Brendan Nyhan has an op-ed in today's New York Times that applies the lessons learned from his research on dispelling political misperceptions to what President Obama described as the "overheated rhetoric" of the health reform debate. His argument:
[P]ublic knowledge of the plan's contents may not improve as quickly as Democrats hope. While some of the more outlandish rumors may dissipate, it is likely that misperceptions will linger for years, hindering substantive debate over the merits of the country's new health care system. The reasons are rooted in human psychology.
Studies have shown that people tend to seek out information that is consistent with their views; think of liberal fans of MSNBC and conservative devotees of Fox News. Liberals and conservatives also tend to process the information that they receive with a bias toward their pre-existing opinions, accepting claims that are consistent with their point of view and rejecting those that are not. As a result, information that contradicts their prior attitudes or beliefs is often disregarded, especially if those beliefs are strongly held.
Regular readers will recall that I summarized his argument in a column two weeks ago, and that it is based on a research conducted with Georgia State political scientist Jason Reifler (who, interests disclosed, once worked for me at my old polling firm). The Bottom line is that the simple "corrections" of factual misrepresentation we sometimes see in news accounts are not likely to dispel them, especially if the partisan wars over health reform continue.
One very important part of this discussion involves when and to what degree Americans start to feel real benefits from the health reform law, something Brendan addresses briefly:
In addition, some have suggested that personal experience will change Americans' beliefs about health care reform. But that reality will also take a long time to arrive for most voters. It will be years before many people experience substantial changes in how their health care is paid for or delivered. Even after the insurance expansion is complete, it's not clear that direct contact will correct the public's mistaken beliefs -- remember the town hall participant who told a Republican congressman last summer to "keep your government hands off my Medicare"?
I wrote another column back in September that pondered how public opinion on health reform might evolve if the legislation passed, focusing on the lessons learned from the implementation of the prescription drug benefit in Medicare, known more formally as Medicare Part D. The short version is that in the immediate aftermath of passage in early 2004, the Kaiser Family Foundation found that seniors were mostly negative about the new law (17% rated it favorably, 55% unfavorably). Their impressions did not begin to turn for more than two years when seniors finally started receiving their drug benefits.
While, as Brendan notes,"the most far-reaching changes" of the new law " won't take effect until 2014," there are narrower benefits that will begin this year, including a special insurance pool for those denied insurance due to pre-existing conditions, some insurance subsidies for small business, the closing of the Medicare Part D "donut hole" for seniors and a provision allowing young adults to remain on their parents' insurance policies until age 26.
A big and difficult question in all of this is the degree to which those benefits are perceived by those who receive them, and the degree to which those perceptions travel to others via word of mouth. One of the things that always struck me when I conducted voter groups is how many average Americans were able to share stories about someone they know with a health insurance horror story: Someone who has been denied coverage or payment or had trouble obtaining insurance. Most Americans have employer provided health insurance (or Medicare or Medicaid) and are happy with it, but stories about those left out travel easily. Will any of the new reforms create a similar sort of buzz that's positive?