What Does Robert Pear Do For a Living?

Either he moonlights for the RNC, or as a New York Times reporter he can’t tell the difference between reporting and regurgitating a press release.

Apparently, he and David Herszenhorn moonlight for the Republican National Committee, and got some of their copy mixed up.  Either that, or someone from the RNC spun them so hard they don’t know which way is up.

My God, where do you start?  Well, how about: “it is not clear that Republicans and the White House are willing to negotiate seriously with each other.”  Except, of course, that both the House and Senate plans are based on Republicans ideas, and the Senate process ground to a halt for months over the Gang of Six process.

Or this: “Congressional Republicans have laid out principles and alternatives that provide a road map to what a Republican health care bill would look like if they had the power to decide the outcome.”  Except that, you know, the Republicans had the power to decide the outcome for several years and did nothing because essentially the system is fine by them.

Or: “The Republicans rely more on the market and less on government.”  Unless, of course, you count things like tax sheltered health savings accounts, subsidies to Pharma under Medicare (dis)Advantage, federal pre-emption of state insurance regulations.

Or: “it is clear that they would not provide coverage to anything like the number of people — more than 30 million — who would gain insurance under the Democrats’ proposals.  But Republicans say they can make incremental progress without the economic costs they contend the Democratic plans pose to the nation.”  Yes, but are they right when they say that?  Does such an assertion even pass the laugh test?  Given that both the House and Senate bills are fully paid for — a fact nowhere mentioned in the piece and not a facet of, say, any GOP policy initiative during the Bush years — maybe some analysis and fact-checking of GOP claims is warranted?

Or: “Republicans would provide federal money to states to establish and expand high-risk pools, for people with chronic illnesses who cannot find private insurance at an affordable price.”  Yes — and many states already have them, and they have done exactly nothing to increase affordability or access?

Or: “Republicans also contend that changes in state medical malpractice laws could lower costs and slow the growth of premiums. However, some of these proposals — like federal limits on damages for pain and suffering and punitive damages — are potentially in conflict with the Republicans’ emphasis on federalism and state autonomy.” Also however — these proposals do virtually nothing to actually reduce costs, as has been shown by study after study for years and years.  (Which isn’t to say tort reform isn’t a good idea on it’s own basis).

Or: “Many Republicans want to expand the role of private insurance companies in Medicare. Insurers already manage Medicare’s prescription drug benefit, and Republicans see that as a model.”  Yes — it’s a model of how to reward Big Pharma and getting nothing in return.  Can’t Pear and Herszenhorn be bothered to cite to the studies showing how inefficient it is?

This isn’t journalism: it’s stenography.  Pear has been on this beat at least since 1993, and apparently hasn’t learned anything since then: little wonder that his work served as Exhibit One in James Fallows’ diagnosis of what is wrong with contemporary reporting.

The piece concludes: “Senator Judd Gregg of New Hampshire, the senior Republican on the Budget Committee, welcomed Mr. Obama’s invitation. But like many in his party, he expressed concern that the session would be used as ‘an arena for political theater.’”  Maybe that’s because theater seems to be the only thing that putative journalists like Pear and Herszenhorn understand.

Author: Jonathan Zasloff

Jonathan Zasloff teaches Torts, Land Use, Environmental Law, Comparative Urban Planning Law, Legal History, and Public Policy Clinic - Land Use, the Environment and Local Government. He grew up and still lives in the San Fernando Valley, about which he remains immensely proud (to the mystification of his friends and colleagues). After graduating from Yale Law School, and while clerking for a federal appeals court judge in Boston, he decided to return to Los Angeles shortly after the January 1994 Northridge earthquake, reasoning that he would gladly risk tremors in order to avoid the average New England wind chill temperature of negative 55 degrees. Professor Zasloff has a keen interest in world politics; he holds a PhD in the history of American foreign policy from Harvard and an M.Phil. in International Relations from Cambridge University. Much of his recent work concerns the influence of lawyers and legalism in US external relations, and has published articles on these subjects in the New York University Law Review and the Yale Law Journal. More generally, his recent interests focus on the response of public institutions to social problems, and the role of ideology in framing policy responses. Professor Zasloff has long been active in state and local politics and policy. He recently co-authored an article discussing the relationship of Proposition 13 (California's landmark tax limitation initiative) and school finance reform, and served for several years as a senior policy advisor to the Speaker of California Assembly. His practice background reflects these interests: for two years, he represented welfare recipients attempting to obtain child care benefits and microbusinesses in low income areas. He then practiced for two more years at one of Los Angeles' leading public interest environmental and land use firms, challenging poorly planned development and working to expand the network of the city's urban park system. He currently serves as a member of the boards of the Santa Monica Mountains Conservancy (a state agency charged with purchasing and protecting open space), the Los Angeles Center for Law and Justice (the leading legal service firm for low-income clients in east Los Angeles), and Friends of Israel's Environment. Professor Zasloff's other major activity consists in explaining the Triangle Offense to his very patient wife, Kathy.

15 thoughts on “What Does Robert Pear Do For a Living?”

  1. "federal limits on damages for pain and suffering and punitive damages — are potentially in conflict with the Republicans’ emphasis on federalism and state autonomy.”

    This was a conflict between ideological Republicans and Republicans whose only goal is to help insurance companies at the expense of tort victims. This conflict last arose during the first Reagan administration, when, within that administration, there were opposing views. The pro-business side won, the Reagan administration endorsed the tort "reform" legislation, and, if any ideological Republicans remain on this issue, we haven't heard from them since.

  2. Jonathan complains about a really anodyne article and then repeats laughable and discredited talking points. Here's a start on where Jonathan goes wrong:

    –The assertion that the Democratic plan (to use a short-hand to describe their negotiating position) is based on Republican ideas demonstrates that someone isn't very serious about policy. There are superficial commonalities, but those are present it seems largely so that Democrats can say they've responded to Republican ideas.

    –Jonathan says that Republicans had the power to make changes to health care, and didn't. Well, it just isn't clear what that's supposed to mean. Certainly Republicans never had anything like the power that Democrats have now. And the procedural hurdles to progress were a more significant barrier to progress, given the smaller senate majorities enjoyed by Republicans. Some Republican ideas, like association health plans, were blocked in the Senate by a Democratic filibuster. (I don't recall lots of opposition by Democrats to the filibuster back then.)

    –Jonathan suggests that Republicans wouldn't really rely less on government, and then provides a confused series of supposed counter-examples. Health savings accounts of course include a subsidy, but they are, relatively speaking, a market mechanism. (The Democratic critique of HSAs that the article includes, the idea that HSAs are a tax shelter for rich people, is both demagogic and moronic.) Medicare Advantage programs don't provide subsidies to Pharma. And federal pre-emption of state regulation is neither more nor less government; the question is what the pre-emption accomplishes.

    –Jonathan asks a hard question about the Republican proposals: would it really accomplish what they say? And that's a real question, but the suggestion that it doesn't pass the laugh test isn't serious. And neither is the suggestion that the Democratic proposal is fully paid for. That's quite simply a lie. (Jonathan can reply with the same definitional games about what's included in the Democratic plan that the Democrats in Congress want to play, but there's no reason not to laugh at their dishonesty. Deal with Medicare reimbursement rates honestly and the plan isn't paid for, and that's before one considers the games played on timing of benefits.)

    –Jonathan says that tort reform would do virtually nothing to reduce costs. There's considerable uncertainty here, and it isn't clear even what Jonathan means by "virtually nothing." The CBO's take is that tort reform would reduce costs by half a percent, which is as an absolute number really big, but as a percentage is obviously very small. (The budget impact of tort reform was estimated at more than $50 billion over the next ten years.)

  3. I favor limits on pain and suffering payments. Here's how to set them:

    1. Prepare a list of bad outcomes: loss of a leg, paralysis, brain damage, etc.

    2. Ask each GOP legislator how much he/she would want to be paid to undergo that outcome voluntarily. Before asking, announce that five legislators, chosen at random, will actually have a leg amputated, or whatever, and receive the payment they specified.

    3. Set the limits at the highest bid for each item.

    That should give us an estimate of a reasonable limit.

  4. The cap on pain and suffering that is usually included in proposed federal tort reform legislation is $250,000. They use that figure because it is the one in California's MICRA (medical malpractice) statute — the first such statute, enacted in 1975, and its cap never revised. $250,000 had about four times the value in 1975 that it has today.

  5. Also note that both California and Texas cap malpractice awards (in different ways), and both are big states with lots of med schools and hospitals, but neither has lower medical costs to show for it.

  6. Wow, truly ignorant.

    I believe that Mr. Pear works for the NY Times. The NY Times is owned by the Sulzberger family of rich right wing fame who have 16 other oligarchy propaganda machines (know AKA "news"papers) scattered around the country.

    Pravda "news"paper in Russia at the height of the cold was not even close to the control of news exhibited in The New York Times. Please see "operation mockingbird" in wikipedia. The article keeps shrinking but gives enough information to track down the ties between the CI lying A illegal operations in the united states and the "news"papers.

    Also, please, note that the NY Times never covers any story for any length of time after the release of "news," if it is not favorable to the richest people in the world, the american oligarchy.

  7. On further reflection, perhaps I should add to my previous comment that not only did capping malpractice not slow the increase in health care costs. After all, capping malpractice awards almost certainly couldn't prevent defensive medicine. Sure, insurance companies can breathe more easily without paying the occasional $5,000,000 judgement. But the doctors, the people whose incentives critics of "defensive medicine" say need to be adjusted, don't really care about this cap. Do you really think a doctor's career can handle a $250,000 judgement of malpractice? Especially a young doctor's? Heck, even if the judgement were for a nominal amount of money do you think their career will stand up well to spending a lot of time defending themselves in court through an extended malpractice lawsuit and perhaps being ruled to be a lousy doctor? How will they practice while in court, and who will employ them if they're found liable? Defending against such eventualities is sufficient to explain defensive medicine, without any serious consideration of their malpractice insurance premiums.

    I suppose the really important fact is that capping malpractice awards has had no effect on the cost of malpractice insurance. A bit surprising, maybe, but the large awards, while flashy, were probably always quite rare. My understanding is that the biggest predictor of the increase or decrease of malpractice insurance premiums is in fact the stock market: because the insurers invest the money they collect as premiums, when they're making money from these invested premiums they can charge lower premiums, and vice versa.

  8. Pear has been on this beat at least since 1993 …

    Since the early 1980s. His reporting has played a small role in the defeat of more than one meritorious health care proposal.

  9. A couple of Canadian compartors: Pain and suffering awards have been capped since 1979 by the Supreme Court of Canada at $250,000 in 1979 dollars i.e. the courts adjust for inflation.

    Insurance rates are always more about the insurers' investment returns than the actual risk of the insured activity. Insurers never undertake to fix or reduce rates based on law reform, no matter how hard they lobby for the reform.

    One US hospital reported a few years back that their malpractice insurance rates were so high they eventually were driven to hiring competent doctors…

  10. A pain-and-suffering cap might actually be a fine idea if the actual-damages part of an award covered actual damages. But in a country without universal health care, mostly without a social safety net for other losses, and without an adequate medical disciplinary system, pain-and-suffering awards are a sort of really bad stopgap.

  11. Paul, actual damages mean actual damages; they cover all medical bills. Pain and suffering awards are designed as compensation for pain and suffering, not for medical bills. The problem with capping pain and suffering awards is that, like all other tort-reform measures, it is a way to help insurance companies at the expense of victims. Our tort system does not work well (only a tiny percentage of medical malpractice victims receive anything, and too much goes to lawyers), but the way to fix it is not to help insurance companies at the expense of victims. The way to fix it is to move in the direction of no-fault coverage, which is a form of health insurance, so that victims do not have to sue. Also, there should be an effort to discipline the small percentage of doctors who are responsible for most of the malpractice. Consider this from a reader of Andrew Sullivan's blog:

    "I'm instinctively sympathetic to this idea in part because I come from a family of doctors and have heard complaints about crazy malpractice suits since I was 12, and in part because I've lived in Europe, where people think American tort law is insane. But part of the reason why Europeans accept restrictions on their ability to sue doctors for malpractice is that they have guaranteed health insurance. It's part of the social contract: doctors accept limited salaries in exchange for limited liability; patients accept that they cannot sue doctors for millions of dollars in exchange for a guarantee of access to decent health care."

  12. Or: “Republicans would provide federal money to states to establish and expand high-risk pools, for people with chronic illnesses who cannot find private insurance at an affordable price.” Yes — and many states already have them, and they have done exactly nothing to increase affordability or access?

    —–

    I have been looking into this a bit for folks with congenital heart disease in Washington state. I was wondering why nobody appears to be using the high-risk pools. Do you have any data or links for me?

  13. Much later, but Henry: you're illustrating exactly the problem I was talking about. Medical bills are often the least of the economic (much less non-economic) costs that people pay for a medical error. Even claims for lost income don't cover voluntary caregiving by family members, constrained choices of living location and careers for everyone else in the family, the loss of productivity that comes with having a fulltime job on the side, etc. And in a winner-takes-all society like that in the US, you're either at the top of your game, or you're out. There's also the problem that loss-of-consortium-style damages (which are different from pain and suffering) are strongly constrained in the case of malpractice against the elderly, because they were going to die soon anyway.

    I'm pretty much with you on remedies, though. The no-fault thing would be particularly nice, because it would ease communication between doctors and patients as well as compensating people without the heart for a lawsuit. And it would mean the end of letters from hospitals that say things like "We can't comment on whether there was any investigation of your complaint, but we're certain that a) the treatment of met all medical norms and b) procedures have been put in place so that the adverse events we assert didn't happen will never happen again."

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