Health Care: Appeals to fear, anger, and hate gain traction when ignorance is wide and deep.

[Sue Copening]

By Sharon Begley | NEWSWEEK
Published Aug 15, 2009

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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[Cheryl M]

I am a "tea bagger" and believe we don't have the money to expand medicare which is essentially what is needed if we want to try to insure everyone. I am all for changes in the system, but disagree with all the rhetoric on both sides of the issue, from death panels to you will get to keep your doctor and insurance and knowing how all government programs that are implemented always go bankrupt and force taxes up.

Just do this one thing. Look up how much money we are paying per WEEK on INTEREST alone on the money we have borrowed from China these past 4 to 5 years after the 1st "stimulus" package. China has a right to come and evict us all from America.

Also a large percentage of people NOW qualify for medicare and don't use it. So basically what I think they are proposing is that everyone be made to pay for it (sign up if they aren't already; no go out and buy private, because they won't be allowed once it is established) even if they don't use it which will help pay for the people who frequent the ER's (who do not have life threatening illnesses; some people go to the hospital for every minute thing; and if it's free, they will go more).

.. it is a mess yes, but we can't afford what is on the table now, which is overtaking the entire industry and regulating it as a whole unit; allowing the existing private "industry" remain, but not fund it the way it was; and all the people who have insurance they like will end up without or have to buy into the government option because the existing companies will likely consolidate, or reorganize or disappear altogether and companies who provide insurance availability to their employees will dump their insurance altogether and pay what ever penalty they are charged with and allow their employees to use the government insurance.

I personally am very fortunate to not need to go to a doctor and just recently had a need for dental work; wherein I recently purchase dental insurance (which is affordable surprisingly; after hearing all about the high cost of insurance). I still have to wait one year before I can use the benefits.

I strongly believe there is a change needed regarding the COST of heath care; but does the government have MONEY and do you think that because the government gets involved that there will be better availability? Maybe so, but at what "cost".. money or quality.. everybody knows how all government agencies are run and want no part of it if it can be avoided. We must find a solution; and I suggest forming alliances between small companies and co-ops (not government sponsored) which is really in the works. I have seen improvements over the last 10 years without government intervention.

[Sue Copening]

Obviously we do need a change. It might be smart to look at the countries that DO get it right, like France, who has the number one health care system in the world, and design a similar system.

France's system is a combination of government PAID health care AND private, supplemental policies.

But some of your points don't really make sense... for instance the reason people now overuse the Emergency rooms is precisely because they don't have health care or insurance, so end up waiting until it is an emergent situation. Then they go to the ER because they are required to treat them, and we all end up paying for it in the cost of ours.

I am not in favor of the current bill. I like HR676 much better. This current one on the table doesn't go far enough to remove the "for profit" incentive of taking peoples money, then denying their claims. Also... about 1 in every 3 dollars goes toward billing and marketing.

In a single payer system you would save that dollar, and could put it toward care. Add to that all those ER users who now have a lower priced heath care provider to visit, eliminated expensive ER visits, and you cut out a lot of waste.

As far as putting private insurers in jeopardy. Frankly, I am more concerned with the lives and health of the citizens than I am with the profits of a corporation. Maybe if I worked for an insurance company then I might be willing to put the bottom line above peoples lives, but I don't.

Frankly, it disgusts me how so many insurance companies are willing to take peoples money, then spend every bit of energy they can trying to deny claims. And it's scary how, if you have a pre-existing condition and lose your job, your life is now in danger because you are uninsured and can't get new insurance because of the pre-existing condition.

It's also sad that so many people are trapped in jobs they don't like, because they are afraid to lose their health benefits (especially if they have a pre-existing condition). It makes us less of a free country. A single payer health care system would give people the freedom to change jobs, or become self employed, without worrying about their health care.

It's a complicated issue, the important thing is that people educate themselves, and speak up.

It is a myth though, that the government can't run things properly. For instance, military hospitals are considered to be the best in the country. But no one is even proposing that in a single payer system anyway. In a single payer health care system the government does NOT run the hospitals, they run the same way they always have... the govt simply PAYS the bills. People overlook that, or get confused about that.

I totally agree this country has a huge debt problem and basically all our citizens are indentured servants (enslaved by their debt), and work to keep the rich richer and the corporate profits flowing, the banks collecting their interest. But if you look at world history no government has ever remained a "super power" for more than 200 years. So, our time is over anyway.

[Cheryl M]

I will be researching the French system!

[Sue Copening]

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Here is a nice video...

[Sue Copening]

CLICK HERE for more: http://i.abcnews.com/GMA/CancerPreventionAndTreatment/story?id=4038...
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