The Future of Health Care Misconceptions.

In today's New York Times, Brendan Nyhan cautions Democrats not to convince themselves that now that health-care reform has passed, people will stop believing in death panels and socialist takeovers. "While some of the more outlandish rumors may dissipate, it is likely that misperceptions will linger for years, hindering substantive debate over the merits of the country's new health care system. The reasons are rooted in human psychology." 

He points to some compelling research that he has performed, indicating that people continue to believe untrue things even in the face of correction. And sometimes, telling them the truth actually increases their certainty about the false thing they believe (e.g. that Saddam Hussein had weapons of mass destruction, or that Bush's tax cuts decreased the deficit). The most plausible explanation is that, faced with a refutation that undermines a belief in which they're ideologically invested, people exert cognitive effort to argue against it and convince themselves even more strongly.

Near the end of the piece, Nyhan says, "Even after the insurance expansion is complete, it’s not clear that direct contact will correct the public's mistaken beliefs — remember the town hall participant who told a Republican congressman last summer to "keep your government hands off my Medicare?" This is a valid argument -- but only to a point. Let's keep in mind that the subjects on which Nyhan has tested this effect are remote. The deficit may be a real thing, but to an individual it's an abstract calculation. Saddam's phantom weapons existed half a world away and we never saw them in the first place. So it can be easy to convince ourselves they were there all along, but were spirited away to Syria (the Hannity explanation).

Health care, on the other hand, is something we actually experience. Nyhan correctly points out that many of the provisions of reform won't take effect for years, but once they do, people will have direct, personal experience with them. It will be awfully hard to tell people that, for instance, the insurance exchanges represent an assault on their freedom if they've actually visited their state's exchange and liked what they found. You can tell people that if a reform passes, a government bureaucrat will be getting between them and their doctor, but it's much harder to tell them that a government bureaucrat is currently getting between them and their doctor if things between them and their doctor seem to be going just fine.

There are certainly opinions that won't be dented by the success of reform. But let's think again about that senior citizen telling government to keep its hands off his Medicare. He may be more distrustful of government than progressives would like. But one thing you can say about him is this: He loves his Medicare. Republicans know that, which is why they pretend they favored Medicare all along. If the same ends up being true of the system this reform puts in place, then that will be more than enough to celebrate.

-- Paul Waldman

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