The Return of a Liar

Like the bad penny of legend, Betsy McCaughey keeps turning up. During the Clinton administration she wrote a very dishonest article on health care for the New Republic, which helped scuttle reform efforts. Now, according to Steve Benen of the Washington Monthly blog, she’s making stuff up about the Obama administration.

Given her renewed prominence, it might be worthwhile to revisit A.M. Lamey’s classic Sans Everything blog post on her, which can be found here. Lamey’s posting (and his accompanying article for the Believer) destroyed nor only McCaughey’s credibility but also any reputation Andrew Sullivan might have as an editor.

An excerpt:

As every freelance writer knows, most magazine articles come and go without a trace. Only a small handful trigger any reaction when they appear. But how many continue to be denounced and debated over a decade after their publication? I know of only one: “No Exit” by Elizabeth McCaughey, which was The New Republic’s cover story for February 7, 1994.

McCaughey’s article was an attack on Bill Clinton’s plan to extend health insurance to all U.S. citizens. McCaughey’s analysis was seriously misleading, for reasons I tried to explain in a 2004 article for The Believer called “Reckless Falsehoods” (linked below). Now American journalist Ezra Klein has revisited McCaughey’s essay, in a blog post that characterizes it as a “dishonest, fearmongering article.”

Klein is right to continue to make an issue of McCaughey’s story and the pernicious role it played in defeating the Clinton plan. I also second his recommendation of the work of James Fallows, who gives a lucid summary of the McCaughey affair in his 1997 book Breaking The News: How the Media Undermine American Democracy. What is especially noteworthy about Klein’s post, however, is that it has generated a response from Andrew Sullivan, who was editor of The New Republic when McCaughey’s essay appeared.

One thought on “The Return of a Liar

    Jerry Avorn, M.D.,
    New England Journal of Medecine, May 2009

    The proposal to include $1.1 billion for comparative-effectiveness research (CER) in the federal stimulus package encountered a vigorous and well-coordinated backlash. The campaign to gut this funding ultimately failed, but the debate it engendered and the resonance of the opposition’s arguments in both lay and policy circles reveal much about the issues that will surround such research and its application in the coming years.

    The contested provisions were designed to support studies comparing the efficacy and safety (and, by extension, the cost-effectiveness) of alternative ways of addressing common clinical problems. Interventions to be evaluated will include pharmaceuticals, devices, procedures, and diagnostic approaches, such as imaging studies. This research will fill important information gaps facing clinicians, patients, and payers concerning what works best. Currently, the Food and Drug Administration (FDA) often approves new medications on the basis of modest-sized studies involving patients with relatively few coexisting conditions who are followed for brief periods. Sometimes the only efficacy requirement is a demonstration that a new product works better than placebo in improving a surrogate outcome measure, such as a laboratory-test result, rather than achievement of an actual clinical benefit. The bar is set even lower for medical devices such as pacemakers and implantable defibrillators, which may only have to be shown to be similar to previously approved products or simply not to be dangerous.

    CER represents one of the best investments we can make to edge the health care system away from the fiscal catastrophe it faces, since such studies will help to reduce spending on poorer clinical decisions and to spare resources for expenditures that will help patients most (and most affordably). This research is a public good, like highways and clean air. The private sector is no more likely to identify badly mispriced or potentially toxic treatments than it was to spot badly mispriced or potentially toxic products of the banking industry”

    As the stimulus bill was being debated in January and February, the opposition to CER found its voice in commentators who claimed that these studies will inevitably lead to government domination of the doctor–patient relationship, “cookbook medicine,” and rationing… The assault took on a more Orwellian tone 10 days later when Betsy McCaughey, a former lieutenant governor of New York, linked funding for CER with the stimulus bill’s provisions supporting the use of electronic medical records. She warned that the inclusion of both initiatives was designed to enable electronic monitoring of individual patient-care decisions by the federal government and punishment of clinicians who fail to comply with imminent rationing guidelines.

    This avalanche of nonfacts did not succeed in derailing the stimulus bill or its CER funding. Although these commentaries painted caricatures of new federal powers that were not in the bill…..As the debate continues, we are likely to see more diatribes designed to further an ideological or commercial agenda. Fortunately, Congress did not let warnings of a dystopian scientific police state undercut the nation’s need to learn what works best in medicine. Given the quality and cost crises we face, preserving ignorance would have been a poor strategy for improving the effectiveness, safety, and affordability of health care.

    (Dr. Avorn is a professor of medicine at Harvard Medical School, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, director of the Harvard Interfaculty Initiative on Medications and Society)


    Above is a digest of a longer article by Dr. Avorn.

    Core to McCaughey’s deviant interpretation of Obamacare was the idea of Obama’s “one new bureaucracy, the National Coordinator of Health Information Technology”, Tom Daschle’s handiwork, and “Daschle’s proposed appointed body with vast powers to make the “tough” decisions elected politicians won’t make. …The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research.” Amusingly, the National Coordinator of Health Information Technology was appointed in April 2004 by George W Bush, and Comparative Effectiveness Research was introduced into the health care debate in 1989 by Dr. Willensky, a Republican, during the Administration of George HW Bush.

    McCaughey’s arrogance is so bullet-proof she obviously sees no need to research or cross-reference her conclusions for accuracy. Quite amazing.

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