Today's blog is my first since returning from a family vacation in London, U.K., during which I was able to follow the U.S. health care debate via the internet. I found it interesting that British politicians were drawn into the U.S. debate, with the leader of the conservative Tory party repudiating remarks from members of his own party that were critical of the U.K.'s National Health Service. (Their remarks had been cited by U.S. critics of health care reform, even thought Obama hasn't promised anything even remotely akin to the NHS.)
During the weeks while I was gone, the debate in the U.S. took a serious turn away from consensus. Instead of moving toward common ground, we have seen warring ideological camps go into attack mode. Instead of all sides listening to each other, we have seen town hall meetings devolve into shouting matches and invective. Instead of arguing on the basis of a common understanding of the facts and evidence - and from there, debating our legitimate policy differences - we have seen misinformation designed to stop health care reform spread like wildfire.
Howard Kurtz writes in the Washington Post that an effort by the mainstream media to debunk even the most inaccurate and outrageous claims - such as that the House bill will create "death panels" to cut off care to the elderly - are not believed by much of the public:
"The crackling, often angry debate over health-care reform has severely tested the media's ability to untangle a story of immense complexity. In many ways, news organizations have risen to the occasion; in others they have become agents of distortion. But even when they report the facts, they have had trouble influencing public opinion."
(Kurtz's online discussion about his column makes for interesting reading.)
Now, I believe that critics of how health care reform, as it is being pursued by President Obama and Congress, have a right and responsibility to make their best case for a different approach and to cite the facts and evidence to support their views, just as proponents must do the same. But I also believe that the public is not well-served when people cross the line from making a principled argument to spreading outright untruths to score political points. Nor is a free and open debate served when people shout down those who disagree with them. Two independent and well-respected fact-checking websites (Politifact and FactCheck) have shown that both sides are guilty of stretching the truth, but some of the biggest whoppers are coming from critics of health care reform.
I also believe that physicians have a special responsibility to get the facts about health care reform. Doctors are trained to analyze evidence to reach the best possible treatment decisions for their patients. No patient would trust a physician who ignores the facts of their case or falsifies the presenting information to make it fit a diagnosis. The public should have the same expectation that physicians will strive for accuracy in weighing conflicting information about the implications of proposed health reforms. As an evidence-based scientific organization, ACP has made resources available to ACP members to help them make their own informed judgments, based on the facts and evidence.
To be sure, "facts" about public policy aren't always clear cut, may be contradicted by other facts, can be cited or ignored selectively to make a point, or may be viewed differently depending on one's own views. As Mark Twain famously wrote, "there are three kinds of lies: lies, damned lies and statistics." By the same token, though, some things about health care reform are either true or false. Saying, for instance, that the House health care reform bill would allow the government to set up "death panels" simply is untrue, while arguing that the government should stay out of discussions of living wills is a legitimate point of view, and worthy of debate.
Today's questions: Do you agree that the health care reform debate is being poisoned by mischaracterizations and untruths? What responsibility do physicians have to get the facts straight?