How Nasty Things Spread

Back in Chicago late last Sunday night after two and a half weeks away, I opened the Sun-Times to read the Kerry endorsement, then spotted the Mark Steyn column a few pages on. Steyn, his usual cocksure self, was ridiculing John Kerry’s position on medical issues. “So this is no time to vote for Europhile delusions,” he wrote. “The Continental health and welfare systems John Kerry so admires are, in fact, part of the reason those societies are dying.”

Steyn, a Canadian who lives in New Hampshire, sneers with the best. “As for Canada, yes, under socialized health care, prescription drugs are cheaper, medical treatment’s cheaper, life is cheaper,” he went on. “After much stonewalling, the Province of Quebec’s Health Department announced this week that in the last year some 600 Quebecers had died from C. difficile, a bacterium acquired in hospital. In other words, if, say, Bill Clinton had gone for his heart bypass to the Royal Victoria Hospital in Montreal, he would have had the surgery, woken up the next day swimming in diarrhea and then died. It’s a bacterium caused by inattention to hygiene–by unionized, unsackable cleaners who don’t clean properly; by harassed overstretched hospital staff who don’t bother washing their hands as often as they should. So 600 people have been killed by the filthy squalor of disease-ridden government hospitals. That’s the official number. Unofficially, if you’re over 65, the hospitals will save face and attribute your death at their hands to ‘old age’ or some such and then ‘lose’ the relevant medical records. Quebec’s health system is a lot less healthy than, for example, Iraq’s.”

This interested me enormously. At the beginning of October I’d never heard of Clostridium difficile–or “C diff,” as nurses call it. But then my mother in Saint Louis contracted the infection–in a clean, cheery Lutheran convalescent home far from the squalor of socialized medicine–and died. My sister, who lives in Vancouver and isn’t an ardent foe of Canada’s health system, arrived in Saint Louis with a packet of information on C. difficile, including an alarming article on the Quebec outbreak published just that morning, October 22, in Canada’s National Post. Dr. John Marshall, a professor of surgery at the University of Toronto whose study of C. difficile was about to be released, told the Post that overuse of antibiotics was destroying the natural defenses elderly patients had against the infection. He predicted that his research could lead to what the Post called a “watershed change” in the use of antibiotics in intensive-care units. Nowhere in the article did Marshall or anyone else suggest that the rash of deadly C. difficile cases could be blamed on socialized medicine.

Moreover, a second article provided by my sister reported the claim of an infection-control specialist in Montreal that the “epidemic strain” of C. difficile plaguing his city had shown up earlier in the U.S. and probably originated there.

So was Steyn drawing on facts, intuition, or ideological shamelessness? I e-mailed him and got a prompt response from his representative, Tiffany Cole. “Why is there such a lack of hygiene in Quebec and Canadian hospitals?” Cole e-mailed me back. “Mark wrote on this once before in relation to the fact that Toronto was the only North American city to get a SARS outbreak. . . . Mark also adds, if you’re gynecologically inclined, you may also wish to look into the women in Labrador who contracted chlamydia from their hospitals. Mark’s contention is that basic hygiene becomes a problem in government run health systems.”

I called Doctor Marshall and began reading Steyn’s column to him.

“That’s absolute hogwash!” he declared before I’d finished. “Canadian medical standards are on average every bit as high as American medical standards. It has nothing to do with the structures of the health-care system.”

I read him Steyn’s conclusion: “One thousand Americans are killed in 18 months in Iraq, and it’s a quagmire. One thousand Quebecers are killed by insufficient hand-washing in their filthy, decrepit health care system, and kindly progressive Americans can’t wait to bring it south of the border. If one has to die for a cause, bringing liberty to the Middle East is a nobler venture and a better bet than government health care.”

“That’s the most outrageous, raving poppycock I’ve ever heard,” said Marshall. “Infection-control procedures do play a role, but I’d wager there’s no significant difference between Canadian and U.S. hospitals. That is just so far over-the-top it’s almost not worthy of commentary. I have a sense this is a man whose thought processes are a little bit out of control.”

Tiffany Cole told me, “Mark has lived under the very different health systems of Canada, the UK and the US and he knows which he prefers.” But one can live under the American system in different ways. I suppose what you think of it depends on whether it shields you or grinds you down. My mother was too sick to be told that the cheery convalescent home she’d been brought to wanted to kick her out because she wasn’t convalescing and therefore Medicare was about to stop paying the bills. To keep her where she was, we children promised to pay for her care out of our own pockets.

Trib Endorses Dewey–or Whoever

Did anyone really think this time would be different? Apparently so. The Tribune’s endorsement of George W. Bush on October 17 aroused such a storm that public editor Don Wycliff devoted his next column to it. He quoted from the Tribune’s statement of principles–“The Tribune is not blindly or uncritically partisan. No political party should take its support for granted”–and conceded that “arguing against that protestation is a record of having endorsed the Republican candidate in every presidential election since at least 1872.” (The Tribune later corrected Wycliff, noting the kind of exception that proves the rule: In 1912 the paper endorsed former Republican Theodore Roosevelt, running that year as the candidate of the Progressive Party.)

But, said Wycliff, “there’s another way to look at that record.” When the Tribune has opposed a Republican, either at the polls or in office, “the Tribune’s reputation as a ‘Republican newspaper’ gave extra potency to its counterintuitive action.” Perhaps “ontological essence” would have put the matter more exactly than “reputation,” but Wycliff’s point was not just clear but valid. The editorial page exists to make the Republican argument.

Wycliff’s column deserved a close reading. He explained that the editorial board consists of ten senior journalists and three ex officio members–publisher Scott Smith, editor Ann Marie Lipinski, and the public editor himself. Editorial-page editor Bruce Dold chairs the meetings and leads the board to a “consensus,” which Wycliff made clear isn’t arrived at by a vote. “As Dold observed in an interview with me Tuesday,” Wycliff went on, “the publisher is the ultimate boss and can ‘overrule’ the editorial board if he wishes. In the normal course of things, however, the publisher wisely leaves the board to its own devices. And in the case of Sunday’s Bush endorsement, Dold said, there was no need to overrule.”

A presidential endorsement is not the “normal course of things.” If Smith had no “need” to overrule the board it’s because it gave him the “consensus” he was looking for (though with little enthusiasm, I’m told). Smith intended to endorse Bush with or without the board’s approval.

Wycliff also wrote that the Tribune was criticized for the “distorting effect that some readers discerned in editorials over the last year that went out of their way to avoid blaming Bush personally for problems or failures of his administration, presumably so the paper wouldn’t have to deal with that criticism in the inevitable Bush endorsement.”

Wycliff had asked Dold about that. “All I can say is I don’t think in those terms,” Dold replied. “We deal with the issue in front of us.” But as you can see, Wycliff didn’t question the premise of the criticism. If, as Wycliff seemed to allow, the Tribune did consistently decline to hold Bush responsible for his own administration, then it was either covering for him or dismissing him as a nullity. Which made its endorsement of his reelection all the more amusing.

The endorsement itself was properly hard on Kerry and improperly easy on Bush. It began by speaking of “new force vectors” that “drive our decision-making,” thereby losing all but the hardiest readers, and went on to hail the “privilege of choosing between two major-party candidates whose integrity, intentions and abilities are exemplary.” Perhaps the Tribune was merely trying to be generous here, but the effect of this outlandish passage was to promise an editorial discussion lightly rooted in the real world.

Meanwhile, the Sun-Times was cranking it up to back Senator Kerry. “This represents a change in outlook for us,” said the October 24 endorsement. “Four years ago, this newspaper endorsed George W. Bush. We thought his administration would be about trimming big government and spending a surplus projected at $4.5 trillion. We liked Bush’s vision for cutting taxes. And, most of all, we saw Bush as a leader who could unite the nation.”

Us? We? The biggest change since 2000 isn’t in Bush. It’s in the Sun-Times, no longer under the thumb of Conrad Black and David Radler. Also gone from the scene is neocon Black crony Richard Perle, a wheeling and dealing Hollinger International board member who also sat on the Defense Policy Board, an advisory body that thinks strategically and reports to an undersecretary of defense. Outlooks change when the outlookers do.

Sticker Shock

Here’s something for Mark Steyn to consider the next time he stops doing cartwheels for the American health system long enough to wipe his brow. During my stay in Saint Louis I had to ask a local pharmacy to refill a prescription. It’s a common drug that costs me $30 a month, but because I’d left my drug-plan card at home, I asked what the full retail cost was. Slightly over $300.