If, this fall, proponents of health-care reform conduct a postmortem on how President Obama's signature issue went down to defeat—I'm not saying it will, but stick with me here—they will not be far off if they trace it to this summer's "great phrase face-off." From Obama, we got "bending the cost curve," his hope of slowing the rise in health-care spending. From Sarah Palin: "death panels." From Obama: "the status quo on health care...is threatening the financial stability of families, of businesses, and of government." From GOP strategist Frank Luntz and his clients: some bureaucrat will put himself "between you and your doctor, denying you exactly what you need." From Obama: "If you like your health-care plan, you can keep" it. From GOP Sen. Jon Kyl: "Imagine needing a new hip that will make it easier to get around, but just because you're over 75, the government denies you that surgery." Not to mention Republican Rep. Lamar Smith's assertion that the Democrats' bill "contains gaping loopholes that will allow illegal immigrants to receive taxpayer-funded benefits." And then there was that sign greeting President Obama outside an August town-hall meeting in New Hampshire: Obama lies, grandma dies.
Which phrases inspire you to grab a pitchfork, or at least e-mail your congressman: bending the cost curve, or stopping the government from condemning Grandma to death because treating her cancer is too expensive? Exactly.
Anyone who believed that the battle over health-care reform would be waged on facts, logic, reason, and concern for the less fortunate—46 million uninsured—probably also scoffed at Lyndon Johnson's daisy ad. As politicians and strategists (at least the successful ones) have finally learned, appeals to emotion leave appeals to logic in the dust. And no emotion moves people more powerfully than fear. To explain the remarkable traction that death panels and other lies have gotten this summer, however, you need to probe deeper than the emotions-trump-reason truism. The specifics of the exaggerations and misrepresentations that work best speak volumes about fundamental aspects of the American character, about the neuroscience of decision making, and about the extraordinary events of the past 12 months. Yes, I'm sorry to say that AIG is part of this story.
At this time last year, if you had asked people whether the federal government would effectively nationalize AIG and Fannie Mae, and whether the Dow would plummet to 6,627 in March 2009 after reaching 14,093 in October 2007, most would have confidently said no, that will never happen in my lifetime. And yet …c "In a world gone crazy, the impossible—even 'death panels'—suddenly seems possible," says psychologist Drew Westen of Emory University, author of the 2007 book The Political Brain. The idea of death panels gains further credibility, he says, "because many people are vaguely aware that end-of-life care is bankrupting Medicare and that at some point we have to figure out how to deal with that." Its plausibility grows even more when respected figures not known for being kooks or demagogues buy in. On Aug. 12 Charles Grassley, one of the Senate's more respected figures in health care, told an Iowa town-hall meeting that because the House health-care-reform bill includes counseling for end-of-life care, "you have every right to fear. You shouldn't have counseling at the end of life?.?.?.?We should not have a government program that determines if you're going to pull the plug on Grandma."
In fact, what the House bill does is require Medicare to cover appointments for elderly people who want to talk about end-of-life care with their doctor. If you have terminal, untreatable cancer and your heart stops, do you want chest compressions, which will likely break your ribs and cause excruciating pain? If you have a massive stroke and fall into a coma, do you want to be fed through a tube? As things now stand, the elderly have to pay for such consultations out-of-pocket unless they are covered by some Medicare Advantage plans. The House provision does not "compel seniors to submit to a counseling session every five years," as former New York lieutenant governor Betsy McCaughey wrote in the New York Post. But the idea of requiring Medicare to pay for the counseling (saving Grandma money!) morphed into Palin's Facebook post that people "will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgement of their 'level of productivity in society' whether they are worthy of health care."
The power of "death panels" as a phrase and a scare tactic also works because Americans are deeply uncomfortable with death. We don't like to think about it or talk about it, says bioethicist Tom Murray, president of the Hastings Center. Only 29 percent of us have a living will. As a result of that discomfort, reminding people of death sends them off the deep end, into the part of the neuronal pool where reason cowers behind existential terror. And we're particularly vulnerable to scaremongering in the atmosphere of dread created by the economic meltdown. When people are already scared about losing their jobs and their homes and paying for health care, it doesn't take a lot to make them afraid of one more thing. We're living with "free-floating anxiety" every day, says psychiatrist Louann Brizendine of the University of California, San Francisco. "The brain is signaling 'danger' right now. Whenever that happens, the brain typically loses its logical reasoning power." Fear is also the most contagious emotion. If Chuck Grassley is worried about death panels, millions of people reason (check that: feel), how can I be sure they're a myth?
Not by availing yourself of the seeming infinitude of information a click or two away. Yes, you can learn that a reference in Mad Men to Fielding beer is an anachronism; the brand didn't exist in 1962. But there is no interest group bent on convincing you that Fielding beer did exist then. In contrast, there is no shortage of groups, politicians, and just plain folks intent on proving that health-care reform will lead to, say, the rationing of medical treatments, and they all seem to have a Web site, blog, and/or Facebook page. Given that people who are sure that the U.S. government faked the moon landings (and that Obama was born in Kenya) can find support for their view online, how surprising is it that you can Google your way to "evidence" of all the evils of Obama-care?
Other health-care lies push the always-reliable hot buttons of sex, homophobia, nativism, and I've-got-mine-so-screw-you. Among them: under health-care reform, you'll have to pay for people's sex-change operations. (No such mandate exists in any of the Senate bills, or in the House bill.) It will cover illegal aliens, or, as a now viral post on a right-wing Web site put it, will cover "some baby making worthless immigrant [so she] can have her 5 brats." (No illegals will be covered. But don't worry: under today's system, some of your insurance premiums do pay for their medical treatment, to the tune of $1 billion a year, because illegals are guaranteed emergency care in every state.) Health-care reform, House Minority Leader John Boehner wrote in an op-ed, "will require Americans to subsidize abortion with their hard-earned tax dollars." (The current prohibition against the use of federal money for elective abortion—not in cases of rape or incest, or where the pregnancy threatens the woman's life or health—remains in place, and the House bill explicitly prohibits using federal money for abortion coverage. But the administration could decide to have a public plan cover abortion, and if the government subsidizes premiums for low-income people enrolled in private plans then, theoretically and indirectly, tax dollars could flow to abortion if the plan covers it). >>> CLICK TO CONTINUE
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