use the more modern vernacular: “salesmanship”.

A short while ago, some folks tried to fund emergency rooms and hospitals with a new surcharge on phone bills. It turned out the electorate didn’t hate phone companies and those who used phones enough to vote the proposition in. So, this time we’re coming at it with more easily vilified targets (at least in California): tobacco smokers, growers, and vendors.

We hate smokers here in California. When I think about it, I’m surprised the folks behind prop 83 didn’t throw smoking on to the list of eligible crimes to improve their chances. How can you possibly vote against a measure that goes after smokers?

Well, first of all, let’s keep in mind here that smokers are really involved in the funding side of this equation. They are going to hit a massive tax increase per packet of cigarettes to help us fund emergency rooms and all other kinds of medical expenditures.

The real aspect of this bill is how it effects hospitals. One of the insane aspects of our private health care system in the US is that we still require hospitals to provide life saving health care to the uninsured. If they can’t pay, that’s the hospital’s problem. The logic is about as faulty as popular logic on tax policy that suggests one is cutting taxes if one reduces the tax rate, even if one doesn’t reduce spending. It’s silly, the bottom line is as long as you are okaying the spending (by requiring health care for the uninsured), you are okaying the bill as well. Sooner or later that money has to come from somewhere, or all your hospitals are going to declare bankruptcy.

Of course, by going the “save them and then try to make them pay even though they probably can’t” is horribly inefficient. You end up with people not getting cost saving preventative treatment but rather very expensive last-minute interventions. This leads to expensive bill collection expendatures for the hospital, and quite possibly bankruptcy for the patient. The bankruptcy process is just a more expensive way for the hospital not to get paid, and in order to make a profit that bill gets passed on to the rest of us in increased medical costs which finally present as… increased health care premiums.

So, we’re all paying for socialized medicine right now, but because we can’t just acknowledge it and build a system around it, it ends up being far more expensive for everyone. It’s kind of like the bond measures vs. tax increase situation that I’ve talked about on previous propositions. Proposition 86 attempts to buffer this insanity a bit by providing some funding from tobacco taxes.

My problem with this is that the measure doesn’t really address the fundamental problem, it just shakes down smokers to provide a small short term band aid on massive open wound. What I’d really like to see is a straight up or down vote on either going with socialized medicine or allowing hospitals to refuse patients they feel can’t pay for their services.

One other aspect of this bill that opponents have gone after is that it provides exceptions to anti-trust laws for hospitals trying to coordinate a emergency care (“how about you cover all cardio work on wednesdays when I give my specialist the day off?”). This just seems like another area where the existing system makes it far too difficult to provide medical services efficiently.

Okay, so my Canadian is showing a bit.

I’ve not really made up my mind on this one, but I’m leaning against it. It just seems like a bunch of half-measures that don’t come close to adequately solving the problem. The problem I have in voting it down is that our current situation seems so bad, even a half-measure seems better than nothing.