Tuesday, February 23, 2010

How Does More Information Affect Attitudes Towards Healthcare Reform?

Apropos the debate we've been having regarding how more facts would affect political views, Tapped links to some interesting polling which sheds light on the question at least with regards to health care.

My thesis on these issues is that facts can persuade when the underlying dispute is factual, but not when it is based on values. So if American opposition to the Obama health care plan is based off a principled objection to government intervention in health care, then more facts won't change that value assessment. By contrast, if opposition is premised off factual miscues about what is in the bill, then providing the truth would result in some changes.

The poll in question first starts by simply asking respondents whether they support or oppose the Obama plan, and come out with a 40/48 split against. They then poll the individual components of the plan, finding that Americans like pretty much all of it, except the parts where they have to pay for it (Californians empathize). Finally, the poll informs the respondents that the previously named components are the Obama plan, and ask them again to register support or opposition. The results in this second round are a 48/43 split in favor -- not overwhelming, but still a pretty substantial 13 point swing (as TAPPED notes, this might understate things given the reticence some people might have to effectively admitting that their prior opposition was based off a lack of information and their own fickleness).

Consequently, it seems apparent that some, though certainly not all, opposition to the Obama plan is traceable to factual error. More importantly, the poll here indicates that this matters at the margin -- that is, providing the facts makes the difference between plurality opposition and plurality support.

18 comments:

N. Friedman said...

David,

I see real problems with your analysis. And, I say this as a person who genuinely supports reform.

First, you note in the poll that, except for having to pay something, there is support. Paying, however, is not a technicality. To most people, it is among the, if not the, main thing. This is something that us lawyers tend to forget, since we make better money than most people.

Further, on top of that, values will always be part of the reason that those who oppose do oppose the bill. Which is to say, while you can factor out values in a poll, it does not stay factored out.

So, if we create a poll that in effect factors out the reasons for opposition, we find improved support for the bill. Duh! Can you really wonder why such an approach might be seen as nuts from the perspective of a politician trying to get (re)elected?

On top of that, the poll covers registered voters, not likely voters. To politicians, the voters who count are those who vote, not those who register. And, polls of likely voters tell politicians that the President's proposal is poisonous to what politicians most care about, which is getting re-elected.

Lastly, there is the point that people have good reason to wonder about the cost of the proposal. While none of us can say for sure, those who claim that governments tend to play down costs are not liars. It is not as if the government's account of expenses has always turned out correct. You might recall the 2 billion dollar "Big dig" project in Boston which has thus far cost over 14 billion dollars.

That said, the current mess must be addressed. My impression is that the best way to go would be to expand medicare. That system is, at least, already set up such that there is some way to take an educated guess at the likely costs. Of course, medicare does not exactly run in the black but, I suppose, bringing in a large number of healthier young people might be beneficial.

That said, my proposal does not have public support, if one takes all of the facts into account. And, neither does the president's proposal, again, if all of the facts are taken into account. And, by facts, I include values and costs and reasonable skepticism, etc., etc.

David Schraub said...

All the post was arguing was that, for some non-trivial amount of people, hearing facts about health care form changes their opinions on the subject -- something we wouldn't expect to see if the opposition was based on values. I agree that it doesn't tell us anything more about the political consequences of enacting the reform.

I don't think the poll "factors out" reasons of opposition based either on value or cost. Any value based opposition shouldn't be affected by new facts (that's what makes it value-based opposition). And the cost issues were in fact presented to the voters, who, despite not liking it, swung in favor of the plan anyway. The poll was structured so as to get people to think both about the things they like and dislike about health care reform, and then decide whether it is worth supporting on the whole. The 48% who support reform after hearing the whole package presumably includes many of the folks who were unhappy about the prospect of paying for it, suggesting that for them this dislike is outweighed by the other components of the bill that they do like.

N. Friedman said...

David,

I said nothing about the political consequences of enacting health care reform. I said that the argument you presented was simple minded and wrong.

David Schraub said...

On top of that, the poll covers registered voters, not likely voters. To politicians, the voters who count are those who vote, not those who register. And, polls of likely voters tell politicians that the President's proposal is poisonous to what politicians most care about, which is getting re-elected.

Sounds like talk about political consequences to me. Outside political consequences, your "critique" is completely non-responsive to the argument of the post, which was nothing more whether factual knowledge changes attitudes on health care. That's all. And the evidence suggests it does, to the tune of a 13 point swing before and after a selection of facts were given to respondents.

N. Friedman said...

I wrote about how politicians would behave, faced with what they think voters will do to them if they vote for the President's proposal. You, by contrast, have stripped my words from their context. That is ok for a lawyer but no good for a budding scholar.

David Schraub said...

What you wrote, though, had absolutely nothing to do with my argument (information can affect attitudes is wrong because the poll canvassed registered instead of likely voters? Buh?) -- to say it shows that "the argument you presented was simple minded and wrong" is simply bizarre.

N. Friedman said...

David,

Not so. What I showed were weaknesses in your position, which was premised on a poll which is investigates the wrong universe of public opinion.

So, there were multiple problems with your presentation including, for example, (a) that you can isolate variables (including important variables such as the cost of health care insurance and the values which people bring to the table in making their opinions) and assume that the results of doing so translate to the real world and (b) that you can do so using a poll which was not aimed at the correct universe of public opinion.

So, yes, what you wrote was simple minded.

David Schraub said...

Not so. What I showed were weaknesses in your position, which was premised on a poll which is investigates the wrong universe of public opinion.

So, there were multiple problems with your presentation including, for example, (a) that you can isolate variables (including important variables such as the cost of health care insurance and the values which people bring to the table in making their opinions) and assume that the results of doing so translate to the real world and (b) that you can do so using a poll which was not aimed at the correct universe of public opinion.


Not only does this not disprove my hypothesis (facts can change opinions regarding health care reform), it doesn't relate to it.

"The wrong universe of public opinion" is an utterly meaningless statement except as a commentary on the supposed political upshot of my post, which I'm not talking about and you're denying you're talking about. It says nothing about whether facts can change attitudes -- at most, it says we don't know if facts can change the attitudes of likely voters, but I didn't make any claims about population subsets, just a very general "facts can change attitudes". Which it did, to the tune of a 13 point swing.

The variable isolation also is an inapt criticism, given that the comparison isn't between the generic support for health care reform versus support for disaggregated components, but support for health care measured before and after respondents were given information about the plan's component parts. In both cases, we're measuring support for the bundled package as a whole (which includes benefits and payment mechanisms, both of which were revealed to the respondents).

N. Friedman said...

David,

I quote your thesis - your words, not mine: "My thesis on these issues is that facts can persuade when the underlying dispute is factual, but not when it is based on values. So if American opposition to the Obama health care plan is based off a principled objection to government intervention in health care, then more facts won't change that value assessment."

You spoke specifically about the impact of facts on the health care debate and, then, used a poll to show how facts might change the dynamics of how people feel.

My response was to point out the obvious, namely, that you misuse the poll and, on top of that, the poll examined the wrong universe of opinion. Or, do you think it really matters if non-voters can be made to favor healthcare reform more than they now do? For your comment to be anything other than nonsense, you had to be interested in how facts effect the view of voters, not the view of non-voters mixed with voters.

Addressing the issue of isolating issues further, years ago, I was hired as an expert - which, in my field, I am fairly well known and recognized as such - to help try a piece of complex litigation. Eventually, co-counsel, from the other law firm involved, asked me to write a legal opinion regarding the settlement he had negotiated. He asked me to write the opinion based on the assumption that it was ok for the client to admit liability in the settlement. However, to the client, the issue of liability was more important than the details of the settlement so I knew that the attorney was playing games, hoping to have an opinion by which to convince the client to agree to the proposed settlement.

I refused, of course, because that is not what an attorney is supposed to do. I gave my unbiased opinion and noted the specific project I was asked to address along with my view that, given the client's objectives, the proposal was terrible. [Note to you as a young attorney: what I did is what is required by the cannons of practice but it had the consequence that the other law firm stopped referring work to me. Such is the price of being a lawyer, of course, and the client recommended me to others because I did good work, at least in my humble opinion.]

That story left an image in my head. And that is: one cannot really isolate variables and expect to understand how people will react when faced with the totality. In my mind, that is what you have done.

You want it to be that, when properly educated, more people will support health reform. However, that is not really so, because the "facts" are not as obviously what we would like them to be (e.g., the promised cost savings is likely BS and anyone who has any memory of how things in the world happen knows that is the case). So, if you can brainwash people into forgetting the obvious and convince them that your facts are the only pertinent fact and convince them to ignore their values, you might get converts who, after the poll ends, support healthcare. But, the poll you presented shows no such thing.

David Schraub said...

It's not "non-sense", it's just not the argument you think it is. It does matter "if non-voters can be made to favor healthcare reform more than they now do", if I'm explicitly disclaiming a political impact. This post is only an exploration about the situations in which facts can persuade people (namely, when the dispute is factual, not value-based). I think you've made certain assumptions about the purpose behind this post that you're stuck on, even though I'm repeatedly telling you they're inaccurate.

Meanwhile, your story is irrelevant because it involved the request to make a normative judgment, which this poll doesn't do. I simply don't agree that revealing the contents of a proposal in any way is playing fast and loose with the subject's value system. If they have a value based objection, revealing facts shouldn't have an effect (saying "this settlement will save $1 million" won't matter if the person has a value side-constraint against admitting liability). That it does have an effect is strong evidence we're in the realm of factual disagreement, not value disagreement.

All this post claims to show is that in certain circumstances, facts can change people's minds on issues. It doesn't say those people are likely voters, or they'll protect vulnerable House members, or this is a route to get health care passed. Just that facts can change opinions in certain circumstances, and this appears to be one of them.

N. Friedman said...

David,

A comparison...

You now assert: "All this post claims to show is that in certain circumstances, facts can change people's minds on issues."

Your original claim was: "My thesis on these issues is that facts can persuade when the underlying dispute is factual, but not when it is based on values. So if American opposition to the Obama health care plan is based off a principled objection to government intervention in health care, then more facts won't change that value assessment."

Notice the difference. Yes. your new claim is supported by what you assert. Your original thesis was not.

Your original thesis, to quote you, was "on these issues." I have underlined that phrase from your original post. And, what were "these issues"? I quote your words that preceded those words:

How Does More Information Affect Attitudes Towards Healthcare Reform?
Apropos the debate we've been having regarding how more facts would affect political views, Tapped links to some interesting polling which sheds light on the question at least with regards to health care.


In other words, you were directly interested in healthcare reform - it being the title, no less, of your post -, albeit as part of your discussion related to facts impacting on political views. And, political views, by the way, are not the same as impacting on just "issues." And, your post was not an abstract issue but a real one in the real world. After all, we are speaking about political views and, more specifically, about healthcare reform.

Stop BS'ing. You will make a better lawyer by admitting errors.

David Schraub said...

These issues refers to "the debate we've been having regarding how more facts would affect political views", not health care specifically. You need to follow the links which pretty clearly establish that as the broad philosophical issue I was engaging with rather than make blithe assumptions and than standby them even as the author tells you they're wrong.

N. Friedman said...

I see. Your title is irrelevant and so is the material you posted that is consistent with the title.

David, if you do this as a lawyer, people will laugh at you.

David Schraub said...

The title presents a case study. If you do this as a lawyer people will think you're being deliberately obtuse.

N. Friedman said...

You title: "How Does More Information Affect Attitudes Towards Healthcare Reform?" But, of course, following your logic, you were not writing about how information affects attitudes towards healthcare reform. Maybe it was an article about the weather.

Again, David, if this is how you act as a lawyer, you will lose a lot of cases. Good lawyers admit the obvious bad side evidence and find a plausible way to fit it into their client's position. In this case, if the title and the lines that follow under the title are not on the topic, then you do not write as well as you, quite obviously, do write. So, you are not helping yourself.

David Schraub said...

You're fixated on one particular interpretation, and are sticking by it quite gamely in the face of repeated assertions that another, totally plausible interpretation is actually superior by the person who actually knows the right answer.

It might actually be a good lawyering quality (though I suspect it would cause one's peers to hate you), but God help us if you ever become a judge.

PG said...

You're fixated on one particular interpretation, and are sticking by it quite gamely in the face of repeated assertions that another, totally plausible interpretation is actually superior by the person who actually knows the right answer.

Good quality for certain kinds of litigators. Bad quality for ADR. Really bad quality for transactional work.

N. Friedman said...

David,

The problem here is that your essay does not support your view. I believe, giving the benefit of the doubt to you, that you intended something different than what you wrote.

Yes, words are capable of multiple interpretations. However, the one you posted here, namely, that "[a]ll this post claims to show is that in certain circumstances, facts can change people's minds on issues," is contradicted by what you posted on the main page. What you wrote on that page claimed to do more. So, this is a case of bad draftsmanship.

PG, you are correct that what works in litigation does not work in negotiating an agreement or in ADR. My point here is that what David wrote is simply not subject to the interpretation he now gives it.