Rip up this awful column

An op-ed by serial health care misinformer Betsy McCaughey is, indefensibly, featured in today's New York Post:

When President Obama addresses Congress and the nation tonight, he should pledge to do three things.

First, he should announce that he will discard the 1,018-page health bill drafted in the House of Representatives and replace it with a 20-page bill in plain English. Twenty pages should be sufficient. The framers of the US Constitution established an entire federal government in 18 pages.

This is absolute nonsense.

First, as Betsy McCaughey surely knows -- though most of her readers do not -- the number of pages is wildly misleading. See, legislation is printed on pages with very wide margins. Text is double-spaced -- and lines are numbered. Here, for example, is what page 483 of the House bill looks like:

Page 483 -- a typical page -- contains only 151 words. That's about half as many words as appear on a page in a typical book. So it's more useful to think of the health care legislation as running about 500 pages. That's quite a bit shorter than a Harry Potter book. Surely it isn't unreasonable for legislation governing the nation's health care and insurance systems to run two-thirds as long as a children's book, is it?

Next: McCaughey says the bill should be written “in plain English.” But legislation is written in highly precise and technical legal language for a reason: If it were written in “plain English,” it would introduce more ambiguity, not less. Enforcement of laws would be more dependent upon judge's interpretation, and less dependent upon the intent of the elected representatives who wrote the law. (A prospect that would make a conservative like McCaughey twitch, if she were honest.)

Think about a “plain English” agreement between you and your daughter: If she cleans her room, she can have ice cream. Seems pretty straightforward, right? Now, think of all the complications that could arise: Who decides what qualifies as “clean”? What if she enlists the help of a friend? How soon does the room need to be cleaned? What kind of ice cream is she entitled to -- the stuff in your freezer, or the soft-serve chocolate-vanilla twist at her favorite ice cream stand, three towns over? How much ice cream? Et cetera. Those details need not be spelled out when you're dealing with your daughter -- at the end of the day, you can impose your will on the situation easily enough. It isn't so easy when you're trying to get your insurance company to cover your prostate exam.

Next: McCaughey says “20 pages should be sufficient” to revamp the nation's health insurance system. That's nothing short of crazy, as the ice cream comparison probably makes clear. Some things need to be elaborate and complicated. Next time you get on an airplane, think about whether you want the pilot's dashboard controls to be as complex as they are, or whether you'd prefer it to consist of an on/off switch, a steering wheel, and a break pedal. Think about whether you'd prefer the mechanics who service the plane to work off detailed step-by-step instructions making clear the 300 safety tests they must perform before each flight, or whether you'd be more comfortable if they were just told “Check it out.”

Finally, as Betsy McCaughey surely knows, the Constitution did not establish an entire federal government in 18 pages. It laid out the basic framework for such a government. Betsy McCaughey understands the difference -- she just hopes her readers don't.

McCaughey's dishonesty and fundamentally-flawed thinking make the rest of her argument impossible to take seriously, but let's look briefly at her next demand:

Secondly, the president should announce that the purpose of his 20-page bill is to cover the truly uninsured. Period.

And do nothing for the already-insured, whose health care costs are skyrocketing? Nothing to stop health insurance companies from doing everything they can to avoid paying for necessary medical care so they can maximize profits? Nothing for people who are locked-in to their current jobs for fear that if they change jobs, they will be unable to get insurance due to “pre-existing conditions”? Nothing to force insurance companies to compete? Nothing to lower costs? Nothing to prevent insurance companies from placing caps on health care payments, which can -- and does -- result in people with top-of-the-line health insurance going bankrupt due to health costs?

Well, at least McCaughey made her perspective clear: She doesn't want to do anything to stop insurance companies from denying payment for necessary procedures. Good to know.