Healthcare, Lies, and Videotape, and More Lies

August 20, 2009
Posted by Jay Livingston

You can’t fool all of the people all of the time, said Honest Abe. Maybe so, but Lincoln missed the point. You only have to fool about half of the people every couple of years. And dishonesty seems to be a pretty effective way to do it.

Some of the assertions about health care reform –broadcast in the media and sent around the Internet – are just plain lies. Here are four of them. The assessments are from either PolitiFact or FactCheck.org

(For a larger, legible view, click on the image.)

Do these lies have any impact? A recent NBC/WSJ poll asked people how likely some of these outcomes were.

• Will give health insurance coverage to illegal immigrants
• Will lead to a government takeover of the health care system
• Will use taxpayer dollars to pay for women to have abortions
• Will allow the government to make decisions about when to stop providing medical care to the elderly

Does lying work? At least for the moment, it certainly looks as though it’s not doing the liars any harm.


One more thing. Of the people who had seen coverage of the town hall meetings, most (62%) said that these made no difference in their views. The rest were about evenly split – 16% said they’d become more favorable to the Obama plan, 19% less favorable, because of the protests.

(Hat tip: Ezra Klein)

Kind of Blue

August 20, 2009
Posted by Jay Livingston

Kind of Blue. The LP was released fifty years ago this week. It’s the best-selling album in the history of jazz, and year in year out, it continues to sell. Has anyone in the sociology of culture tried to explain this kind of durability?




It’s easy to explain how and why Kind of Blue was different and influential – its use of modes rather than chord changes as the basis for solos (though the first track on the album Milestones, recorded a year earlier, was also modal in concept). But that’s probably not much of a consideration for most people who buy and listen to the album. Its initial success owed something to the tastes of the time. It came out when jazz was at its most popular. But does that account for its continued popularity?

Are there other albums in other genres that still sell decades after they first came out. The Wall? Sgt. Pepper? The Glenn Gould Goldberg Variations?

Inside the Insurance Industry

August 19, 2009
Posted by Jay Livingston

Is just the threat of a public option changing the way insurance companies do business? I had to call my insurer yesterday to find out if an MRI at the place designated by my doctor would be covered. The MRI lab is in New York, my coverage is in New Jersey, so it wasn’t clear and simple. The guy I talked to was incredibly polite and helpful, checking every way he could, explaining the problem, asking if it was all right to put me on hold while he checked. He might as well have been saying, “We really, really want to keep your business.”

Meanwhile, if you had any doubts that the structural forces of the market affect health care, and not always for the benefit of the patient, check out this long interview with Wendell Potter. Potter is the former Cigna head of “corporate communications” who has been telling tales out of school, revealing what insurance companies actually do – how and why. (The “loss ratio” he refers to is the percent that the insurance company pays out to cover medical expenses. The lower the loss ratio, the higher the company’s profit. See this earlier SocioBlog post. )

As recently as fifteen years ago, the medical-loss ratio in this country was 95 percent. Since then, there’s been great industry consolidation to the point that now there are seven companies that dominate. They’re all for-profit. During the time that this consolidation, this shift to for-profit occurred, the medical-loss ratio has continued to drop. Now it’s around 80 percent. That means twenty cents of every dollar goes to something other than paying medical claims. Just fifteen years ago, ninety-five cents of every dollar went to paying medical claims. This trend is due to pressure from Wall Street. If a company misses Wall Street’s expectations—if the medical-loss ratio starts to inch up—the company will suffer. I’ve seen companies lose 20 percent of their stock value in one day by disappointing Wall Street with their medical-loss ratio.

Sightseers on the sociology tour bus will come across other points of interest in this interview.

• Social movements? The role of corporate PR in the “grassroots” reaction against health care reform. (“They’re skilled at setting up front groups to spread disinformation.” )
  
  
• Ideology? The relation between the insurance industry and Congress (“The industry has contributed so heavily to the Republicans over the years that they are pretty much assured that every single Republican in Congress will vote exactly the way they want.”)
  
  
• Social psychology? How the structure of insurance executives’ lives shapes their perceptions and misperceptions (“you get a very skewed understanding of America.”)

Potter also cites the events that led to his own apostasy (“Sicko,” a free health care expo at a fairgrounds in Virginia (“hundreds of people waiting in the rain while physicians attended to patients in animal stalls . . . ‘Is this the United States?’ ”).

The Roads Go Without Saying, Don’t They?

August 18, 2009
Posted by Jay Livingston

The Republican attack on Obama’s health care proposals has worked marvelously. The “public option” is all but dead. Harking back to Ronald Reagan’s line that “government is the problem,” Republicans railed against “government run” health care, stating as fact that the government can’t run anything well. For Republican lawmakers, this apparently includes the legislatures they themselves are part of. But pay no attention to that.

There’s a lot more to pay no attention to, and not just the government-run medical programs that do exist – the VA, Medicare, and Medicaid. Most of the protestors drove to their protests on government-run roads; most send their kids to government-run schools, and honor their government-run police and fire departments. . . .

Here’s Monty Python making the same point thirty years ago. “All right, but apart from the sanitation, medicine, education, wine, public order, irrigation, roads, the fresh water system and public health, what have the Romans ever done for us?”


(Hat tip: Mark Thomson at The League of Ordinary Gentlemen.)