Matthew Yglesias provides a good example of what Democrats must avoid if they are to become a majority party. He presents a graph on Medicare spending and concludes that the solution is “crushing of the doctor’s lobby” and “some kind of doctor-crushing initiative.” Fortunately he has many readers, which presumably includes liberal Democratic voters, who debunk both his argument and his framing.
The flaws in his argument are already presented by those commenting on his post so I will not bother with that other than to note that inequities in health care spending with respect to both region and specialty are well known and are of concern to many doctors. The problem could be better solved by working with them as opposed to speaking of crushing doctors. While the cost of defensive medicine to prevent law suits is often exaggerated by conservatives as a defensive mechanism to allow them to ignore all other health care problems, this is an important aspect of the situation which Yglesias presents. When there are many subspecialists in an area, primary care physicians do feel pressured to refer more often to cover their asses, and the subspecialists feel obligated to do something (and spend some money) to justify the referral to them, as well as cover their own asses. Shakespeare’s advice with regards to lawyers might make for a better solution as opposed to crushing the doctors.
Posing his argument in this fashion will obviously not earn Yglesias any friends in the medical profession. The damage goes beyond that. To many people, even if incorrect, the differences between the Republicans and the Democrats is one of a difference between the successful and failures. Some see Republicans as the party of both those who are currently successful in our economy and those who strive to become successful by virtue of their own efforts. They see Democrats as the party of those who cannot succeed without government help. Barack Obama’s numerous supporters among the affluent is ignored in promoting such stereotypes, or written off as irrelevant elitists. Regrettably a recent Democratic campaign has only served to help promote such right wing memes.
When viewed with these stereotypes, a the promotion of crushing doctors by a Democratic blogger will be seen as a personal threat by successful individuals of all professions. The gut reaction to this post from Yglesias will be that if the Democrats are going to crush doctors once they take power they might next decide to crush me. Class warfare has been a failing strategy for Democrats in the past, as well as for those who resorted to it in the recent primary campaign. Fortunately the Democrats were wise to move beyond this mindset with the nomination of Barack Obama.