< Rewrite


Friday, May 22, 2009

BOB GARFIELD: Last week saw the beginnings of a multi-million-dollar ad campaign by opponents of Obama's not-yet-announced health care reform plan. The ads featured Britons and Canadians who say they've been let down by their country's health care programs.

BRITISH WOMAN: If you have cancer in the U.K. today you are going to die quicker than any other country in Europe.

BOB GARFIELD: Those spots, brought to you by the PR firm responsible for the Swift boating of John Kerrey, mark the beginning of round two in the U.S. health care wars. The political right won the first round when it knocked down Hillary Clinton's proposed health care reforms back in 1994. We wondered if this preemptive strike could, in fact, derail health care reform efforts a second time around, especially when we recognized a familiar voice making the cable news rounds.

WOMAN: Embedded in this stimulus legislation which has already passed are provisions that will mean less health care for you.

BOB GARFIELD: That voice belongs to Elizabeth McCoy. Way back in 1994 she wrote a piece for The New Republic called "No Exit" which radically reframed the health care debate. McCoy claims to have painstakingly gone through the bill as a disinterested observer months before she happened to run, successfully, as a Republican lieutenant governor. At the time The Atlantic's James Fallows wrote about the article and found that McCoy's reading of the bill didn't exactly square with the bill as written.

JAMES FALLOWS: What she found was something that was summarized in her article by saying, quote, "The law will prevent you from going outside the system to buy basic health coverage you think is better. Quote. The doctor can be paid only by the plan, not by you." that is, you'd be stuck with this presumably mediocre government health insurance coverage and nothing else. It would be the nightmare of the East German medical system where you were stuck with no anesthesia and whatever the government doctor decided to give you.

BOB GARFIELD: So The New Republic is an influential magazine. However, it isn't "American Idol." Not every American is even aware that it exists, much less following every policy-wonkish piece about health care reform in it. It took talk radio and the rest of the Republican echo chamber to turn her piece into conventional wisdom.

JAMES FALLOWS: George Will was a crucial link in the chain because in his Newsweek column he turned the idea that you wouldn't be able to choose your doctor into the "doctors in jail," that phrase which then turned up in talk radio. The talk from his column was, quote, "It would be illegal for doctors to accept money directly from patients and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem necessary," unquote. Now, this was just simply wrong, and there was no provision in the bill for anything like this. But Rush Limbaugh had the "doctors in jail" theme which then was propagandized. And "doctors in jail" beat whatever Hillary Clinton and the rest were able to say against it. One intermediate factor is that the White House prepared a rebuttal to McCoy's piece, which The New Republic failed to run, and there wasn't a blogosphere then to say look, "doctors in jail" is just wrong.

BOB GARFIELD: And, you know, I was going to ask you a question where were the Andrew Sullivans of 1994, you know, the bloggers who come in and truth squad assertions of this sort and dissect them and so forth? But [LAUGHS] I know where Andrew Sullivan was in 1994.

JAMES FALLOWS: Yes - yes, you raise the awkward truth that Andrew Sullivan was the editor of The New Republic at that time who both ran the piece and then didn't run the reply from the White House. Andrew Sullivan is now my colleague and friend at The Atlantic Monthly, with whom I [LAUGHS] — I agree on most items of policy. This is one where we disagree about whether that piece should have been run in the first place and whether the White House's reply should have been carried in. And I think it's a really important fact about the ecology of news and opinion in the time since then; we can lament many things about the rise of sort of politically anchored cable news channels, where there is MSNBC against FOX and there are all these blogospheres, but it meant that in those days something that was plainly false, and provably false, could not be knocked down because there wasn't an alternative machine to deal with it.

BOB GARFIELD: And then there was the historical efficacy of "the big lie" to begin with. If you can somehow distill the public's fears around a horrifying notion, it sort of doesn't matter whether it's true or not. You can still — you can still worry the public, no?

JAMES FALLOWS: It — it's a great point. And here — here's the illustration of it: the big lie if you pay your doctor for care you need, he's going to jail for 15 years and maybe you too. Here's the rebuttal to it, which is essential — almost on the first page of the act, which says, quote, "Nothing in this act shall be construed as prohibiting any individual from purchasing any health care services." Unquote. Now, that's pretty clear legally in a court of law that would carry to the day, but it doesn't have the same punch as "doctors in jail."

BOB GARFIELD: So I guess what it comes down to is this, Jim: 15 years ago there was no blogosphere, there was talking points memo to go over the health care proposal line by line. Can you Swift boat a policy issue in 2009 in the way that they were able to pull off during the Clinton Administration?

JAMES FALLOWS: You can probably do it in some way, but I think that particular form of misinformation is a lot harder now. And, interestingly, there's a test case to this effect because back in February of this year the same Elizabeth McCoy had a similar kind of foray she was using preemptively against Obama's health care plans. There was part of the stimulus bill which had a provision trying to expand the use of electronic medical records, and she misinterpreted this as being something that would restrict the kind of care doctors could give, which was not the case at all. The significant thing is there was instant feedback. There were bloggers from all over the place, including in a modest way, me, saying, look, this just is false. And that didn't get any kind of traction. And so, in that one test case, you know, if the same kind of response system had been there 15 years ago the results could have been different.

BOB GARFIELD: Jim, thank you so much.

JAMES FALLOWS: My pleasure. Thank you.

BOB GARFIELD: James Fallows writes for The Atlantic and is the author of "Postcards from Tomorrow's Square, Reports from China."