- The Washington Times - Saturday, October 14, 2000

"The Carol Burnett Show" once did a series of parody ads on the then-hypothetical question of what would happen if doctors could advertise. One distraught character told an interviewer how her husband died while being treated by Dr. Smith. "My next husband, I'm gonna take to Dr. Jones," she wails.

That sketch rang through my head while watching a segment of "Critical Condition," a "Democracy Project" documentary that airs Wednesday night on PBS. In that segment, surgeons and medical institutions look bad because they don't want the surgery death rates for individual hospitals and doctors made public.

That some hospitals or doctors are better than others … to whom, exactly, is this news? Can anybody follow the news and not realize that princes and potentates go to the Mayo Clinic, not County General? This typifies the aggravating qualities of "Critical Condition."

On the one hand, the show is informative and holds the attention for the full three-hour running time — partly, because it's structured in four 45-minute segments, each with several vignettes, thus keeping the show flowing nicely.

But "Critical Condition" also frequently veers off into the earnestly tendentious liberalism that we've all come to know and love from PBS. Its earnestness prevents it from having entertainment virtues — although sometimes the show plays like a straight version of "Roger and Me" — and so the judgment of "Critical Condition" depends entirely on the show's intellectual acuity.

I'm no expert on the field of health care, but I had no difficulty spotting how the show was guiding me toward an intellectual conclusion — toward a single-payer socialized health-care system.

But these flaws almost add to the show's appeal — frankly, who can resist something that features the perpetually sober Hedrick Smith and has the gall to declare itself as coming from the "Democracy Project"?

The four segments are titled "The Quality Gap: Medicine's Secret Killer," "The Chronically Ill: Pain, Profit and Managed Care," "The Idealistic HMO: Can Good Care Survive the Market?" and "The Uninsured: 44 Million Forgotten Americans."

The titles alone should give a general sense of what to expect. "Pain" is yoked with "profit" and the uninsured are "forgotten" (by people who haven't followed U.S. politics for the last decade, I suppose).

In the first segment, for example, we're breathlessly told about "wide gaps" in death rates from heart-bypass surgeries. But (and if you blink, you miss it) the death rates only vary from 1.88 deaths per 100 surgeries to 6.02. You could just as easily slice that salami the other way and say the survival rates vary from 94 percent to 98 percent, which gives a rather different view of the matter.

But scoring the hospitals, "Critical Condition" concedes, has resulted in doctors altering diagnoses, not performing high-risk operations and transferring patients in order to gin up the results. These same doctors, by the way, we are later told in the segment on greedy health maintenance organizations are selfless paragons making diagnoses for the sake of patients, not profits.

The third segment deals with Kaiser Permanente. In it, we of course get the usual coupling of the terms "radical," "social mission," and "idealistic" with the fact that Kaiser was "widely derided as socialized medicine."

The segment makes the sensible point that Kaiser's innovation of early screenings for colon cancer imposed risk on the company because such screenings are expensive in themselves, although they pay off handsomely years down the road because of lower costs for treating cancer.

The only way Kaiser can get a return on its investment is if people stay with the company for decades. But the primary means of providing heath care today is employer-based health insurance and people change jobs often. Since we're not going to bar people from changing jobs … we would have to have only one health-care provider.

But most manipulative is the second segment on the "wonderful racket" of health insurers. It's repeated as though it's a blinding insight worthy of a "health economist" that "commercial insurers make a profit when members stay healthy and lose money when patients need a lot of care."

The segment begins with a crying child while the earnest voice-over says, "What if your health plan tries to take it (insurance) away?" A repeated motif involves superimpositions of sick old people and children, the lines of a brain-monitoring machine and an electronic Wall Street ticker. This is the stuff of silent melodramas, with squealing heroines tied to the train tracks while the rich, mustache-twirling villain stands a foot away, laughing lustily.

We live in interesting times when the phrase "we can't be all things to all people" is used to make someone look bad.WHAT: "Critical Condition With Hedrick Smith"WHERE: WETA (Channel 26) and WMPT (Channel 22)WHEN: 8 to 11 p.m. Wednesday

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