Paul Krugman steps up to defend Hillarity's thematically defensible but factually challenged health care parable. One might have guessed that since Hillary took flak for getting the facts wrong, Krugman would take care to get the facts right. Guess again:
Not long ago, a young Ohio woman named Trina Bachtel, who was having health problems while pregnant, tried to get help at a local clinic.
No - Ms. Bachtel never contacted the nearby clinic. Following a collection effort regarding unpaid bills from 2002 (eventually settled in 2005) the clinic had informed her by mail that she would need to pay $100 cash upfront if she sought treatment there.
Unfortunately, she had previously sought care at the same clinic while uninsured and had a large unpaid balance. The clinic wouldn’t see her again unless she paid $100 per visit — which she didn’t have.
Half true - per the WaPo, the debt had been "repaid in 2005".
Eventually, she sought care at a hospital 30 miles away. By then, however, it was too late. Both she and the baby died.
Well, she initially sought care at the hospital affiliated with her obstetrician's practice; this is from the Columbus Dispatch:
In 2005, she joined the O'Bleness Health System in Athens, according to Linda Weiss, a spokeswoman for O'Bleness.
During her pregnancy in 2007, Bachtel was under the care of River Rose Obstetrics and Gynecology, which is part of the O'Bleness system and across the parking lot from O'Bleness' hospital in Athens.
According to Jane Broecker, an obstetrician at River Rose, Bachtel made 14 visits between Feb. 8 and July 31. "She came regularly for appointments," Broecker said.
In addition, records made available by O'Bleness show that Bachtel visited the hospital seven times in 2007 on an outpatient basis. Six of those visits took place on the same day she had been at River Rose.
On Aug. 1, Bachtel was admitted to O'Bleness, where her baby boy was stillborn. Two days later, she was transferred to Riverside Hospital in Columbus and finally to Ohio State University Medical Center, where she died Aug. 15.
That information scuttles the rest of Krugman's re-telling and the message he takes from it:
First of all, visits to the emergency room are no substitute for regular care, which can identify and treat health problems before they get acute. And more than 40 percent of uninsured adults have no regular source of care.
Second, uninsured Americans often postpone medical care, even when they know they need it, because of expense.
True and worth discussing, but Ms. Bachtel had insurance and was receiving regular care.
The end result is that the uninsured receive a lot less care than the insured. And sometimes this lack of care kills them. According to a recent estimate by the Urban Institute, the lack of health insurance leads to 27,000 preventable deaths in America each year.
But are they really preventable? Yes. Stories like those of Trina Bachtel and Monique White are common in America, but don’t happen in any other rich country — because every other advanced nation has some form of universal health insurance. We should, too.
Stories like Tina Bachtel - a woman who had insurance, received regular care, but died anyway - don't happen in any other rich country? Do tell.
Krugman explains the lesson of our shameful media behavior:
Some readers may already have recognized the story of Trina Bachtel. While campaigning in Ohio, Hillary Clinton was told this story, and she took to repeating it, without naming the victim, on the campaign trail. She used it as an illustration of what’s wrong with American health care and why we need universal coverage.
Then The Washington Post identified Ms. Bachtel, the hospital where she died claimed that the story was false [in the NY Times, a factoid oddly omitted by Krugman] — and the news media went to town, accusing Mrs. Clinton of making stuff up. Instead of being a story about health care, it became a story about the candidate’s supposed problems with the truth.
In fact, Mrs. Clinton was accurately repeating the story as it was told to her — and it turns out that while some of the details were slightly off, the essentials of her story were correct. After all the fuss, The Washington Post eventually conceded that “Bachtel’s medical tragedy began with circumstances very close to the essence” of Mrs. Clinton’s account.
Well, it was not the Washington Post that conceded that “Bachtel’s medical tragedy began with circumstances very close to the essence” - that was the AP. (Geez, someone ought to mention to these academics the importance of accurate citations.) And the AP version excerpted below differs from both the WaPo and the Columbus Dispatch:
But at an earlier time, Casto said, Bachtel lacked health insurance and ran up unpaid bills when treated at a clinic near her home in Middleport. When she returned for treatment when pregnant, the clinic demanded $100 per visit to help retire the outstanding debt, Casto said. Because Bachtel could not afford the fees and found it difficult to travel, her aunt said, she postponed receiving treatment.
Bachtel eventually went to O'Bleness, about 30 miles to the north, for attention.
Reason with me - if, as per the Dispatch, Ms. Bachtel had insurance and was routinely going to O'Bleness to see her obstetrician, and routinely crossing the street to stop in the hospital, why would she have gone to the clinic? I am backing the WaPo version, which says she never even contacted the clinic, figuring that their door was closed and that she had her own health care provider anyway. The AP is wrong here; back to Krugman:
And even more important, Mrs. Clinton was making a valid point about the state of health care in this country.
As previously noted, I offered the "thematically accurate" defense a few days back (and even mentioned Reagan, as did the Dispatch). But my goodness, that defense applies to candidates slogging along the long, dusty campaign trail, not columnists with access to Google and Lexis-Nexis. Dare we expect Krugman or his editors (as if!) to intersect intermittently with reality?
Krugman delivers in his Big Finish:
And if being a progressive means anything, it means believing that we need universal health care, so that terrible stories like those of Monique White, Trina Bachtel and the thousands of other Americans who die each year from lack of insurance become a thing of the past.
Well, I suppose the terrible stories won't become a thing of the past if people keep making them up. Well, that's Paul Krugman - reality based. Just like fruit drinks based on 10% real fruit juice.
DISPUTE RESOLUTION: Krugman claims that Ms. Bachtel is a story of a woman without insurance. The Times reported this last Friday:
But hospital administrators said Friday that Ms. Bachtel was under the care of an obstetrics practice affiliated with the hospital, that she was never refused treatment and that she was, in fact, insured.
Can't both be right! Clark Hoyt, the public editor, lives to duck questions like this, but a real paper would run a correction somewhere. Vex him at "[email protected]".
FTR TM, you are so prolific lately that it's impossible to keep up. I haven't yet decided if that is a good or bad thing.
Posted by: Jane | April 11, 2008 at 12:06 PM
Yeah--what are you into the geritol of something?
As for percentages. Yesterday I saw a poll which showed after all the media lies and Dem kettle banging* on the subject, only 29% want to see any changes in out medical delivery system.
(In Eastern Europe if your neighbor was in the field when you stopped in to talk, you picked up his tea kettle and banged on it with a spoon to get his attention. It is the source of the yiddish expression-Hock mer nisht ka-chainik--don't bang on my tea kettle.)
Posted by: clarice | April 11, 2008 at 12:24 PM
Fake but accurate raises its ugly head again.
Posted by: GMax | April 11, 2008 at 12:24 PM
"But are they really preventable? Yes. Stories like those of Trina Bachtel and Monique White are common in America, but don’t happen in any other rich country — because every other advanced nation has some form of universal health insurance. We should, too."
This should be entered into the "Bumper Book of Bollocks".We have compulsory state "Insurance" and private insurance,still people die.
Posted by: PeterUK | April 11, 2008 at 12:28 PM
Well, I suppose the terrible stories won't become a thing of the past if people keep making them up.
That line deserves a journalism award of some sort.
Posted by: Barney Frank | April 11, 2008 at 12:31 PM
Okay, okay, TM. But. Let me respond on Krugman and Clinton's behalf.
A while back, there was this lady Tina Bachtel. Because didn't have insurance she didn't receive regular care and as a result she passed away. I bet you never heard that story.
Long ago, Senator Hillary Clinton thought up a plan to give us all great government medical care. I bet you never heard that story.
Posted by: Jim | April 11, 2008 at 12:34 PM
"still people die"
Mr Uk,
The NHS style guide much prefers "become one with nature" or "return to nature" rather than your rather coarse usage. Remember - the sustainability cycle requires that entrances and departures be eternally balanced. The duty of the NHS is to maintain that delicate natural balance. The recent increase in births must be countered by a slight acceleration in departures, preferably through wholly natural means, but if that's not possible, the NHS will do its duty.
Hillarycare seeks the same end here in the
Peoples RepublicUS.Posted by: Rick Ballard | April 11, 2008 at 12:38 PM
I hope they remember to encumber carbon on their way out for gosh sakes. GB is part of the enviro friendly EU is it not?
Posted by: GMax | April 11, 2008 at 12:53 PM
Ya know, as widespread as the problem of people not receiving healthcare is, you would think they would be able to find one instance of it that isn't ginned up. It's starting to look like the hung for bigfoot or the LochNess monster.
Posted by: Pofarmer | April 11, 2008 at 01:01 PM
Pessimistic bias.
Posted by: Patrick R. Sullivan | April 11, 2008 at 01:02 PM
Notice Beckel and some other Hacks for Hillary and a couple for Obama have a nasty and, surprise, mendacious response when called on their fabrications. "Remember how Reagan used to talk about "Welfare Queens"? That was all made up so.... " Again, the insular nature of the Leftoverse leads them astray. Certainly and demonstrably (from criminal convictions) there was widespread, endemic and grand fraud in the system. I recall the old man refering to an NYT story on welfare fraud; that being, of course, a bilious font of Rightwing agitprop. Said article featuring a ponderously large woman who drove, majestically, a garish Lincoln kitted out at taxpayer expense. Do not let obvious lies like these pass... Hannity, I'm lookin' at you! Whether it is your friend, colleague or sainted mother (we'll make a spousal exception) do not let obvious and insulting falsehoods go unchallenged. It's for the planet. Or the children. Or something.
Posted by: megapotumus | April 11, 2008 at 01:22 PM
Mr Ballard,
The NHS prefers the more anodyne DNR,so much more comforting when visitors read their elderly relative's chart on the end of the bed.
The Prime Minister's initiative whereby organ donors have to opt out of donating rather than ,er ,donate is such a confidence building measure.Before the kind young man in the white coat was probably checking one's condition.Now he is weighing one up for spare parts.Socialism is such a wonderful thing don't you think?
Posted by: PeterUK | April 11, 2008 at 01:25 PM
Oh, and for fans of fabricated health scare stories, the most hideous and egregious is from yesteryear.
http://www.jewishworldreview.com/michelle/malkin020400.asp
It is well to think that political rhetoric, whatever its ills, won't killya.
Usually.
Posted by: megapotumus | April 11, 2008 at 01:30 PM
Back on the other thread we speculated as to whether Ms. Bechtel maybe wasn't so swift and perhaps contributed to her own and her baby's demise by not recognising the signs of preeclampsia in time. This
tells a quite different story. That sounds like a pretty standard story of prenatal care, done well, which nonetheless was unable to prevent a catastrophe. Because Eccplampsia of Pregnancy (what killed Bechtel and her baby) is a nasty, poorly-understood condition that is quite likely to kill those unlucky enough to get it, no matter how much money they have, no matter how attentive and alert the medical attention they receive. This is despite the fact that an extraordinary amount of money and effort has gone into research to prevent/treat ecclampsia over the last century. My OB once told me that ecclampsia is the number one most spectacular failure of medical research in all of history. We have devoted huge amounts of money and some of the best minds of several generations -- things which have gained us huge advances in understanding, prevention and treatment with every other disease -- but we are basically just as mystified by this thing as we were in 1900.Other disease and conditions you can believe that money matters. Not this one. It was a particularly poor choice for an example, and Krugman is just prattling along...
Posted by: cathyf | April 11, 2008 at 01:37 PM
Targets acquired and taken. Reality is shootings at schools and car accidents and shower accidents. I guess that happens a lot in the US, so buy some more comments and mount!!!
Rice is the perfect VP, whether it's McCain or Obama! Obama is the Messiah of international relations and trade!!! Powell is the best!!! Krugman is right! You never know where the snipers are!!! War is bad and the occupational forces of the imperialist dogs should go home now! The secret launch sites are in Cuba and we should blockade and invade!!! New Orleans was a conspiracy between the residents and foreigners manipulating the weather(sorry).
That guy is a jerk and stupid and mentally retarded or something.
Posted by: dfr | April 11, 2008 at 02:48 PM
Ana Marie Cox in wired on the Great ans Powerful Kos:
At what's arguably the top of his game, Moulitsas says he's "going offline" next year, taking his obvious knack for building online communities and applying it to that other great American pastime: sports. And once he gets his network of sports blogs ramped up, he'll turn to building communities in the real world, a chain of giant meeting places "replicating megachurches for the left" – complete with cafés and child care. Moulitsas has shown he can harness people's enthusiasm, but he says he doesn't want a leadership role in these "democracy centers"...
While working on the mechanics of the sports blogs, he plans to embark next year on building real-world destinations for progressives and liberals throughout the Midwest, "cultural outposts" designed to attract thousands of like-minded liberals. "Each one of these would have a vast left-wing conspiracy component," he says, like leadership training or discussions on progressive issues.
Didn't we used to call these things Sanatoriums?
Posted by: GMax | April 11, 2008 at 02:53 PM
Wow, already today we've had Bill retelling Hillary's Bosnia lie with a flourish, now Krugman reinvents her Health Care Fable with statistical snark. Don't these things come in 3's, like lightning or airplane crashes? So what's next? My money's on Carville doing a soliliquy on her trying to join the Marine's, but bigger odd's are on Begala telling us she was named after Edmund Hillary's father, Otis. Care to bet?
Posted by: Daddy | April 11, 2008 at 03:00 PM
Carville isn't evil and killed a bunch of people!!!! Booing Congresswomen is wrong!!! The troop rotations are too long!!!! Fox news is a right wing conspiracy against democrats and should be shut down!!! Obama is a grass roots organizer on a global level, just like PC volunteers!!! It's your mommy and teacher who gave Obama money(yes, you can have the pony!!) Tax money is there for jobs!!! The Daily Show and that other guy are right, it's okay about the ruined society!!!! I fired Penn!!!! McCain hates civil rights!!! Bush approval is the lowest in history because he's rich!!!! Street money is good, unless it's bad!!!
Terms and conditions apply. That guy is like the news, he's always changing!!! This is really chat!!! He sleeps in a separate bed from his wife!!! He's 'slow' and fat!!!
Posted by: dfkj | April 11, 2008 at 03:33 PM
Didn't we used to call these things Sanatoriums?
Well Gmax did you have a premonition or something? Looks like at least one has escaped.
Posted by: royf | April 11, 2008 at 04:17 PM
Didn't we used to call these things Sanatoriums?
I thought they were called communes.
Posted by: fdcol63 | April 11, 2008 at 04:28 PM
Didn't we just see a report that over half of British hospitals and clinics had had to turn away at least one pregnant woman during the last year? If so, even if we were to grant Krugman's version of the facts, how could nationalizing our health care make sure that 100% of pregnant women receive care when the British system fails to live up to that standard?
Posted by: David Walser | April 11, 2008 at 04:31 PM
Communes I like that too
Posted by: GMax | April 11, 2008 at 04:36 PM
re education camp implies that some learning was imparted previously so that wont quite fit with this crowd, how about virtually reality centers?
Posted by: GMax | April 11, 2008 at 04:38 PM
Setting aside the sanitoria for a bit;
what kind of sports blog would a pencil necked geek like Kos promote?
Badminton? Male cheerleading?
Posted by: Barney Frank | April 11, 2008 at 04:42 PM
" ...how about virtually reality centers?"
LOL .... but that would imply a link to reality.
How about Fantasyland?
Posted by: fdcol63 | April 11, 2008 at 04:44 PM
I don't know Barney, curling perhaps?
Not that there is anything wrong with that...
Posted by: royf | April 11, 2008 at 04:50 PM
Synchronized twirling.
Posted by: GMax | April 11, 2008 at 04:53 PM
Men's synchronized swimming?
Posted by: DebinNC | April 11, 2008 at 04:55 PM
royf:
I don't know Barney, curling perhaps?
Not that there is anything wrong with that...
Hell no there's nothing wrong with that.
Jane is a curler.
Posted by: hit and run | April 11, 2008 at 05:09 PM
Harumph! No curling bashing! Or I will challenge you to a 4 day bonspiel!
Posted by: Jane | April 11, 2008 at 05:21 PM
How much mud is involved in a bonspiel?
Posted by: hit and run | April 11, 2008 at 05:31 PM
Opps! What can I say I have a God given gift. I knew I should have kept my mouth shut.
Posted by: royf | April 11, 2008 at 05:46 PM
More mud and more beer than you can imagine Hit!
Royf, don't keep your mouth shut, I love an opening to talk about curling because it makes people groan.
Posted by: Jane | April 11, 2008 at 05:55 PM
Well, curling is just frozen bowling for Nordic types in the permafrost so I couldn't imagine a sport less congenial to a pantywaist like Kos.
Posted by: Barney Frank | April 11, 2008 at 06:02 PM
What do they call the guymnastics sport where they jump around will carrying those streamers? That is so Kos. Metrosexual in spades.
Posted by: GMax | April 11, 2008 at 06:43 PM
What do they call the guymnastics sport where they jump around will carrying those streamers?
Rhythmic gymnastics.
Don't ask me how I remember that.
Some neurons somewhere held on to that bit of useless information just for this occasion.
Posted by: SteveMG | April 11, 2008 at 06:50 PM
And if being a progressive means anything....
Join the crowd, Paul. We can't figure out what being a progressive means either!
Posted by: Elroy Jetson | April 11, 2008 at 07:02 PM
Don't these things come in 3's, like lightning or airplane crashes? Posted by: Daddy | April 11, 2008 at 03:00 PM Fox said today that Begala really showed his butt about Penn. Number 3? Hmmmmmm. A four day bonspiel with a JOM hottie? With mud and beer, too? Where's the signup sheet?
Posted by: Larry | April 11, 2008 at 07:22 PM
"... and the thousands of other Americans who die each year from lack of insurance "
A lot of people try to manufacture language for an issue that is favorable to their position (pro-life vs. pro-choice.)But no one has ever died from a condition known as lack of insurance. People die due to actual illnesses or injuries.
As a separate condition, Lack-of-insurance actually has an extremely high rate of survivorship.
Posted by: Mike S | April 12, 2008 at 03:57 PM
As a separate condition, Lack-of-insurance actually has an extremely high rate of survivorship.
Posted by: battery | December 30, 2008 at 02:39 AM
We all love game, if you want to play it, please cheap penya and join us.
Posted by: sophy | January 06, 2009 at 09:57 PM