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Gupta vs. Moore
GUPTA vs. MOORE....Barack Obama has nominated celebrity doctor Sanjay Gupta to be Surgeon General, and over at his place Ezra Klein has a full rundown of the smackdown between Michael Moore and Gupta after Sicko came out a couple of years ago. I remember being annoyed by this at the time, primarily by Gupta's idiotic insistence that, no, America doesn't spend $7,000 per person on healthcare, it spends only $6,000. Wham! Take that, Moore!
This seemed even more egregious than Gupta's other errors, since it was a purely technical disagreement and Gupta knew perfectly well that (a) there was nothing wrong with Moore's number and (b) it was a trivial difference anyway. Moore's point was that we spend way more money than other countries without getting better results, and that's beyond argument. In the end, though, I wrote it off not so much to mainstream dislike of Moore as to mainstream insistence that if you're going to fact check something, then by God you'd better find some errors even if there aren't any.
Gupta had a few other issues with Moore that Ezra didn't comment on (is national healthcare "free"?, do other countries have longer waiting times than the U.S.?), and he didn't do much better on those. Still, I guess in the end I agree with Ezra that this has been blown out of proportion:
But it's not, as some of the e-mail has suggested, evidence that Gupa is either conservative or an opponent of universal health care. He's read Obama's plan. He's coming on in a largely communications capacity. And that'll be his role. Krugman says that the problem with Gupta's performance was that it was another example of elites engaging in "Village" behavior. He's right about that. But at the end of the day, if the villagers support Obama's heath reform plan, it has a far better shot than if they don't. That's why Gupta's hire is good for health reform, even if it's not good for pundit accountability.
Surgeon General just isn't that big a deal. Gupta will be an effective public face for healthcare, but it's not likely he'll have any major input into the policy end of Obama's primary healthcare plan. It's not worth getting too excited about.
UPDATE: Over at Kos, DrSteveB writes the brief for the opposition. The main problem is that Gupta has a long string of connections with various pharma and healthcare companies. I'm not sure how unusual this is, and I'll wait to hear more about it before saying more. But it's certainly something that needs to be addressed.
UPDATE 2: Oops. Turns out the long string of connections belongs to a different Sanjay Gupta. DrSteve has updated accordingly. Obviously the usual vetting is still in order, but there's no evidence that Gupta has any inappropriate industry ties.
The larger problem isn't whether or not Gupta supports Obama's health care plan. It's that Obama's health care plan isn't a plan for health care so much as it's a welfare plan for the insurance industry.
I think we've seen the entire medical profession, most likely including Dr. Gupta, changing their tune on national health care over the last two years. So what happened when "Sicko" came out is a whole different universe than today.
I would hardly consider Michael Moore to be a template against which any appointment or policy would be judged. He is a rabble rouser and a good one. He obviously roused Gupta.
I don't watch teevee except at the gym. And that is with the hearing impaired thing. But I do see Gupta's encylopedic grasp of health issues. Wide, perhaps not deep.
There has been no public face for health as there used to be. Koop's specialty was smoking. He did well. Now, we have obesity and exercise. We have the challenge of bringing preventive health care to all. It is a mainstay of the proposed overhaul of the health care system. We have many many issues that must be addressed by a public face.
Gupta or Michael Moore? Come on. No brainer. And, not to be unkind, Moore is hardly the picture of good health himself.
I'll also add that I'm more concerned about a Surgeon General's positions on things like stem cell research, availability of birth control, the over prescribing of antibiotics and drug resistant bacteria, funding of basic research, and public health initiatives in general. As Kevin said, the Surgeon General is little more than a talking head. But the wrong talking head (C.E. Koop) can do some real damage.
Kevin's right that it's not an issue in political or policy terms.
However, it IS a huge issue in the constant battle to prevent the Village mindset from taking over the world.
Gupta may have jumped on the universal health-care bandwagon in the couple of years since Sicko, but he's still a Villager with a Villager's bubble mentality, and that's an extremely bad thing to have in this administration.
For better or for worse, the fact that Gupta has tangled with Michael Moore will be seen by the Villagers as a feature, not a bug. Just wait for it: "Gupta is no ideologue. He once took left-wing filmmaker Michael Moore to task over innacurracies in the agitprop documentary Sicko. But when Gupta looks at a health care system collapsing under the weight of escalating costs and increasingly unaffordable insurance coverage, he concluded that nothing short of dramatic federal intervention could avert a crisis."
Obama is setting up the chess board.
We need someone with a public health interest or background. Gupta has neither and seems more interested in self-promotion and not alienating the powers that be--the health care industrial complex and the media.
He is not a good choice.
People keep inventing these Nixon goes to China scenarios for Obama and his appointees.
I agree that the Gupta pick isn't that big a deal. What has been a big deal is the decades of disinformation about Euro health care, which Gupta furthered in that incident. Progressives should have challenged all that disinformation a long time ago. But as a movement, we just aren't good at that.
Respectfully, I vehemently disagree. The Surgeon General position is important, but you have only seen it lately as a factotum of Bush-carrying, science-undermining placeholders. I wrote about health policy, professional nursing and patient advocacy for several years, but I was and am still dismissed out of hand. Progressives do not read substantive posts about policy and the decimation of government functions and the public well-being.
I wrote specifically about former Surgeon General Rich Carmona and what he offered during Congressional testimony. It was hair-raising, but it didn't garner a ripple from progressives. Carmona has excellent emergency preparedness expertise and experience. He testified that he requested to be sent to New Orleans as a Katrina first responder and that he was denied. Gupta never mentioned that.
Gupta, on the other hand, reports advertiser, commercial pharma crap as unbiased health reportage. He stays to a Wall Street Journal, free market, traditional corporate model of healthcare reportage messaging. He is a commercial sell-out, and he also has many undisclosed conflicts of interest.
Moreoever, there is a growing body of evidence that commissioned officers of the USPHS working in the DIHS - the branch that Gupta would be attached to - have been used as agents of abuse and torture on immigrant detainees. The Surgeon General would certainly be obligated to investigate that and report, but no one has. Sec HHS Leavitt has methodically weaponized HHS and used it against the health of the citizenry. DIHS, which was accountable to the USPHS somehow magically migrated to ICA and DHS, and no one is investigating or stopping abusive practices. So not unsurprisingly, people are suffering and dying and no one is doing anything about it.
Gupta has never investigated any Bush/Leavitt/HHS policy or practice. He's remained silent while the FDA and CDC abdicated their oversight and regulatory responsibilities and imperiled the public safety. For the past eight years, Gupta has never questioned a single thing that the Bush Admin has done.
CNN has even proudly announced that they have repressed all coverage of health policy and health reform since Obama contacted Gupta. The public can not be informed by media who deliberately and willfully withhold vital information.
Buy a clue - read some decent health policy and reportage investigatory blogging.
Otherwise, you are going to get exactly what you deserve - and your health will not be better as a result.
The main question is whether Gupta has to wear some sort of fancy Navy Dress uniform? I have heard he is pretty vain, so he might get all C. Everett Koop on us.
Krugman discusses this in terms of Digby's "Village Behavior."
Whoops, guess you saw that too. Score one for nepeta.
America needs low-cost or free health care clinics for those without health care insurance. These could be staffed by just one doctor and several nurse practitioners. They could be cheaply installed in a vacant big-box store near you. The property owner could have a property tax holiday for as long as there is a clinic. (Or the Feds could pay the property tax to the local governments.)
Such clinics will give our country a chance if there is a public health emergency. If one in six Americans don't have health care, what's going to happen if there's a pandemic?
Think small. This plan has the greatest bang for the health care buck, that is, helps the greatest number of Americans.
Gupta, who plays a doctor on TV, is a bought-and-paid-for (very highly paid for) shill for the pharmaceutical and insurance corporations, as his on-air debate with Moore demonstrates.
The question is, did Obama appoint him to continue shilling for those corporations, or to shill for the public interest?
This is an interesting question since the public interest would, beyond reasonable question, be better served by a universal, single-payer, nonprofit medical insurance system under open, transparent, efficient, accountable public administration -- which is entirely inimical to the profit interests of the the corporations that have enriched Gupta.
Personally, if we are going to have a made-for-TV personality as Surgeon General, I'd rather have Dr. Gregory House.
What bothers me is that Obama has said very publically that he is going to restore evidence-based science policy and has picked smart, savvy, technically qualified people for other science posts.
But for SG he picks Gupta? There are many, many, many more qualified people who could restore the dignity of this post and do a decent job on TV. Gupta is a bad pick.
I will take Gupta over the Green Beret trauma surgeon who shot a murder suspect with a hostage in Tuscon and wasn't allowed to talk about birth control.
There are zillions of Guptas out there, and a jillion of them are named Sanjay (and similar variants).
. . . there's no evidence that Gupta has any inappropriate industry ties.
Only that he acts as their apologist whenever possible. The difference between Moore and Gupta is that Sanjay doesn't see consumers as stakeholders in the healthcare system, only Pharma, insurance companies and doctors.
The SG is in charge of public health in the US. S/he sends engineers to Indian reservations to design and build water treatment systems and sewage plants. They set up and administer vaccination campaigns. They must provide advice and try to steer public policy.
In theory, the office of the Surgeon General is the most egalitarian post in the administration. The bar ought to be a lot higher than being a talking head on TV with a side job 1 day a week as a real doctor. The job requires excellent communication skills (which Gupta has) but also administrative skills and a deep policy understanding to advance practices that often go unheralded but aid ALL citizens without respect to most political and social divisions.
Gupta doesn't have the chops.