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10.06.09

The Ugliest Health-Care Debate

You think the political jousting in the Senate Finance Committee is rough? Wait til you see the right’s rumor machine, Betsy McCaughey, square off with big-government lover Anthony Weiner.

You think the political jousting in the Senate Finance Committee is rough? Wait until you see the right’s rumor machine, Betsy McCaughey, square off with big-government lover Anthony Weiner.

If you like partisan combat, the New York University/Langone Medical Center in Manhattan was the place to be Monday night. Betsy McCaughey, former lieutenant governor of New York and the leading purveyor of discredited right-wing health-care rumors, squared off against U.S. Democratic Rep. Anthony Weiner, a once and future mayoral hopeful who’s called for a complete federal takeover of health care.

The results were as explosive as advertised, bringing the virulence of a summer town-hall meeting—complete with heckling, shouts of “liar!” and signs conjuring socialism to one of America’s most liberal ZIP Codes.

Weiner opened with a detailed explanation of why, like 86 other members of Congress, he supports a single-payer system, which has fallen off the table in the current health-care negotiations. He likened it to Medicare, which operates in a similar fashion with lower overhead than private insurance. “Get the idea out of your head that this is a free market,” he said. “It's not.”

“This bill is a medical assault on seniors!” McCaughey shouted multiple times over the audience’s boos and applause.

But before ending his opening 15-minute presentation, Weiner made a pre-emptive strike against his opponent, dutifully listing the many independent organizations and news outlets that have judged McCaughey's claims to be false, from Politifact to John McCain adviser Gail Wilensky (some have gone so far as to label her a liar). He prepared the audience for McCaughey's usual modus operandi, which she's employed for the better part of 15 years: Present a nonstop flurry of page numbers and out-of-context quotes that are impossible to evaluate in real time.

“The theme is whenever there's a discussion about saving money in Medicaid, Medicare, or anything, she says someone's going to die,” he said. “When there’s any discussion about having inefficiency—uh uh, someone's going to die from that, too.”

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McCaughey followed her script, presenting a flurry of indecipherable excerpts from legislation, medical journals, and studies, with little context and even less time to absorb the dense text on screen. She jumped from complaints about the length of the bill—complaining it was not written “in plain English”—and repeatedly demanded that members of Congress pledge to read it in its entirety before voting.

“This isn't a problem of people not reading the bill,” Weiner responded. “In your case, it's a problem of reading the bill and then lying about what’s in it.” It was enough to make the deliberations now unfolding on Capitol Hill seem like a Miss Manners tutorial.

McCaughey seemed exceptionally agitated. She frequently raised her voice to a shout even when she had the floor, banged on the table, and even marching toward Weiner to address him directly at times—apparently forgetting how that ploy turned out in another fabled New York debate, pitting then-Senate candidate Hillary Clinton against Rick Lazio.

“This bill is a medical assault on seniors!” she shouted multiple times over the audience's boos and applause.

The outbursts undercut her appeal. McCaughey’s special talent—the one that drives the left bonkers—is her ability to deliver demonstrably false statements with a calm, confident authority, dismissing any contrary information as the feeble efforts of an uninformed mind. She goes on offense, and leaves it to her opponent to chase after her and point out the errors of her ways. But by the time they’ve done that, it’s often too late—and her assertions have hardened into received wisdom, helping her carry the debate.

As expected, the public option was the pivot point; Weiner argued for single-payer or at least a strong public insurance plan, and McCaughey, as predicted, argued every step of the way that even a watered-down version of the public option would be deadly for everyone involved. McCaughey warned repeatedly that less-discussed elements of the legislation, like using comparative effectiveness research to determine which treatments are superior or rewarding hospitals for using commonly acknowledged best practices, were in fact the most dangerous of all.

"I'd like to hear if Anthony is going to vote for that bill even though it will devastate New York's hospitals, New York's patients, and New York's health-care workers!” she proclaimed.

Michelle Goldberg: Is Obamacare Pro-Life? At one point McCaughey seemed to advocate going beyond removing passages of the bill that would reimburse doctors for discussing living wills with their patients (the source of phony “euthanasia” rumors she's spread with great success), saying that some doctors refuse to follow living wills in general and treat their patients regardless of their final wishes. As Weiner pointed out, living wills were not only legal (and until recently uncontroversial) but McCaughey's call to physicians to shred them was blatantly illegal.

It can be hard to tell what angle McCaughey is going for sometimes. Is she just a contrarian? A more academic Ann Coulter or Michelle Malkin? It's hard to ignore that her views happen to line up with pharmaceutical and insurance companies' wildest fantasies or that she recently resigned from the board of a medical-supply company to avoid conflicts of interest after her high-profile battle with Jon Stewart on The Daily Show. And recently Rolling Stone's Tim Dickinson uncovered internal memos from Philip Morris from the early 1990s that described how they helped shape a noted magazine article McCaughey wrote (entitled “No Exit,” it was published by The New Republic) that helped kill President Clinton's health-care push. She denied that she’d had any contact with Phillip Morris and instead suggested to me that the Phillip Morris staffer who wrote the memo was “somebody puffing himself up” by attaching his work to her name.

There was one truly bizarre moment in the debate, at the very end of the evening. Moderator Ben Smith of Politico asked about her organization, the Committee to Reduce Infection Deaths. McCaughey passionately argued for establishing best practices guidelines in hospitals on how to avoid infections and then penalizing doctors who fail to follow them. "I'm very much in favor of rewarding hospitals for following proper safety measures," she said, describing how withholding payments from doctors for failing to follow safety procedures could help prevent deaths.

Weiner looked stunned: McCaughey was suddenly calling for more intense government regulation of health-care practices—and building her argument on the same principle as the comparative effectiveness studies supported by the Democrats that she had just spent the last hour decrying as "a body blow" to patients and a "medical assault on seniors." Just moments earlier, she had talked about how "you don't want your doctor having to choose between you and avoiding a government penalty," but there was no clear reason why the guidelines she laid out for preventing infections shouldn't be applied to any other health-care practices, let alone feared as a deadly bureaucratic takeover as she alleged. Her position seemed to be that government should get out of the health-care business, except when it came to her pet cause.

So who won? Weiner did his best, but some progressives in the audience questioned the wisdom of giving McCaughey such a prominent forum in the first place. “It is impossible in a comparable amount of time to knock down the misstatements that she can make so quickly and so briefly,” one of McCaughey's recent debate partners, Brookings Institute senior fellow Henry Aaron, told The Daily Beast. “So all you can do I think is go after and discredit her.”

With the two of them making a joint appearance on MSNBC the next morning before a far larger TV audience, the publicity surrounding the event offered yet another opportunity for McCaughey to demagogue the debate.

Weiner’s view: “I'm either a masochist or a sadist,” he told The Daily Beast. “You decide.”

Benjamin Sarlin is a reporter for The Daily Beast. He previously covered New York City politics for The New York Sun and has worked for talkingpointsmemo.com.