Swampland, TIME

Armey and the "Healthy" Debate

I'd like to join in thanking Dick Armey for entering Swampland this week. He may remember that I spent some time covering him, Newt Gingrich and the rest of the GOP leadership that took over the House after the 1994 mid-term elections. I wrote one story in 1997 I doubt he liked much, after the failed coup attempt against Gingrich. A year earlier, I wrote a piece about him that took me down to his north Dallas district. What I remember from the trip is that Armey was extremely skeptical of me, and of the media in general. He wouldn't let me come along when he went bass fishing, his favorite pastime (As Karen recalls, Armey's screensaver in his House office was a photo of him kissing a large-mouth bass he'd just caught). And he made a point of not letting his staffer pick up the tab for my cheeseburger at McDonald's. "I'm not gonna feed the hand that bites me!" Armey declared, which had me both laughing and scratching my head.

I'm not an economist, but I'm also scratching my head about this section in Armey's most recent post:

Look at the healthy components of our health care system. What they have in common is a large measure of independence from government subsidies and price regulation. For example, eye surgery centers, fertility specialists and cosmetic dental surgery. Costs have fallen dramatically, innovation abounds and safety improves.


Economists have a fancy term for this phenomenon. It is called price posting. When consumers see the prices available, they make better informed decisions and competitive pressures emerge and more information results which starts the virtuous circle anew. Unfortunately, by pushing consumers all the way back to their own goal line, past public policy decisions are a formidable defense against better health care in America.

It seems to me that Armey is making a false -- or inapt -- comparison here. Lasik, in-vitro fertilization and cosmetic dental surgery are all elective. They are not about health care; in the case of eye and cosmetic dental surgery, they're usually about vanity. That's why they're not covered procedures. (IVF is different, of course, although it is still elective. Which is why most insurance companies either don't cover it or offer limited coverage). People choose to do such procedures in order to improve their lives, not save them. My question for Armey is, Would we really be better off if we could shop around for the best price on a quadruple bypass? Or chemo therapy? Wouldn't that lead to even greater disparities between the quality of care received by rich and poor? Unlike getting your eyes fixed (or your lips puffed up, for that matter), having a tumor removed from your colon is not optional, if you want to live. Price posting works to drive prices down for things like Lasik and dental veneers precisely because consumers can do without them if they're too expensive. Or so I think. Readers? Mr. Armey?

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Reader Comments (42)

Florida:

So what you're saying is that Armey's first name fits him well.

I think the problem with Armey's posts are that they are fact-free and a waste of time. The closest he comes to incorporating facts is his "By one measure" line. That's a straw man unless you cite sources. It's like Fox's "some people say" stunt.

And that's the problem with the right these days--they just make it up as they go. But for some reason, the press takes it seriously.

KevinA:

I guess it would be too much to ask that a Democrat be added to Swampland, now that a prominent Republican is on this blog.

Oh well, "liberal media" indeed.

Cubiclewarrior:

Lesson to be learned here? Pick up the check on that cheeseburger next time, Dick.

Oh yeah, supporting your argument with points that are even tangentially related might also prove helpful.

JJ:

Well put, Jay.

John:

I actually applaud Armey for not inviting you bass-fishing, or paying for your meals. That's exactly the kind of cozy relationship that infuriates me about you Beltway types: how can we expect to get honest, in-depth coverage if all you folks are buddies?

Crust:

Well said. Anonymous Liberal (as "A.L.") made a similar point nicely in the comment thread there.

And fun anecdotes.

Anonymous:

The poor always recieve the worst services. Worse healthcare, worse education, worse food, worse cars (with higher insurance). They smoke more, drink more, and die earlier.

Our focus should be on keeping people out of poverty. Taxing me into poverty is the cycle which good government should avoid.

Greg VA:

Dick Armey is used to giving speeches to audiences that already agree with him, so he doesn't have to back up any assertion with pesky facts -- he can just spout a bunch of nonsense and get big applause and an even bigger check.

But here on the internet we like those pesky facts and documentation and links. And a blowhard like Armey is just a fish out of water in this environment.

He's just clogging up the intertubes with his conservative applause line nonsense.

The Republiklan party has not changed much since Herbert Hoover. The decency of this party died with Teddy Roosevelt.

Republicans do not believe in free markets. They believe in rigged markets. Republicans create disasters that they ignore until people die and then the people throw them out of power for a generation. That has begun last November. Let's continue this in 2008.

By the way, only a Northeast liberal President has saved our country from a depression and won a world war. So much for the leaders of the REPUBLIKLAN party complaining about north east liberals.

Raising taxes? Sure we need to raise taxes on the wealthy who currently do not pay their share. We also need proportionately enough taxes so our government, voted for by you and I, will take care of the poor and the middle class when they have problems through no fault of their own.

Oh and the myth of Republican strength on national security and defense exploded and died with the passengers on the planes that hit the world trade center towers on Sept 11, 2001.

Crust:

John: "That's exactly the kind of cozy relationship that infuriates me about you Beltway types: how can we expect to get honest, in-depth coverage if all you folks are buddies?"

That's a good point. Especially after putting up with 6 years of a certain President that pundits urged on the country in part because they thought he was more fun to have a beer with (despite being a teetotaler, but I digress). It's infuriating to think that we're in Iraq because of who pundits thought was fun to go to the bar with, but there you have it.

James, Los Angeles:

Mr. Armey is clearly out of his depth in writing about health care policy. Shoehorning the issue into standard Republican dogma, which has been proven en masse to be bankrupt, unworkable, and without value as a governing policy, isn't to speak knowledgably or rationally about the realities of American health care. I mean, if you really want to talk about changing health care policy, you should probably *start* with the current reality. Mr. Armey, and Mr. Klein, are apparently unable to do that. Thus neither of their views are worth much.

Crust:

BTW, it's great to see some back and forth between posters at Swampland.

JJ:

"I actually applaud Armey for not inviting you bass-fishing, or paying for your meals. That's exactly the kind of cozy relationship that infuriates me about you Beltway types: how can we expect to get honest, in-depth coverage if all you folks are buddies?"

Eric Alterman (sorry Joe, you piqued my curiousity and now I do occasionally read him) had something similar to say in a recent essay up on TNR (a bit harsh, but he has a good point to make):

****Izzy Stone used to say that one reason he didn't like to interview top officials was that--and I paraphrase--it made you understand why it was such a good idea not to print things. It's just bad manners to call the people you lunch with, party with, green-room with liars, incompetents, charlatans, and, in some cases, crooks. But many of them are. So one has to choose in Washington, between a sense of being part of mainstream culture--with all its attractions: whether material, social, or merely psychological--or telling the truth.****

http://www.tnr.com/doc.mhtml?i=w070430&s=altermanyglesias050207

It's hard for me to tell, living far from the beltway, how true this is, but how would you print something that's going to hurt someone's career if you know them well and travel in the same social circles? I know I heard that Norah O'Donnell is seen to socialize with some of Cheney's PR flacks. Can something like that be a good thing for the news we depend on as a country?

Crust:

Re "It's infuriating to think that we're in Iraq because of who pundits thought was fun to go to the bar with, but there you have it."

I meant to say "we're in Iraq *in part* because..."
If pundits hadn't pushed this trope we wouldn't be in Iraq, but that's not quite the same statement. The election was so close, I could probably list 100 things that if the press had done a better job on any one it would have gone the other way.

arch stanton:

"I'm not gonna feed the hand that bites me!" Armey declared, which had me both laughing and scratching my head."

Scratching my head too, meanwhile Jay, you're scratching Armey's back. Did he scratch yours first? Maybe w/some access or an invite to a hot cocktail party?

"It's infuriating to think that we're in Iraq because of who pundits thought was fun to go to the bar with, but there you have it."

Relax guys, those days are over. NOw, according to Chris Matthews, its all about "If your car were broken down on the side of the road, who would be most likely to help you...Democrats or Republicans.


Reposted:

Time can't sell magazines anymore because, well its garbage, and no one wants to pay for garbage. So they're trying the new web-based paradigm to try and eek out a profit, and we, those who come here, are the ones making it possible. Maybe its time people stop coming here? Whats the point really...do you really need to know what Joke Line's 'sense' is on any issue? We've all tried to get answers, all we got in return was defensiveness, Mark Halperin and Dick Armey to show for it. I don't know about you but I've never read anything insightful at Swampland. Its the same beltway conventional wisdom we get 24 hours a day anyway. I for one came to bury Caesar and not to praise him, yelling at the MSM can make you feel okay for a few minutes, until you realize that they don't care what you think about 'em, they got your money, or in this case, your hit/page view, which they then show to advertisers so they can get more money and keep the whole disgusting show going.

I'd like to see some discussion of this here amongst the regs. Maybe a month off at least? This Dick Armey crap is just kinda the last straw for me. I will continue to post for the rest of this week about this very issue, but after that I think I'm done here. The only way we can change this corrupt machine is to stop putting gas in it's tank.

John:

Sorry, I didn't mean to drag the conversation so far off-topic.

Yes, Armey's post did include a rhetorical bait-and-switch: swap in examples of products with elastic demand to replace the real sources of the problem.

People aren't going bankrupt to pay for the caps on their teeth. People aren't dying for lack of funds to pay for LASIK.

But people *are* going bankrupt to keep the insurance companies in business. People *are* dying because they can't afford proper medical care.

That's the real problem, and HSAs don't solve it.

YMM:

Jay, you should look at what recent strategies the health care industry - that is insurance companies - are talking about: Consumer Driven Health Plans, and Transparency. Right now, HSAs have
begun rolling out, but the component that insurance companies use to justify to the employers who purchase those plans is Transparency.

Transparency is this plan to provide employees with 'some' information on costs and the quality of care for some practitioners. The reality is that the information is never exact. Insurers negotiate with practitioners unique prices based on volume and per treatment. What one doctor, hospital or group gets is never the same across the board. If an insurer were to show this, it opens up the possibility of folks understanding their actuarial numbers which determines how much they can pay out based on the kind of employees (ratio of sick vs healthy) in a plan and the care they might receive (preventive vs extreme/costly).

On the flip side of the Transparency coin is quality of care - something insurers would like to put out, but that practitioners fight hard to not see the light of day. God forbid consumers realize the mortality rate of their favorite hospitals.
The point of all this is that the industry is designed to protect all of the participants except the consumer. Any real attempt to give control to the consumer will never be possible, because health care would become unprofitable. Folks like Dick forget to point out that the whole premise of a market driven health care industry is to make a profit, and the only constituent they can make that profit on, is the consumer, which usually means, less access, poor quality of care, and higher prices.

jayackroyd:

Crust--

Re: that post by the anonymous liberal. He goes on to note that these exchanges with Armey illustrate why right wing blogs generally don't permit comments. The inanity of the "analysis" is so easy to expose it's as if they were setting up strawmen for liberals to knock down. As he closes in that post:

"There is no better example of a functioning marketplace of ideas than a blog with an active and open comment section. The fact that most right-wing commentators choose not to engage with this market speaks volumes about their confidence in their own ideas."

And I would add it also speaks volumes about the honesty of their commitment to markets.

jayackroyd:

Crust--

Re: that post by the anonymous liberal. He goes on to note that these exchanges with Armey illustrate why right wing blogs generally don't permit comments. The inanity of the "analysis" is so easy to expose it's as if they were setting up strawmen for liberals to knock down. As he closes in that post:

"There is no better example of a functioning marketplace of ideas than a blog with an active and open comment section. The fact that most right-wing commentators choose not to engage with this market speaks volumes about their confidence in their own ideas."

And I would add it also speaks volumes about the honesty of their commitment to markets--and to freedom.

space:

I've always been amazed at political corruption. Not that you can buy a politician (that doesn't surprise me a bit), but at how cheap it is. It's amazing what only a few thousand can get you.

But I'm even more blown away at how cheaply Carney would sell his own integrity. A freaking Big Mac? You are a cheap date, Jay. And not too embarrassed to admit it, either.

It's one thing to cross a line and another to not even realize it is there. (Or that THEY are there. There are actually two concerns here. The first is that politicians would waste taxpayer money on frivolous expenditures. The second is that journalists can be bought.)

Lastly, I'm amazed that Carney would presume that a politician would take him bass-fishing. Look, I understand it when politicians DO want to let a journalist in. But to presume access to a politican's private life when it is largely irrelevant to whatever story needs to be written is stunning.

John:

To answer a question I raised in the last post: "I wonder who's been signing checks to Mr. Armey?"

http://www.spinwatch.org/content/view/763/9/

Agreed.

But we need to go further and reject the market solutions for health care. They don't work and they're immoral.

YMM:

Justin's latest post:

http://time-blog.com/curious_capitalist/2007/06/ezra_dick_dick_ezra_now_talk_a.html

Got to love the title too:

"Ezra, Dick. Dick, Ezra. Now talk amongst yourselves"

An Outhouse:

"The poor always recieve the worst services"

Come on, what's the matter with a little anti-freeze in your tooth paste? At least you can still squeeze it out when you crawl out of your card board box on a cold winter morning.

Thoughtful comments Jay.

What's the over/under on whether Armey will engage or even acknowledge the posters at all, or will he just pull a Kinsley?

Michael Gardner:

The appropriate economic "structure" or "model" for Jay's definition of HEALTH Care: public utilities...not the FREE Market (wild?) of an Adam Smith nor the waiting-in-queues for bypasses of socialized medicine.

We ALL pay for it in some fashion (consumers, businesses, gov't, etc)...we all get it per each's medical needs as determined by the doctors.

The only reason this is hard is because the current vested interests don't want to give up what they already have.

Stuart Zechman:

"Posted by www.dmocrats.org
June 5, 2007

The Republiklan party has not changed much since Herbert Hoover. The decency of this party died with Teddy Roosevelt."


Hey buddy:

Is there a reason why this infantilism needs to accompany your points?

Do you really think that poorly conceived puns work particularly well to advance an argument?

You're not helping yourself.

I'd like to entertain agreeing with you in substance, but silliness like "Republiklan" or "Rethuglican" or "BushCo" or "Repukes" really puts off those of us attempting to judge political or policy propositions on their merits.

It's gratuitous.
It makes you look rabid and foolish.
It taints the Democratic brand, and puts a clown face on legitimate partisan debate.

Stop it, please.

John:

You know, I really don't *mean* to wander off onto another meta-critique, but this whole Armey incident is so rich with opportunity.

It is too much to ask for a journalistic entity such as Time to demand full disclosure from its authors? Why do I have to dig around the internet to find out who has paid Mr. Armey to endorse their views? Why doesn't his blurb include the fairly fundamental information that Mr. Armey is a paid lobbyist for Piper Rudnick? Isn't this data important, especially when he is busily spewing fact-free spin points?

And yeah, I know that organizations like FreedomWorks are not required to disclose their donors. But imagine, just imagine, if editors held their authors to a slightly higher standard than just "is in compliance with the law".

Imagine if editors demanded full disclosure before publishing an astroturf editorial. Wouldn't that be what most of the rest of the world calls "honest"?

JJ:

Imagine if I were in the Sierra Club, and I started posting pro-environment spin with no disclosure?

JJ:

Well, not exactly no disclosure. But it's hard to imagine, say, former congressman Tom Andrews from Win Without War as a guest blogger for Time.

Because he's a D.F.H.

But Dick Armey, trying to rid America of the legacy of the New Deal? No problem!!!

p_lukasiak:

"Imagine if I were in the Sierra Club, and I started posting pro-environment spin with no disclosure?"

the proper comparison would be if you were a PAID LOBBYIST for the PETA, and you started posting about how the only way to save the country would be to make it illegal to eat meat, or wear leather....

arch stanton:

You continue to put money in the pockets of Time's corporate masters, Bill Kristol, Joke Line and now apparently Army of Dick. Its fun to yell at the MSM for a while, but in the end they don't change. We've made our position clear re the MSM's slavish devotion to right wingers...what did we get? Bill Kristol, Mark Halperin and Dickhead Armey. Armey doesn't read your comments and has proven himself resistant to logic or reason. Every time you come
here it counts as a page hit/view, which Time shows to advertisers in order to generate ad revenue, which they need now cuz their god awful magazine has crashed and burned in terms of subscriptions and sales. So they give us more
right wing crap to generate controversy, and as a result, more page hits/views. They aren't adding Armey et al to gain conservative readership because wingnut America doesn't read, they add them to piss YOU off enough to come here
again and again. While you're at home cooking a nice dinner for Time, Time is hangin on the corner w/ the boys wearing a wife-beater t-shirt, playing dice and making time w/ the girls in the hood and drinking beer. Stop playing the victim.

www.rawstory.com/
www.talkingpointsmemo.com/
atrios.blogspot.com/
www.juancole.com/
noquarter.typepad.com/
www.tpmcafe.com/
www.crooksandliars.com/
thinkprogress.org/

Beth in VA:

Jay Carney, you are so correct! Army's laissez fair health care idea is survival of the richest.

D.A. Fritz:

I think this line of reasoning needs to be talked about more in the healthcare debate. The fact that market action is not just competition in the market place. It also includes finding a price the market will sustain with the least amount of cost. For example, a heart surgeon can make a fine living providing services for very few at a much higher cost. The market factor is not how many want the services of a heart surgeon but the supply of heart surgeons. Heart surgeons are not as easy to bring to market in mass quantity as cell phones. That being said, there are aspects of the healthcare system that would benefit from the direct competition Armey suggests, most notable example is prescription drugs which are protected from competition in the U.S. right now. I imagine a comprehensive plan on so large an issue would need a combination of many ideas to really help anybody.

"It seems to me that Armey is making a false -- or inapt -- comparison here."

What a surprise.

Here's an idea, let's count how many times Mr. Armey DOESN'T make a "false or inapt comparison." Shouldn't take more than the fingers on one hand.

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