• Health care myths are a real problem

    In this month’s Medical Care there’s a great study by Brendan Nyhan and colleagues:

    Context: Misperceptions are a major problem in debates about health care reform and other controversial health issues.

    Methods: We conducted an experiment to determine if more aggressive media fact-checking could correct the false belief that the Affordable Care Act would create “death panels.” Participants from an opt-in Internet panel were randomly assigned to either a control group in which they read an article on Sarah Palin’s claims about “death panels” or an intervention group in which the article also contained corrective information refuting Palin.

    Findings: The correction reduced belief in death panels and strong opposition to the reform bill among those who view Palin unfavorably and those who view her favorably but have low political knowledge. However, it backfired among politically knowledgeable Palin supporters, who were more likely to believe in death panels and to strongly oppose reform if they received the correction.

    Conclusions: These results underscore the difficulty of reducing misperceptions about health care reform among individuals with the motivation and sophistication to reject corrective information.

    There’s also an accompanying editorial by yours truly. Here’s a taste:

    Medical myths are common.6,7 But I have always believed that with the right information and the right coverage we could convince people that vaccines do not cause autism, that you really do not need 8 glasses of water a day, and that sugar does not really make kids hyperactive. Nyhan and colleague’s work has forced me to question that belief. For many, it is not going to be enough to present them with the correct “facts.” For many, often the best informed among us, such efforts may backfire.

    Unfortunately, both are gated. If anyone comes across a legitimate link the the full articles, I’ll post them.


    • So if we just read PPACA we’ll understand it and love it? Is that what I am to conclude from this study? It’s one thing to make fun of vaccine/autism believers (the science is demonstrative of no link), but to say that one would like the ACA if only the “death panels” misperception were cleared? No, there are not death panels, but that doesn’t mean I like the bill any better. That’s a matter of the role of government, not a matter of science.

      • Generally people like PPACA better when it’s described without either that name or “Obamacare”. If you ask people about the following hypothetical proposal: “the government should prevent insurers from discriminating by pre-existing condition, mandate everyone get insured to prevent an adverse selection death spiral, and offer subsidies to those who can’t afford it”, significantly more people like that proposal than “Obamacare”, even though they’re the same thing.

        Sure, there’s lots of other stuff in PPACA, but nobody ever seems to mount role-of-government objections over e.g. tanning bed taxes or the IPAB.

        • So when premiums jump by 80% to accomodate all of those requirements, are these findings still going to hold? I’m still not seeing an argument deeper than what is taught in a Comms 101 course. Words can change, but the facts remain the same.

    • Is it possible politial idealogues will claim to not believe the facts even though they actually do, so that they can more reliably convince others to vote for or against a candidate for reasons other than the particular fact(s)?

      • That used to be the prevailing theory of right-wing propaganda, but it appears to be being replaced by actual epistemic closure (the “motivation and sophistication to reject corrective information” (ye gods, what a depressing phrase) referred to).

        As examples, take Mitt Romney’s apparent belief in the Benghazi talking points (from the debates) and the “skewed polls” theory (when he was apparently rather surprised at not winning easily). Even Karl Rove, the apparent personification of cynical propagandizing, got caught by the latter.

    • Seems like some people do not understand that “death panels” is a metaphor but those with high political knowledge do. Those who do not understand that “death panels” is a metaphor when explained what it means change position on the issue.

      That said what really bothers me about the “death panels” rhetoric is that no system in the world prevents one from seeking care that the system refuses to pay for. You can always pay for it directly yourself. Even the Canadian system, which is about the most restrictive i have heard of, allows a patient who would like to try a procedure that is not considered effected by the government can get the procedure ether by going to the US or by private providers in Canada.

      They should be called “refuse to pay for ineffective treatments panels”.

    • Politically informed supporters of an issue will respond to an argument against their beliefs by developing counter arguments, something that politically less sophisticated people have more difficulty doing.

      I hope they screened for prior knowledge of the death panel claim, otherwise the politically sophisticated are more likely to have known of it and developed a stronger more resistant belief in it.

    • The Kaiser Family Foundation did a study that found people liked parts of the health reform bill, when described one-by-one. When the elements were put under the umbrella of “health reform”, they were rejected. It’s the taint of government control that put people off, not the actual provisions of the law.