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New article on health care misinformation

Topics: Barack Obama , Betsy McCaughey , Bill Clinton , death panels , euthanasia , health care , misperception

I have a new article on health care misinformation in The Forum that may be of interest to Pollster.com readers (link requires free registration; ungated copy here):

Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate

Both Bill Clinton and Barack Obama struggled to overcome widespread and persistent myths about their proposals to reform the American health care system. Their difficulties highlight the influence of factual misinformation in national politics and the extent to which it correlates with citizens' political views. In this essay, I explain how greater elite polarization and the growth in media choice have reinforced the partisan divide in factual beliefs. To illustrate these points, I analyze debates over health care reform in 1993-1994 and 2009-2010, tracing the spread of false claims about reform proposals from Bill Clinton and Barack Obama and analyzing the prevalence of misinformation in public opinion. Since false beliefs are extremely difficult to correct, I conclude by arguing that increasing the reputational costs for dishonest elites might be a more effective approach to improving democratic discourse.

The article covers several topics I've discussed on my blog such as Betsy McCaughey, death panels, and naming and shaming in much greater depth. It also includes a new empirical analysis of survey data on misperceptions about the Clinton and Obama plans -- here's the key graph showing the perverse relationship between perceived and actual knowledge of the plans among opposition partisans (the y-axis is the predicted level of belief in the listed misperception):

Hc-misp

Please read my article to find out more. (Note: It's part of a special issue of The Forum on health care reform that's worth checking out.)

 

Comments
Farleftandproud:

I think the misinformation that the GOP extremists have portrayed health care to be is going to come back to bite them really bad. A majority of Americans do not use logic and react to mass hysteria. People like Bachmann, Palin and Grassley did a great job at using the fear for political purposes, but to not see our health care system as it is now as problematic there is something wrong with you.

The GOP had no alternative solutions this time around on health reform. In 1994 they actually did but at that time the medical lobby and big insurance had absolute power over our nation. By 2008, the system had become so bad their power finally caved in, and enough people wised up including the AARP, to finally get something accomplished this time.

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GARY WAGNER:

I would read the article but I didn't realize this was just an infomercial for an article that you have to pay to read.

What helped keep the "death panels" belief alive was some prominent liberals attempting to counter the argument by saying that we already have "death panels" but they are currently controlled by insurance companies.

If we already have death panels and if the healthcare bill doesn't stop them, then aren't death panels supported in the healthcare bill?

This is another one of those arguments that the democrats are trying to keep alive - just like the obama birthplace question. They are actively working to bait the hook and then mock people who take the bait.

And then you have to ask the question about what the healthcare bills creation of the "Independent Payment Advisory Board" is.

They have the power to deny coverage and that denial could very well be a death sentence for a medicare patient? That means that this is a government panel created to make life and death decisions.

Is that, or is that not, a "death panel"?

If you liberals would rather call it a "life panel" because they also have to power to save a life then go ahead if that makes you feel better.

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Trey Fairweather:

I have to say buddy you are a prime example of "growth in media choice [reinforcing] the partisan divide in factual beliefs." No one I repeat No one believes that patients will have to appear before a panel that will decide if they live or die. What people do believe, and I agree, is that increasing access without increasing supply will lead to shortages. Thus it was with Jimmy Carter's Gas price controls when you had line ups and people went without, thus it was with bread lines in the USSR, Thus it was and is in every major city with rent control, and thus it is in every other developed country in the world with some form of national health care. When there are shortages some people go without and there will have to be a mechanism for determining who gets it and who doesnt.

Ditto for choosing your own doctor. Just because the bill doesnt say "Thou Shalt Not Choose Thine Own Doctor" doesnt mean you will be able to choose your own doctor. I live in Canada and you can in theory choose your own doctor here, if you can find one who is accepting patients. I dont have a doctor and I have been looking for 3 years now. Its free but I still go without.

Back to the death panels: In the US 1% of people who get prostate cancer die from it, 2% for skin cancer. In England 30% who get it die from Prostate Cancer, 28% in France, 22% in Canada. This accounts for insured and uninsured. I think this kind of thing is worth noting.

As for the canard about the USA having lower life expectancies there are 3 reasons for this - you have way lower instances of abortion than other countries. In Europe and Canada as well as less developed places like Cuba for instance they often "abort" babies after they are born if they have birth defects and they do not count it toward life expectancy, in the US they often live with crippling defects for up to several years and even if they die 1 day after birth you still count it toward the life expectancy average. You guys also have lower tobbaco taxes and booze taxes than the rest of the world leading to higher use, and you enforce drug prohibition much more thoroughly resulting in people obtaining illegal *pharmacuticles* that are impure at best. People also share dirty needles and things like that because if they come out with their habit you throw them in the clink where they get raped repeatedly (also spreading disease). Your heavily enforced prohibitions also lead to your high instances of young people in gangs murdering each other to weed out their competition. Third you guys dont enforce all kinds of food bans like we do on high fat foods and things of that nature, and you are richer than the rest of the world and like to spend your money on Crispy Cream donuts and things of that nature. I think its disgusting but its your choice.

There is more to say but I have to leave it there because I'm going to go try and wait in line for 8 hours at the emergency room to get my pnemonia looked at.

In conclusion I would appreciate it if you would drop the condescending attitute toward the poor wretched dummies *sarcasm* who vote republican and like markets. Just because you assert that they are always wrong doesnt make it so. And pollster is one of the best websites out there I wish it wouldnt sully its reputation with this lack of self examination for bias.

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Gary -- the article is free with registration; you don't have to pay anything. I also posted a link to an ungated copy. Hope you will check it out.

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GARY WAGNER:

Thanks, Brendon. Sorry about the sarcasm. It's been a bad morning. I saw that I could read the article for free but it appeared that a request would be sent to someone to subscribe. I've been burned by "trial subscriptions" enough that I have trouble trusing anything with the words "free" and "subscription" in it.

I'll read the entire article. I can't promise that I have an open enough mind to change it.

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Ptolemy:

Predictions such as "Social Security will run out of money" or "government-funded health care will not always provide lifesaving treatment" are not factual statements, because they cannot be verified in the present. Politicians make promises, of course, but for now it's a matter of trust!

"Death panels" is clearly a metaphor (for denial of care by bureaucratic fiat) and taking that phrase literally is intentional disinformation. Conversely, beyond their denotation, poll questions can have connotative power. Some people will respond to what they can infer from the context of the question.

Opinion polls are just that, opinions. One side may assume that what they believe is real, and the other side is believes in myths. Better to try and understand why the others don't agree...

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Marcello Mastroianni:

The thing is, Americans usually don't trust politicians when we *can* see what they're doing. When they lock the doors and turn out the lights, we assume that they're plotting to stab us in the back. Sometimes we're right.

Both Clinton's and Obama's health care bills were mostly put together behind closed doors -- in Obama's case, this involved breaking a significant campaign promise. In both cases, it was a terrible, terrible mistake. In the absence of real information, it was inevitable that misinformation would spread rapidly.

When the bills were finally presented, and the politicians told us that it was all for our own good, the public had to ask the obvious question: "If you guys are working for our best interests, then why are you working in the dark?"

It's a good question. Still unanswered, unfortunately.

I don't know if the article addresses this issue -- I didn't see it after a quick scan -- but it's probably fair to say that when American politicians try to hide something, the American people assume the worst.

Which is exactly what we should assume.

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GARY WAGNER:

I read the entire article.

Death panels is not a myth – it is a label. This bill created panels that have the power of life and death. You can reject the label, “death panel”, but you can’t reject the panel. They are real. They exist.

It was refreshing to have a little political balance (very little but at least there was some). There are three times as many “9-11 truthers” as there are “Obama birthers”. That shows that democrats are not immune to believing political myths.

It is interesting you focus on the issue of people losing their doctors with Hillarycare. That may or not have been true but the same debate occurred with Obamacare. He claimed over and over that we would not lose our doctors and if we like our insurance, we could keep our insurance.

My wife already lost her doctor because of Obamacare and we can’t find another because of Obamacare. I like my insurance but they announced that it has to change beginning next year – because of Obamacare. I don’t get to keep the one I like.

His own panel last week here said that 14 million people will completely lose their insurance because of Obamacare.

We have been hit with lie after lie already, so what credibility is there that there are no death panels?

For a year, we heard Obama mocking people that believed the “myth” that people would lose their doctor. It isn’t a myth – it is reality. He derided people for believing that they wouldn’t get to keep their insurance. People are losing their insurance.

I have dealt with death panels with my private insurance. My wife’s doctors agreed that the insurance company panel's decision to not cover a surgery she needed would mean she would die. Another state panel, you could also call that a death panel, overrode the insurance companies death panel and as a result, the surgery was covered and my wife is still alive today.

These death panels don’t go away. They already exist and they will continue to exist.

The only legitimate complaint about the term “death panels” is that it is a term that democrats despise. But it can’t be disputed that there are panels created in this bill that have life and death decisions. This term is like, “partial-birth abortion”. Abortion advocates hate that term because it sounds so much worse than “late term abortion” – but they are simply two different terms for the same thing. They hate the term, “death panels” for the same reason. It puts a label on a panel that does exist that democrats would much rather call a “Patient Cost Savings Commission”.

From your article: “I follow Nyhan and Reifler (N.d.) in defining political misperceptions to include both demonstrably false claims and unsubstantiated beliefs about the world that are contradicted by the best available evidence and expert opinion.”

By that definition, you can’t call the term “death panels” a misconception. There were specific claims made about the death panels that are false and can be called a misperception. But that isn’t enough to kill the label – which will probably persist forever because there is a basis in reality.

Democrats will just have to learn to deal with it like they deal with “partial-birth abortion” now.

What is the most interesting is how one simple claim, and especially one simple label can completely control the debate over a political issue. Both political parties have found those labels that frame the debate in the way they want it framed.

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Aaron_in_TX:

People believe a lot of wrong things because they either reinforce or otherwise allows them to wear their identity on their sleeve.

This is true for liberals and conservatives. When I see a person drinking a $4 latte at Starbucks and reading the $2 New York Times, I usually think that person is more interested in making a social statement about themselves than real interest in the news. They could have gone to Valero, gotten a 89 cent coffee and a 75 cent copy of the San Antonio Express News.

Another example is gun enthusiasts. They've been pushing the narrative that Obama wants to take your guns away. I've never heard Obama say one thing about guns since he's been president, and generally stayed away from the topic during the campaign. Yet, people have been making statements about their beliefs by stocking up heavily on guns and ammo, and some even wear their holsters to school or take their guns to rallies to make a statement.

So I think the misinformation may be believed by a few, but most use those kind of things as propagandistic bludgeons.

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Aaron_in_TX:

"I have dealt with death panels with my private insurance. My wife’s doctors agreed that the insurance company panel's decision to not cover a surgery she needed would mean she would die. Another state panel, you could also call that a death panel, overrode the insurance companies death panel and as a result, the surgery was covered and my wife is still alive today."

My dad also dealt with something like this. So the democratic claim that there are already death panels is a fair one. One may or not be better than the other.

Obviously health care is not an inexhaustible commodity and there has to be some rationing. We do it based on ability to pay or insurance situation. Other countries have wait times, although in my experience you can wait many weeks or months for specialists in the U.S. as well.

In my opinion the entire system from top to bottom is deeply flawed from the training of doctors and nurses to the unnecessary luxury that accompanies much of the delivery. It's too hard to become a doctor and when they do graduate they do so with insane amounts of debt. There are a lot of people who want to be nurses but not enough people who want to train nurses. Med techs with a 2 year degree make more than people with master's degrees, there's something wrong there.

So, I think the health care problem is systemic but no politicians from either party have the courage to actually make some fundamental changes to that system.

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GARY WAGNER:

I used one in the army but I have never owned a gun (oh the things they would have done to me if I called it a "gun" in the army). I haven't bought one yet either but I'm still keeping one eye open to make sure a total ban isn't secretly buried in a bill that congress passes in the middle of the night on Christmas eve.

The level of believability in political myths and misperceptions is directly related to the level of trust in government. Trust in government is lower than it has ever been in history so the ground is extremely fertile for planting political myths and misperceptions.

And it is foolish to think that the republicans are the only ones planting those myths and misperceptions. In my opinion, democrats invented the practice. "Reagan is going to take your social security away", "Reagan is going to start a nuclear war", 'Reagan hates little children and wants them to eat nothing but ketchup so they will die.".

It probably started centuries before that but that's when I remember the myth mills ramping up to insane levels.

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Aaron_in_TX:

"Trust in government is lower than it has ever been in history"

I would say it was worse when 11 states so distrusted the newly elected president, they seceded. Also worse during the watergate era.

"that's when I remember the myth mills ramping up to insane levels"

If you have a chance read "The Paranoid Style in American Politics" by Richard Hofstader. It was written in the 60s but it's a good insightful overview of how illogical Americans can be about their politics, and it's happened throughout our history. You can find it on google scholar. One of my favorites.

Here's some great quotes from it that illustrate so well the conspiratorial thought that we have today:

"The final contention is that the country is infused with a network of Communist agents. just as in the old days it was infilrated by Jesuit agents, so that the whole apparatus of education, religion, the press, and the mass media are engaged in a common effort to paralyze the resistance of loyal Americans."

Sounds like he ripped that from Rush Limbaugh or Glenn Beck.

Another of my favorite quotes:

"This enemy is clearly delineated: he is a perfect model of malice, a kind of amoral superman: sinister, ubiquitous, powerful, cruel, sensual, luxury-loving. Unlike the rest of us, the enemy is not caught in the toils of the vast mechanism of history, himself a victim of his past, his desires, his limitations. He is a free, active, demonic agent. He wills, indeed he manufactures, the mechanism of history himself. Or deflects the normal course of history in an evil way. He makes crises, starts runs on banks, causes depressions, manufactures disasters, and then enjoys and profits from the misery he bas produced. The paranoid's interpretation of history is in this sense distinctly personal: decisive events are not taken as part of the stream of history, but as the consequences of someone's will. Very often the enemy is held to possess some especially effective
source of power: he controls the press; he directs the public mind through "managed news"; he has unlimited funds; he bas a new secret for influencing the mind (brainwashing); he has a special technique for seduction (the Catholic confessional); he is gaining a stranglehold on the educational system."

Sounds similar to how some folks talk about Obama, no? Particularly the parts about the press and educational system and manufacturing economic disasters, etc... "himself a victim of his past, his desires, his limitations" - ever see people talk about Saul Alinsky, Rev Wright, Karl Marx, et al when talking about Obama? Talk about victim of desires!

Some of what Hoftader alluded to there were some of the criticisms that were levied against John F. Kennedy, Dwight Eisenhower, and Harry Truman. The whole of the essay is so good, though, because it explains that the minority element in America is very likely to resort to sensationalism and conspiracism, has done so since the 18th century, and that is exactly what we see now. The difference now is that it all seems so loud thanks to the new media.

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GARY WAGNER:

The latest pew poll shows trust in government at 22% is lower than it has been in 50 years. That includes the watergate years and clinton in 94 when we came very close to this low.

http://people-press.org/report/606/trust-in-government

The last 2 times we were this close to these lows (1980 and 1994) Reagan and republicans swept into power in the biggest landslide in history and Republicans took 54 seats away from the democrats under Clinton.

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Ken:

The death panel term is silly for both the federal health care plan as well as for private insurers. It really should have been avoided by both sides.

That being said, I have had to do "battle" with private insurers for my patients, and have failed occasionally. I haven't had to to do this with publicly insured patients, at least not yet. Sometimes losing your job and going on public aid can be lifesaving, at least in states with functioning health care systems.

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Ken:

The death panel term is silly for both the federal health care plan as well as for private insurers. It really should have been avoided by both sides.

That being said, I have had to do "battle" with private insurers for my patients, and have failed occasionally. I haven't had to to do this with publicly insured patients, at least not yet. Sometimes losing your job and going on public aid can be lifesaving, at least in states with functioning health care systems.

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I wrote about my own experience with my mother and father in law that led me to believe there is absolutely a need for so-called "death panels" (http://bit.ly/aoRTY5). That may sound strange, but please be assured that I love both of these relatives. The problem is that our society wants to prevent death at any cost, unless it is very clear that there is no option. Sometimes, though, all the other options aren't really good choices for anyone, but nobody will say that because patients want to live, families want their relatives to live, and doctors want to help them live. But what's the price (and I don't just mean in dollars). Sometimes death is right, and a group on the outside should be able to step in to say it.

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