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Tomorrow's Bizarre Smears Today

Andy writes in:

An arch-conservative friend of mine is convinced that something in the "Establishing of National Priorities for Performance Improvement" section of the Medicare piece of HR 3200 is going to establish "healthcare racism" because it contains the words "addressing health disparities across groups and areas." I have no idea what this provision is really about. Do you have any idea? I assume he got this from some right-wing this some new angle of hysteria that we can expect? If so, sigh, how should I prepare myself to respond to it when all my other conservative friends pick up on it?

When talking to Republicans, I so often find myself utterly blindsided by the nature and focus of their objections. I consider it my civic responsibility to be able to make the broad case for my (liberal) position on the major points of major issues. But I usually find myself confronted not with the broad conservative case but with obscure and sideways points about things that I wasn't even aware could be construed as issues.

This was the point of my earlier post on the public option: There is an endless wealth of issues for opponents of reform to distort and lie about. Taking one off the table simply ensures they'll move on to the next.

Take this nonsense of health-care racism. Reducing the disparities in outcomes of different ethnic groups is a longtime goal in health-care policy. A good example is infant mortality: African-American infants die at much higher rates than white infants. This persists even when you adjust for class. The infant mortality rate for college-educated black women is 11.5 per 1,000 births, which is more than double the 4.2 per 1,000 for white women with similar education. Opposition to addressing this is literally support for more dead infants. There's not really a nice way to put it.

H.R. 3200 has a lot of sections dealing with infant mortality, but the main piece for Medicare is Section 1221, which mainly deals with demonstration programs in which hospitals would have on-site interpreters to help bridge the language barrier between a sick patient and an uncomprehending doctor.

As far as I can tell, Andy's friend hasn't found section 1221, and is in fact concerned with section 1191, which isn't primarily concerned with disparities, but suggests that improving "health disparities across groups and areas" should be one area in which we strive for improvement, alongside "prevalent, high-cost chronic diseases," efforts that "have the greatest potential to decrease morbidity and mortality in this country" and interventions that exhibit "the potential for rapid improvement due to existing evidence, standards of care or other reasons."

Section 1191 is, in other words, boilerplate, but it won't sound that way when you hear about it in talk radio. In any case, if you're really concerned about health-care racism, H.R. 3200 is a lot less dangerous than Sonia Sotomayor, who is expected to rule that treating non-Latinos violates the 14th Amendment, and is punishable by abortion.

By Ezra Klein  |  August 19, 2009; 1:07 PM ET
Categories:  Health Reform  
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Next: More on the Coming "Health-Care Racism"


Not that we should quit making jokes because the world is crazy - that's why we do it - but you can fully expect some version of that last line about Sotomayor to turn up on some rightwing blog, citing the "Washington Post" as evidence that Sotomayor is Dr. Mengele in Latina drag. It's no more bizarre than the ditz who confronted Barney Frank at his town hall yesterday asking him why he supported a "Nazi plan."

Posted by: brucds | August 19, 2009 1:23 PM | Report abuse

That's how these GOP denial of service attacks on the national bandwidth for sensible discussion work. find an obscure detail, spin some cockamamie intent to destroy the republic around it, and get the media to "give it a hearing." Pretty soon there's no space left for talking about sensible things, or even for talking sensibly about anything.

Posted by: bdballard | August 19, 2009 1:44 PM | Report abuse

Since Woodstock nostalgia is in the air:

[warning hippie music - Steve Stills/Buffalo Springfield]

"paranoia runs deep, into your life it will creep".

BTW: The History Channel had a great two-hour show on "Woodstock, Now and Then" produced by the original hippie producer of Woodstock (Mike Lange) this week. It was outstanding history as told/seen by the particants - principals and audience.

paranoia and fear and change and economic collapse and disparaging of 'the other' all go together into the soup pot of social upheaval. it will get worse before it gets better (if it does get better).

Posted by: JimPortlandOR | August 19, 2009 2:00 PM | Report abuse

Mr. Klein: Is any opposition to the Left's version of health care reform nonsense? If not, what forms of opposition would not be nonsense?

Posted by: Dellis2 | August 19, 2009 2:12 PM | Report abuse

The thing I really wonder about this stuff is whether or not there are strategy sessions with right-wing hacks where they all sit down in a room and plan this stuff out. Is there some conference call going on between Rush, Betsy McCaughey, Palin and Gingrich right now in which they're bouncing ideas off eachother:

Gingrich: "hmmmm, section 29(a) suggests reimbursements for drug counseling. I wonder if it would work if we started telling people that Obama is really just using this as a way to try to get drug addicted pedophiles to move next door."

Palin: "Maybe, lets put a pin in that one."

Posted by: Matt40 | August 19, 2009 2:13 PM | Report abuse

"If so, sigh, how should I prepare myself to respond to it when all my other conservative friends pick up on it?"

"If you can keep your head when all about you
Are losing theirs and blaming it on you,
If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or, being lied about, don't deal in lies,
Or being hated dont give way to hating,
And yet don't look too good, nor talk too wise;
If you can bear to hear the truth you've spoken
Twisted by knaves to make a trap for fools,
Or watch the things you give your life to, broken,
And stoop and build'em up with worn-out tools
Yours is the Earth and everything that's in it..."
~~~~~~rudyard kipling

just keep doing the work.
keep your hand on the plowshare,
and go straight ahead.

Posted by: jkaren | August 19, 2009 2:44 PM | Report abuse

i predict this will become known as "reverse eugenics," and that "death panels" will receive a "birth wing" which guarantees that, just as fast as old (largely white) people are killed off, a higher percentage of brown babies will be born and survive.

Posted by: fling | August 19, 2009 2:49 PM | Report abuse


The problem is that you have planted a seed upon which the the knuckle dragging troglydytes seize. Your sarcasm does not register in the minds of those who could believe that there is legislation being developed by the Nazis in Congress that creates death squads.

There has to come a tipping point at which time the malevolence and political expediency of the likes of Mr. Boehner and Mr. DeMint becomes apparent and the debate changes in favor of the common good.

Posted by: jgrecco | August 19, 2009 3:00 PM | Report abuse

Dellis, making that comment in this particular thread makes me think that you're joking. If you're not, you should be.

Posted by: MosBen | August 19, 2009 3:52 PM | Report abuse

I'm not joking. I am concerned that Mr. Klein is clearly implying in this post that the opposition to health care reform is inherently full of distortions and lies. I still feel that Mr. Klein has not adequately responded to the many valid criticisms of the current proposals in Congress.

Posted by: Dellis2 | August 19, 2009 4:23 PM | Report abuse

Wouldn't the purpose of "Establishing of National Priorities for Performance Improvement" be something akin to Medicare establishing guidelines for treatment of elderly heart attack patients? Which, by the way, Medicare did. And it's action in doing so has been credited with reducing the number of deaths from heart attacks in elderly patients.

Posted by: ChrisBrown11 | August 19, 2009 4:30 PM | Report abuse

In my opinion, objection to this passage should be taken to mean that the speaker is against improving infant mortality in our country.

I wonder how that will go over? And it's not even really a distortion? Saying "the gummint is gonna give better care to the blacks" is tantamount to saying you oppose efforts to improve the health of citizens who may happen to be black.

Posted by: wovenstrap | August 19, 2009 4:38 PM | Report abuse

Dellis, opposition to healthcare reform would not be nonsense if it were based in reality. False claims about what certain provisions would do are nonsense. An argument that reform would increase the federal deficit and not restrain the overall rise in healthcare costs (for example) may or may not be valid, but is not nonsense. Lying about death panels, socialism, government takeovers, and eugenics are nonsense. If an argument is based in reality and logic, then it's valid. Hope that helps.

Posted by: etdean1 | August 19, 2009 5:07 PM | Report abuse

The distortions come, not just from right wing cable wack-jobs, but from the Republican leadership. Here's something I posted at, in which the House Republican Conference derided as "babysitting" a Democratic provision to help struggling parents better their child-rearing skills.

Posted by: editor | August 19, 2009 7:57 PM | Report abuse

and is punishable by abortion.

I thought mandatory gayness would have been the punishment.

Posted by: alibidrain | August 20, 2009 3:02 AM | Report abuse

Some people just make assumptions based on the healthcare system in other countries. Others get their lies and mis-information in emails like the Stephen Fraser, MD email circulating around.

I'm addressing the truths to counteract the lies. I'm also reading the healthcare bill (h.r.3200) and detailing what it actually says at

Posted by: FaithfulinPrayer | August 21, 2009 12:15 PM | Report abuse

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