Health Wars II have begun.
James Fallows warns us to watch for the name McCaughey (emphases mine) - and for the reemergence of amoral journalism ...
Let's stop this before it goes any further - James FallowsNCIT is not new, last time I looked it had to do with IT standards. (You can imagine the way it's pronounced, for a while we had several CIT groups, including "ONCIT" and "OhCHIT". Ok, maybe not the latter.)
... The award for "Most destructive effect on public discourse by a single person" for the 2000s, so far, goes to Dick "no doubt" Cheney...
My nominee for the winner in the 1990s would be Elizabeth "Betsy" McCaughey. At various stages in her career she has been a banker, a Republican politician, and a staffer at conservative think tanks, but she entered the public stage in the mid-1990s in the guise of a dispassionate, independent researcher who considered it her duty to inform the American public about the dire threats it faced. Come to think of it, that is more or less the guise Cheney took in warning about the threat from Iraq.
In McCaughey's case, the equivalent of weapons of mass destruction was the original Clinton Health Reform plan. In 1994 she wrote a cover story in the New Republic "revealing" a number of hidden dangers in the Clinton plan that less careful analysts had somehow missed. Unfortunately for McCaughey, most of what she wrote was false. Unfortunately for the Clintons, most of what she claimed was echoed uncritically and became part of the conventional wisdom of why the bill couldn't pass.
After the jump, a passage from my 1995 Atlantic article "A Triumph of Misinformation" about McCaughey's article and its effects. More on this topic in my 1996 book Breaking the News -- and especially about why sloppy press coverage did as much to thwart health-care reform under the Clintons as it did to bring on the Iraq war under Cheney and Bush.
Why bring this up now? Because McCaughey has sprung up again to "reveal" another hidden danger in another Democratic administration's plans. Buried inside the new stimulus bill, she has discovered, are new big-brother tactics similar to those she warned against years ago. In a recent Bloomberg.com opinion column she wrote:.. 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....
This time, no free pass for McGaughey. She earned her rep.
1 comment:
OK folks. Let me try to explain this to you. First, the bill sets up an incentive program where physicians who are blessed by the "Secretary" will receive $15,000 in year 1, $12,000 in year 2, then $8,000, $4,000 and $2,000 in the succeeding 3 years. Now how does the Secretary decide whom to bless? Easy: Go to Part II, Sec 4311. This adds a new provision entitled "o" which itself has a provision (2) "Definition of a Meaningful EHR User”. To be blessed as such, you must (i) have the EHR system in place (sounds OK), (ii) be able to interchange electronic records (OK still), and (iii) report on "clinical quality measures" which some bureacrats are going to make up (WARNING BELLS!). I understand - at this point you are laughing saying, "See - my doctor can still recommend procedures he or she likes so there is no federal control. It's just money for being a techie doctor." Au contraire, mon amie. The federal government is now going to come up with lots of swell "quality" metrics such as "Number of people over 70 years for whom you prescribed super expensive tests" and "Number of pregnant women with suspected Down's babies whom you did not counsel to abort." Plenty of doctors would say that these measurements are not indicative of quality of care. However, your maverick doctor, who cares more about patient care then some stupid bureaucracy, has a very difficult choice: either go on record as stringently disagreeing with the bureacrats' definition of quality health care, or forego the incentive payments.
Am I the only one who sees the obvious next step? It's the beginning of the end for "patient first" doctors. And welcome to our Brave New World where "team player" doctors who wisely obey their federal overlords will be blessed, promoted, and respected in the profession.
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