Summary: We hear lots, including from former President Obama, about the serious problem of disinformation stoked by social media algorithms, polarizing our society. What we hear less about is disinformation regarding private health insurance that comes from both Dems and the GOP and that compromises our ability to get care. We must address both.
âRegulation has to be part of the answerâ to combating online disinformation, Barack Obama said at Stanford event, Stanford News, April 21, 2022, by Melissa De Witte, et al.
Former U.S. President Barack Obama delivered a keynote address about how information is created and consumed, and the threat that disinformation poses to democracy.
Obama told a packed audience of more than 600 people in CEMEX auditorium â as well as more than 250,000 viewers tuning in online â that everyone is part of the solution to make democracy stronger in the digital age and that all of us â from technology companies and their employees to students and ordinary citizens â must work together to adapt old institutions and values to a new era of information. âIf we do nothing, Iâm convinced the trends that weâre seeing will get worse,â he said.
During the 1960s and 1970s, the American public tuned in to one of three major networks⊠âWhen it came to the news, at least, citizens across the political spectrum tended to operate using a shared set of facts â what they saw or what they heard from Walter Cronkite or David Brinkley.â
Fast forward to today, where everyone has access to individualized news feeds that are fed by algorithms that reward the loudest and angriest voices (and which technology companies profit from). âYou have the sheer proliferation of content, and the splintering of information and audiences,â Obama observed.
Facts are competing with opinions, conspiracy theories, and fiction.
âSolving the disinformation problem wonât cure all that ails our democracies or tears at the fabric of our world, but it can help tamp down divisions and let us rebuild the trust and solidarity needed to make our democracy stronger,â Obama said.
The responsibility also lies with ordinary citizens, the former president said. âWe have to take it upon ourselves to become better consumers of news â looking at sources, thinking before we share, and teaching our kids to become critical thinkers who know how to evaluate sources and separate opinion from fact.â
Republicans Have Stopped Trying to Kill Obamacare. Hereâs What Theyâre Planning Instead, Politico, April 26, 2022, by John E. McDonough
So it doesnât take a lot of effort to observe an active health policy ecosystem on the right that is busy recycling and developing ideas that would influence the direction of health policy in a future Republican-dominated federal government. Most of their attention focuses on the employer and individual commercial health insurance markets and the federal-state âmarketplaces/exchangesâ â the ACA-created entities where individuals and small employers can buy health insurance, ironically a model adapted by Democrats from a Heritage Foundation idea pioneered in the 1990s and early 2000s.
The result would be a system with more options and fewer guarantees. Giving employees less money to cover slimmed-down health insurance will lead many workers to forego coverage entirely. Are conservative politicians prepared to look the other way when they develop serious diseases and have no way to pay for care?
The two behemoths of federal health policy, Medicare for senior citizens and many disabled, and Medicaid for low-income households of every variety, are far less the reform target of Republicans and conservatives than they used to be. An essential reason for this is that both programs, with little controversy, have become increasingly privatized.
Indeed, a small and growing chorus of voices now suggest that Medicare Advantage could be the foundation for a unitary and reformed national health system, not Sandersâ âMedicare for Allâ which would eliminate Part C, but âMedicare Advantage for Allâ that would eliminate Medicare A and B, and make Part C universal.
In sum, conservative and Republican health policy voices, in spite of a full retreat on ACA repeal, are active and ambitious to reengage if and when Republicans retake the Senate and/or the House. This is especially true regarding private commercial health insurance, inside or outside of the ACAâs health marketplace/exchanges. They are ready to confront any and all threats to the growing hegemony of Medicare Advantage and to find new opportunities to expand it. They stand on the sidelines regarding fast-growing interest in health care equity and social determinants of health. They are down for the current moment and will be back with ideas and plans when the political climate changes. If prior history matters, so will their emerging ideas.
Comment:
By Don McCanne, M.D.
Much of the noise around disinformation today stems from the misuse of online social media technology such as Twitter and Facebook. The massive threat that this disinformation poses led Barack Obama to speak on the issue in a conference at Stanford University. Although the hype has been about the technology, we should also be concerned about the transmission and misapplication of disinformation regardless of dissemination paths.
Look at our health care system. Is it suffering from disinformation propagated by social media, or is its failure due to disinformation spawned by political ideology and transmitted via all sorts of communication channels?
Obamacare is a system established by the Democrats built on a foundation of a Republican concept of federal-state marketplaces/exchanges. The public Medicare program established by Democrats is now well on its way to becoming private Medicare Advantage plans, and Medicaid is also largely taken over by private insurers. These are Republican concepts being implemented by Democrats. It is difficult to see how disinformation has not played a major role â not the disinformation that Obama addresses in this speech, but his administrationâs disinformation about health policy. It brought us todayâs flawed health care financing.
Obama is right when he says that all of us must work together to adapt old institutions and values to a new era of information. That means out with the old disinformation, and in with valid health policy science. An essential feature of valid health policy science is truth. Out with fiction; in with facts. Those of us at HJM and Physicians for a National Health Program stand ready to help you sort out and discard the rampant disinformation that has permeated our health care system so that we can implement a system of health care justice for all.
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