In this world nothing is certain except negative patient-care outcome and revenue enhancement. Or, to put it another way, nothing is certain except death and taxes.
Welcome to the world of "Doublespeak"--where apartheid is a "cultural group concept," potholes are "pavement deficiencies," the poor are "fiscal underachievers," rubbish is "post consumer secondary materials" and used cars are "previously distinguished vehicles."
Prof. William Lutz of Rutgers University has been tracking this world for better than a decade and has published his findings in a new book called "Doublespeak."
He describes a world where the telling phrase "meaner than a junkyard dog" turns into "meaner than a re-utilization marketing yard dog" and the Mafia becomes "a career-offender cartel."
Lutz's conclusion is that English is under attack from a cabal of businessmen, lawyers, advertisers, doctors and government officials out to "mislead, distort, deceive, inflate, circumvent and obfuscate."
He uses this cascade of verbs because he wants to be perfectly clear about the terrible things that are happening in American institutions ranging from the stock market to the post office.
In the world of "Doublespeak", Peacekeepers are deadly missiles, aerodynamic personnel decelerators are parachutes and radiation enhancement weapons are neutron bombs, which were almost named "widow-makers" because they were designed to "eliminate an enemy with a minimum of damage to friendly territory."
Doublespeak is not exactly new. History, both ancient and modern, is replete with examples.
Julius Caesar described his brutal subjugation of Gaul as "pacifying" the place. The Nazis called their genocide of Jews a "Final Solution" and President Nixon called the American invasion of Cambodia during the Vietnam War an "incursion."
President Carter called the failed raid to free American hostages in Iran "an incomplete success" and the invasion of Grenada in the Reagan Administration was "a vertical pre-dawn insertion."
Prince Sihanouk once explained the Khmer Rouge's slaughter of a million Cambodians this way: "Cambodians prefer to be killed by the Khmer Rouge because they are Cambodians and not be wiped out by the Vietnamese or the Soviets."
Yassar Arafat said that people who asserted that the PLO wanted to destroy Israel were wrong because, "We do not want to destroy any people. It is precisely because we have been advocating co-existence that we have shed so much blood."
Lutz says that never before have so many people in so many places tried to confuse so many others.
"Doublespeak is becoming a flood tide because television allows a lot more transfer of the language. So, if the President of the United States uses a Doublespeak phrase, everybody hears it," he said.
He also thinks that over the years people have become much better at Doublespeak, especially with the example set by the Reagan Administration.
Arms control for Reagan was building more weapons, reducing the federal budget deficit meant increasing it and if you worry about the environment you should remember that Reagan said "trees kill."
Catsup was a vegetable, according to one Reagan bureaucrat concerned that school lunches were costing too much. Even Reagan, however, found that too much and reversed the decision.
Lutz says that next to government, the medical profession is a prime offender, using such phrases as "diagnostic misadventure of a high magnitude" as a deliberately vague way of saying the doctor's incompetence caused the patient to die.
"There was a case of a man not suing after his wife died because he had been told she died of 'diagnostic misadventure.' Had the man known she died of medical malpractice, he would have called the lawyers in," Lutz said.
"People are paid to think these terms up because somebody wants to cushion the blow or mask what is really happening in the media."
He said the phrase "revenue enhancement" was thought up by the Reagan Administration because it pledged not to raise taxes. "What is revenue enhancement other than taxes," asks Lutz.
Lutz said he finds his examples by combing the newspapers and hearing from equally concerned citizens around the world who flood his mailbox with examples.
"There is no dearth of material," he said, adding that for pleasure he likes to get away from the world of Doublespeak by reading ancient Greek and Latin.