BehindTheMedspeak: 'The hospital where former President Bill Clinton awaits bypass surgery has the highest death rate for the operation in New York State.'

I don't know about you, but if I were Bill Clinton, I'd probably have spilled my morning coffee when I read this, the first sentence of Lawrence K. Altman's story in this morning's New York Times.

How can this be?

Why would Bill Clinton, who could go anywhere, go to a place that has a risk-adjusted 3.93% death rate for coronary artery bypass surgery, when the state average is 2.32% and the best hospital - Staten Island University-North - has a death rate of 0.34%, less than one-tenth that of the one he's chosen?

The answer is simple: he's a victim of V.I.P. medicine.

V.I.P. medicine is where you're treated not like the average Joe - or bookofjoe - but, rather, differently from normal.

And that's when bad things start to happen.

People go out of their way not to inconvenience you or hurt you, and the end result is that you end up dead more often than the anonymous John Doe.

At least they treated him like anyone else in terms of scheduling his surgery.

At first, the news reports said he'd get his operation last Saturday morning; then, when it became clear that the "A team" had Labor Day holiday plans, and wasn't changing them for Clinton, the surgery suddenly wasn't urgent anymore, and could wait until this morning.

Of course, that raises the question, was it really necessary at all?