A couple of months ago I wondered why many policy issues continue to be treated as ideological or political (supposedly reflecting differences of opinon or taste) as opposed to broadly scientific. We've got tons of evidence, for example, about which approaches to health care provide the most health for your buck, and interestingly, in this case, all the main desiderata---for an economical, humane, effective system---point toward single-payer or at least the general availability of universal, not-for-profit care. The measly public option that is presently under discussion in the U.S. would appear to be the bare minimum one might do by way of respecting the clear facts... so (to raise just two questions) why aren't (supposedly reality-based) progressive politicians and mainstream media hammering home facts clearly supporting a public option, and why are so many right-wingers frothing at the mouth about it?
I don't think the answer to the first question can ultimately advert to politicians or media being in the pocket of the health insurance industry. For example, politicians aren't really getting that much in campaign contributions---a few mill, tops (which makes me wonder why someone doesn't do whatever it would take to guarantee that these guys would, if they did the right thing, get compensating grass-roots monies). Moreover, it's clear that in many cases no amount of lobbying would provide reasonable grounds for a politician to support an empirically discredited cause (e.g., Christian Science).
So I guess I still don't understand why politicians, pundits and the media don't just keep throwing up slides showing, in particular, cost and health- and life-expectancy figures as between the U.S. and all the developed and semideveloped countries with government-based universal coverage.
I was thinking that the presupposition of the first question (namely, that the facts aren't getting out) suggested an answer to the second question. The reason so many U.S.-ers don't "get it" is that so many U.S.-ers are, for whatever reason, generally unaware of the empirical facts, about health care and other pressing issues of the day. Relatedly, as a friend pointed out, many are unaware of relevant causal mechanisms between things that they protest against (e.g., "socialist" health care and education) and things they desire (e.g., stable, safe and fulfilled people and communities.)
This is certainly part of the answer, and would explain why people better at accessing information tend to support heath care reform:
A guy at AEI has a piece
about how younger voters feel about health care. He begins with a
relatively accurate description of how he thinks younger people today
function, calling them “generation choice”. Then he posits three
reasons why younger voters might be better disposed towards health care
reform than older voters: (1) they haven’t analyzed the bill, (2) they
care more about the fairness of expanded coverage, and (3) they don’t
care much about health care because they’re young and healthy. There’s
an obvious fourth reason: they know that our system costs nearly twice
as much as anyone else’s and is consistently ranked at the bottom in
quality among western countries. Hence, they would choose a different
system if possible.
It’s always important to remember that
many, if not most, beliefs and customs in our society exist because of
the widespread propagation of falsehoods. It’s why some people believe
we have a great health care system. It’s also why some American League
managers continue to use the sacrifice bunt.
For whatever
reason, the internet has curbed the spread of these falsehoods among
(the mostly younger) people who are able to navigate the internet
without using AOL key words (though it may
well have hastened the spread among people who are not). And that may
well mark a sea change in American politics.
But it turns out that even when people are presented with the facts, there's no guarantee these will penetrate. As Sharon Begley explains:
Some people form and cling to false beliefs about health-care reform
(or Obama's citizenship) despite overwhelming evidence thanks to a
mental phenomenon called motivated reasoning, says sociologist
Steven Hoffman,
visiting assistant professor at the University at Buffalo. "Rather than
search rationally for information that either confirms or disconfirms a
particular belief," he says, "people actually seek out information that
confirms what they already believe." [...] "For the most part," says Hoffman, "people completely ignore contrary
information" and are able to "develop elaborate rationalizations based
on faulty information."
Of course, we all experience (dis)confirmation bias to some degree, but what is surprising is the extent to which retrospective rationalization ("inferred justification") can occur:
For their study, the scientists whittled down surveys filled out by
246 voters, of whom 73 percent believed in a Saddam-9/11 link, to 49
believers who were willing to be interviewed at length in October 2004.
Even after the 49 were shown newspaper articles reporting that the 9/11
Commission had not found any evidence linking Saddam and 9/11, and
quoting President Bush himself denying it, 48 stuck to their guns: yup,
Saddam Hussein, directly or indirectly, brought down the Twin Towers.
When
the scientists asked the participants why they believed in the link,
they offered many justifications. Five argued that Saddam supported
terrorism generally, or that evidence of a link to 9/11 might yet
emerge. These counterarguments are not entirely illogical. But almost
everyone else offered some version of "I don't know; I don't know
anything"—that is, outright confusion over the conflict between what
they believed and what the facts showed—or switched subjects to the
invasion of Iraq. As one put it, when asked about his Saddam-9/11
belief, "There is no doubt in my mind that if we did not deal with
Saddam Hussein when we did, it was just a matter of time when we would
have to deal with him." In other words, holding fast to the Saddam-9/11
belief helped people make sense of the decision to go to war against
Iraq.
"We refer to this as 'inferred
justification,'" says Hoffman. Inferred justification is a sort of
backward chain of reasoning. You start with something you believe
strongly (the invasion of Iraq was the right move) and work backward to
find support for it (Saddam was behind 9/11). "For these voters," says
Hoffman, "the sheer fact that we were engaged in war led to a post-hoc
search for a justification for that war."
Begley suggests, plausibly, that anti-reform nuts are typically people who didn't vote for Obama (or more generally, think progressives are spawn of satan) and are accordingly mainly engaging in inferred justification for their anti-Obama/progressive stance.
UPDATE: On second thought, I'm not sure that the phenomenon of inferred justification ultimately undermines the basic (and more hopeful) thesis that those clinging to discredited beliefs are suffering mainly from ignorance. Wrt the study case, for example: what the clingers seem to be doing is trying to make some rational sense of why we went to war... they cling to the Saddam connection (perhaps) because they are unaware of alternative explainations, primarily related to oil- and related military-industrial-corporation complex considerations.
