Facts? We Don't Need No Stinking Facts.

People like me often complain about "he said/she said" reporting, which treats all claims by competing political actors as having equal validity, and doesn't bother to determine whether one side or the other might not be telling the truth. There are lots of reasons why that kind of reporting is harmful, but it's important to understand that it doesn't just keep people soaking in a lukewarm bath of ignorance, it can actively misinform them, leading them to believe things that are false.

Today's New York Times has a textbook example of what happens when political reporters can do when they refuse to adjudicate a factual dispute between candidates. In the story, Michael Barbaro doesn't just allow Mitt Romney to deceive, he actively abets that deception in the way he constructs his narrative. Here's the key excerpt:

In a speech here in Orlando, Mr. Romney seized on a statement that the president made on Monday about the Affordable Care Act.

In an interview, a television reporter had asked the president about a small business in Iowa, whose owner claimed that the president's health care legislation had contributed to its closing in the state. Mr. Obama said that such an assertion of cause and effect was "kind of hard to explain."

"Because the only folks that have been impacted in terms of the health care bill are insurance companies who are required to make sure that they're providing preventive care, or they're not dropping your coverage when you get sick," Mr. Obama said. "And so, this particular company probably wouldn't have been impacted by that."

A gaffe? Mr. Romney treated it that way, and in his speech at a factory that makes air filters, he called the statement "something else that shows just how much out of touch" the president is. "He said he didn't understand that Obamacare was hurting small business," Mr. Romney said. "You have to scratch your head about that."

Mr. Romney cited an online survey of almost 1,500 small-business owners, performed last July for the U.S. Chamber of Commerce, which found that three-quarters of them said they would be less likely to hire because of the burdens of the Affordable Care Act.

The candidates disagree about things many, many times a day, but because Barbaro's whole story is about "gaffes," his inclusion of this particular disagreement implies that Obama's statement must belong in that category. After all, if what Obama said was a plainly accurate description of the Affordable Care Act, then not only wouldn't it be a "gaffe," the disagreement would actually be an example of Mitt Romney being dishonest. But Barbaro classifies it as a gaffe (and don't tell me the inclusion of a question mark gets him off the hook for doing so), which can only mean that Romney is right, or at the very least that Romney has a reasonable case to make.

But of course, that's not true. Not even remotely. Obama was absolutely accurate in what he said. First of all, there are no provisions of the ACA that have already taken effect that affect small businesses. Secondly, the provisions that will take effect in 2014 will benefit small businesses. So if there's a business owner in Iowa who says he closed his business because of the Affordable Care Act, there are only two possibilities: either he's crazy, or he's lying. It's as simple as that. It would make no more sense to ask the president, "Mr. President, there's a guy in Iowa who says his business shut down because the Lilly Ledbetter Fair Pay Act mandated that he spend eight hours every day building life-size butter sculptures of Bella Abzug and Gloria Steinem, and that left him no time to balance his books. Doesn't this show that the law is imposing impossible burdens on small business?"

I don't doubt that many small business owners believe that the Affordable Care Act is one day going to impose some terrible, as-yet-to-be-specified burdens on them. After all, they've been told that many times by Republicans, by conservative media figures, and by pro-Republican groups like the U.S. Chamber of Commerce. I'm also sure that many small business owners believe that they've been abducted by anal-probing aliens, or that astrology is a science. But that belief doesn't make it true. There is an objective reality here, and it isn't a complicated one to figure out.

If the candidates have a disagreement about how the ACA affects small businesses, and a political reporter isn't actually familiar enough with it to determine who's telling the truth, he has a few choices. He could use that secret trick known to only the most experienced journalists, called "picking up the phone," and call someone who knows what the Affordable Care Act does, and ask that person how it affects small businesses. There are a few hundred people in Washington who'd be happy to take his call and explain things. The reporter could also go to this thing called "the Internet," which can prove quite helpful on matters like this one. If you type "Affordable Care Act provisions affecting small businesses" into Google, you get this handy fact sheet from the Kaiser Family Foundation as your first result. Read it and you'll learn that most of the provisions relating to small businesses will make the coverage they obtain more comprehensive, and probably less expensive. You'll also learn, if you didn't know it before, that companies with fewer than 50 employees are exempt from the Act's requirement to carry health coverage. It's true that companies with over 50 employees will have to offer insurance to their employees, but the fact sheet will tell you, intrepid reporter, that 92 percent of companies with between 50 and 100 employees already do, as do 97 percent of companies with over 100 employees.

These aren't complicated things to learn. You don't need a public policy degree to grasp them and incorporate them into your reporting. You could even ask Romney or his representatives exactly what burdens they believe the ACA imposes on small business, and when they say, "Um, regulation and stuff!" ask them again to be specific, and when they can't actually come up with anything, relate that fact in your story. Or there's a final option available to you, one that this reporter chose, and many other reporters do every day: You can just not bother to find out the truth and share it with your readers. Why do they deserve it, anyway? Better to just wait for the next exciting "gaffe" and write four or five stories about that.


With or without Obamacare, there is on the horizon a problem that few even discuss. Consider:

Most of us drive our vehicles very carefully, even though we have insurance to cover accidents.

But suppose you had no insurance. (I periodically went without it when I was a young adult and earning a pittance.) Think how much more carefully you'd drive! And how much more slowly. Yes, you would. And you'd likely drive less. (And maybe walk more and become healthier for it.)

For many people, I suspect, the more auto insurance they have, the more they tend to drive and to drive faster and less guardedly. (For proof of that, keep imagining how you'd drive without insurance.) That means more accidents in which people are killed and injured. Although insurance is a wonderful thing — preventing, for example, countless bankruptcies and bestowing peace of mind — it might have the unintended consequence of causing more accidents and more deaths and injuries than if no one had insurance.

Now consider:

In a report on how to fight pandemics, the March 2012 Discover magazine says the secret to fighting them is “knowing their real cause: disease factories built by people. Ironically, hospitals turn out to be highly efficient disease factories. They allow the proliferation and spread of dangerous germs among patients, and the evolution of those germs to extreme levels of virulence.”

In that same vein, the Journal of the American Medical Association warned us 12 years ago:

“America's healthcare system is the third leading cause of death in the U.S., causing between 230,000 and 284,000 fatalities per year, behind only heart disease and cancer.”

The report didn't say the third leading cause of death is poor health. It said the healthcare system itself. In other words, our country's third leading cause of death is the army of good-intentioned doctors, nurses, and others whose ultimate duty is to help us avoid death.

JAMA provides a breakdown of the deaths caused by healthcare:

- 12,000 deaths per year due to unnecessary surgery
- 7,000 deaths per year due to medication errors in hospitals
- 20,000 deaths per year due to other errors in hospitals
- 80,000 deaths per year due to infections in hospitals
- 106,000 deaths per year due to negative effects of drugs

Then add the nearly 200,000 patients that may be killed each year by blood clots following surgery or illness, the leading cause of preventable hospital deaths in the U.S., according to David Goldhill, author of “How American Healthcare Killed My Father,” citing a report in The Wall Street Journal. (Watch Goldhill's video at http://www.cato.org/event.php?eventid=6597)

It makes one want to ask an absurd question: “Why don't we drop our health insurance and stay away from doctors?”

If no one had health insurance, lots of things could happen, good and bad. Here's a quirky thing I believe is possible:

In 2008, shortly after the economic collapse, I was watching a CNN reporter interview a woman on the street. She had just lost her job. The reporter asked how she was coping.

“Along with my job, I lost my health insurance,” she said [I paraphrase]. “Now I have to really be careful to watch what I eat, lose weight, exercise, and take better care of myself.” I got the impression that while she had health insurance, she tended to be a bit reckless with her health, figuring she was covered if she got sick.

Some people, maybe many, are like that, due to what is called the “moral hazard.” (See http://www.slate.com/articles/business/the_dismal_science/2011/07/does_health_coverage_make_people_healthier.html, which says, “Insurance is also the source of what economists call ‘moral hazard,’ where those who are protected against the consequences of their actions take greater risks than they otherwise would.” See also “The Oregon Health Insuance Experiment” at http://www.nber.org/papers/w17190.pdf?new_window=1: “Although health insurance is expected to improve health through increases in the quantity and quality of health care, it is also possible that by reducing the adverse financial consequences of poor health, health insurance may discourage investments in health and thereby worsen health outcomes.”)

Without health insurance, CNN's interviewed woman became like the driver without car insurance.

Enter President Obama's Affordable Healthcare Act (AHA), whose aim is to get everyone insured and require everyone to pay a premium.

A lot of young adults currently elect to have no health insurance (as I did years ago) because of its cost, or because they want to save money while they're young and healthy. Once forced to buy insurance under AHA, many can be counted on to frequently see a doctor for minor things simply “to get my money's worth.”

How many more people, BECAUSE they have insurance, will pay less attention to diet and exercise like CNN's woman on the street, and develop medical problems (such as diabetes) that require visits to the doctor that they would not have had to make while uninsured and cautious?

AHA will bring an estimated 32 million more people, mostly young adults, into the healthcare system and countless others into it more often. It's obviously supposed to do that, because Mr. Obama wants to spread the health around.

Moreover, every day for the next 18 years, 10,000 Baby Boomers will reach age 65 and become eligible for Medicare; many of them will seek healthcare services before losing their employer insurance, and many others who'd had no insurance and had put off healthcare will put it off no longer.

Finally, we have a obesity epidemic that is growing, especially among the young for whom obesity has jumped from 9% of the adolescent population in 2000 to 23% in 2008, and threatening to overwhelm our health care system. The main threat is the costly diabetes that is often obesity's side effect.

The upshot is that millions more will interact with the healthcare providers who are, according to JAMA, our nation's third leading cause of death.

These providers, unless there is a huge increase in their already insufficient number, will be stressed by the increased demand for services. Their error rate is likely to rise.

Could our healthcare system then become the second leading cause of death? Or even, in the greatest of ironies, the first?

Do we really know what we're doing? A tsunami is coming.

Having health insurance doesn't encourage people to be careless with their health.

Why? because good health is pleasant and poor health is unpleasant. And because preventative care improves health.

If access to health care enables unhealthy living, and lack of access leads to healthy choices, poor people would be healthier, on average, than rich ones. We know that's not the case.

Male Matters... you are one smooth Troll my friend.

Nobody drives less cautious because they have car insurance. People who don't have insurance don't drive any more cautious. People drive as cautiously or recklessly as they see fit. That in and of itself creates an informal fallacy.

http://home.honolulu.hawaii.edu/~pine/EL/chapt4-EL-am.pdf is a link to a great paper on what an informal fallacy is.

Also people choosing not to have insurance because they cannot afford it is the very reason that Obamacare as you call it was passed. We did make a deal with the devil in how it's implemented only through private health insurance companies who will offer varying health packages. These various packages will further stratify care in this country.

Also those facts you keep citing only point to the problem with a broken class system in this country where the rich get great healthcare the middle class get mediocre healthcare and the poor get emergency care.

http://www.economist.com/node/13899647 is a great article on why stratified health care is bad for everybody.

However since I know you to be a B.S. spouting troll I'll not comment further on your alarmist claims, I really just posted those links so people can easily refute similar claims by other uninformed whackos.

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(If there's one thing we know about comment trolls, it's that they're lazy)