Jack Abramoff's associates take a shot at yours truly …

Posted by Joshua Holland at 11:56 AM on July 27, 2006.

The National Center for Public Policy Research (NCPPR) is among the most insidious of the many organs of corporate propaganda posing as "non-partisan' think tanks. According to Mediatransparency, it was formed in the 1980s to support Reagan's military interventions in Central America. In the 1990s, NCPPR got into the business of denying climate change -- ExxonMobil's a big donor. Jack abramoff was an active board member until … uh, recently. Abramoff, you'll remember, used the NCPPR to funnel lobbying money through non-profits. They paid for his infamous Scotland golf trip with Tom DeLay. And despite the fact that they're all lily-white right-wingers, they're also behind much of the infrastructure of the "black conservative movement," as I pointed out to their chagrin over a year ago.

They're ideologues who have their answers in advance, and work backwards from there -- the antithesis of public policy analysis.

And they have a blog, written by NCPPR's president, Amy Ridenour, a former bigwig among the College Chickenhawks Republicans and knee-deep in Abramoff's hanky-panky (the WaPo reported: "E-mails suggest Ridenour was well aware that Abramoff viewed her organization as a convenient pass-through").

On it, after a brief introduction by Ridenour, David Hogberg, a "senior policy analyst" (and American Spectator and NRO contributor), takes me to task for a recent post about making Medicare available to all:

Over at AlterNet, Joshua Holland argues that the way to universal coverage - which he inexplicably supports -- is to open Medicare to all of those who want to join, not just those age 65 and older.

Just the fact that someone might want every American to have health coverage is "inexplicable" to this senior policy analyst.

Holland's article is so riddled with ignorance that it is going to require more than one blog post to set it straight.

I can't wait for the follow-up. 'Til then, me and my prize-hog Rufus'll just be settin' here, stewin' in our ignorance.

Let's begin with the type of health care system that Holland believes is superior to the one in the U.S.:

Holland: The day you pass a law opening up Medicare enrollment to everyone who wants in is the beginning of the end for our bloated, overpriced private health care system. Within ten years, we'd have universal, single-payer health care, with just a small percentage of Americans sticking with private insurance (like in the UK).

If we were to go the UK route, we would soon end up with a health care system that would be overused because people would think (erroneously) they are getting something for free. In response, the government would have to ration care, yielding a system characterized by bureaucracy and inefficiency:

-We could have a system that results in over 770,000 people on a waiting list to get surgery, like in the UK.

-We could have a system that results in children with heart defects on waiting lists to see a specialist, sometimes for two years, like in the UK.

-We could have a system that results in about 61,000 surgeries cancelled annually due to lack of resources, like in the UK.

Thanks, but I will take what Holland calls "our bloated, overpriced private health care system" over the UK's any day of the week and twice on Sunday.

First the dishonesty -- these people can't enter the fray without it -- and then the substance.

The strawman here is that I never proposed a national health system like they have in the UK; I proposed a single-payer healthcare system with diverse providers, and said it would be like the UK only in that a small percentage of the population would remain privately insured (17% of healthcare in the UK was privately financed in 2004 compared to our 55% (OECD data)).

Let's move on to Hogberg's statement that he'd choose our bloated healthcare system "any day of the week and twice on Sunday."

He lists some of the problems with the UK's healthcare provision -- again, I didn't propose anything like that -- but fails to mention that we spend $5,267 dollars per person on healthcare, while the Brits spend $2,160 (OECD Data from 2004). It's an intentional and required ommission, one that economist Dean Baker is always bitching about when analyzing media stories about healthcare.

A free-marketeer like Hogberg (he was a big pusher of Social Security privatization) should understand that we might expect a lot more healthcare than the Brits, given that we're spending two and a half times as much as they are.

But we don't get it. They have some waiting lists and some elective surgeries get cancelled. But one in seven of us aren't covered at all. Our infant mortality rate is 36 percent higher than the Brits; they live a year longer than we do on average and they have more nurses per patient and more beds per capita.

Here's what a real analyst, Bernard Wasow at the Century Foundation, has to say:

… the United States appears to be doing badly, not just compared to Britain but compared to every advanced country in the world. Taking into account the overall standard of living and spending on health care, we should expect a newborn in the United States to live 81 years. In fact, life expectancy at birth is 77 years. Of 25 high-income industrialized countries, the United States is in last place, both in life expectancy at birth and in the gap between actual life expectancy and predicted life expectancy given the standard of living and spending on health care. The next worst outcome, behind U.S. life-expectancy deficit of four years, is a deficit of 2.7 years in Denmark. In contrast, a Japanese newborn is predicted to live about 79 years but actual life expectancy in Japan is nearly 82 years. A Japanese newborn can be expected to live two and a half years more than Japanese living standards and medical spending would lead one to expect, while an American lives four years fewer.

In the whole world, only five countries have a bigger gap between actual outcomes and what might be predicted based on spending. They are Haiti, Papua New Guinea, Laos, Russia and Guyana.

Here's a handy chart:



It's not only life expectancy -- we're sicker across the board. A study looking at U.S. and British health released earlier this year found that "Americans had higher rates of diabetes, heart disease, strokes, lung disease and cancer -- findings that held true no matter what income or education level." Of course, that can't all be put on our healthcare delivery system -- there are lifestyle factors and whatnot -- but, remember, they're getting those outcomes while spending 40 cents to our dollar.

Wasow concludes:

Our health care system certainly delivers innovations in pharmaceutical and other technologies… But it does not deliver medical care equitably to all Americans. Those who can pay have access to the best health care in the world. Those with good insurance plans--a decreasing fraction of the population--get good, life-extending health care. The rest must make do. And the result is that enough people fall through the cracks to place us at the bottom of the rich country life expectancy tables.

That's the system that Hogberg would choose twice on Sunday. As they say, there's one born every minute.

I didn't intend my post to be a comprehensive look at a complex subject, nor did I propose it would be a magic bullet. It's a baby step. But before we go anywhere, we'll have to get past the hacks like Hogberg who, for a few dollars in wingnut welfare, are happy to whistle past the graveyard as our healthcare system remains in deep crisis.

Joshua Holland is a staff writer at Alternet and a regular contributor to The Gadflyer.