NPR logo

Episode 780: On Second Thought

  • Download
  • <iframe src="https://www.npr.org/player/embed/534132561/534150798" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
Episode 780: On Second Thought

Podcast

Episode 780: On Second Thought

  • Download
  • <iframe src="https://www.npr.org/player/embed/534132561/534150798" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

KENNY MALONE, HOST:

If you think one thing and then, at some later moment, you think something different...

JACOB GOLDSTEIN, HOST:

If, in other words, you change your mind...

MALONE: Sure. You become vulnerable. You get called mean names.

GOLDSTEIN: Wishy-washy, flip-flopper.

MALONE: In England, it is apparently U-turner. And in Australia and New Zealand, you get called back-flipper.

GOLDSTEIN: On the other hand, if you do not change your mind, people say - oh, I like that guy. He sticks to his guns. I know where he stands.

MALONE: This is messed up. This is backwards. Changing your mind is brave. You've faced the world. And you're saying, I was wrong.

GOLDSTEIN: And maybe this is obvious, but I've got to say it here. Changing our minds - it's what we're supposed to do because - what? - are we right all the time about everything? No.

MALONE: No.

GOLDSTEIN: No, we are not right about everything. And when we realize we're wrong, we should change our minds.

(SOUNDBITE OF GEORGE MCFARLANE'S "CANDY GROOVE")

MALONE: Hello, and welcome to PLANET MONEY. I'm Kenny Malone.

GOLDSTEIN: And I'm Jacob Goldstein.

MALONE: Today's show, in praise of flip-floppers - and U-turners and back-flippers.

GOLDSTEIN: We've got three stories. One's about an economist. Another is about a novelist. And the third is about a Scottish teenager who built a world where literally hundreds of thousands of people help each other change their minds.

(SOUNDBITE OF GEORGE MCFARLANE'S "CANDY GROOVE")

MALONE: First up, Katherine Baicker. She's a health economist at Harvard.

GOLDSTEIN: And she told us about something you hear about a lot. And that is, hospital emergency rooms are full of people who, one, do not have health insurance and, two, do not have a medical emergency because in the emergency room, under federal law, they have to treat you, even if you don't have insurance. They can bill you later, but they cannot send you away.

KATHERINE BAICKER: If you had insurance and you could afford it, you'd go to the doctor. But if you're uninsured, the emergency room is the only place you can afford to get care.

GOLDSTEIN: And this is a problem for a few reasons. For one thing, it makes emergency rooms more crowded in general. And for another, it's really inefficient. The emergency room is an expensive, bad place to get basic medical care.

MALONE: And so here's what Katherine Baicker thought - if you gave people health insurance, you could solve this problem.

GOLDSTEIN: They'd be less likely to go to the emergency room when they didn't have a medical emergency.

BAICKER: Their health would improve. You would spend less money because insured people don't go to the emergency room to get their basic care.

GOLDSTEIN: And, by the way, over and above the emergency room thing and the economic case, Baicker just believed in expanding health insurance.

BAICKER: So I've always held the view that it's a public policy priority to insure low-income people and to make sure they have enough food and housing. But I know those are my views as a voter and as a taxpayer. That doesn't mean that there is scientific evidence to say that's what everyone should think or that's what we ought to do.

MALONE: A while back, Baicker heard about this thing happening in Oregon. The state decided to expand its health insurance program for the poor, its Medicaid program, to thousands more people. But Baicker says there were still way more uninsured people than there were available spots.

BAICKER: So just as a fair way to hand out those limited spots, they held a lottery. They got a whole bunch of people to sign up on a waiting list. They drew names by chance. And the people whose names were drawn got a chance to get the public insurance. And the people whose names weren't didn't.

GOLDSTEIN: This seems kind of cold or cruel somehow. But, you know, they had to choose some way to do this, and this is the way they chose. And crucially for Baicker, Oregon's decision to do it this way created this sort of natural experiment. You know, you have this big pool of people. Some of them are randomly selected to get Medicaid. Some of them are randomly denied. And Baicker looked at this and realized, if you followed both groups of people and compared what happened to them, you could learn so much.

BAICKER: That provided a perfect opportunity to figure out exactly what Medicaid does.

MALONE: In particular, you could actually test whether people, in fact, go to the emergency room less after they get Medicaid.

GOLDSTEIN: So Baicker and her colleagues went out to Oregon, talked with the people who were getting insurance and the people who weren't and with, you know, all the officials. And then they posted their entire study plan in advance. They explained everything they were going to measure and how they were going to measure them so that everybody knew they weren't just, like, waiting until the end and cherry-picking the results that they liked.

MALONE: Once they did this, it was just a matter of waiting for the results to come in. And then the day arrived.

BAICKER: It was almost like a movie. We joked we should get popcorn and just watch the results...

(LAUGHTER)

BAICKER: ...Spool out.

GOLDSTEIN: And where were you? And were you with, like, your co-authors? Just where were you when the data came in this way?

BAICKER: Life isn't like a movie. I was sitting by myself looking at my computer screen (laughter), and I got the results via email.

MALONE: She clicked open on the email, and she saw the result. People who got health insurance did not go to the emergency room less. In fact, they went to the emergency room more, 40 percent more than people who did not get insurance.

GOLDSTEIN: Her first thought was, like, maybe they'd done the math wrong or made some error in the processing.

BAICKER: It was so surprising. I had not expected a result of nearly that magnitude. A 40 percent increase was really much higher than I had even imagined.

MALONE: But the math was correct.

GOLDSTEIN: Bottom line, Baicker says, her study showed very clearly that when people get Medicaid, they get more health care. Not only do they go to the emergency room, they go to the regular doctor more as well. Her study found that Medicaid does not save taxpayers money.

BAICKER: For science, it seemed like a really interesting, important finding. And frankly, not every paper elicits that reaction (laughter).

GOLDSTEIN: Sure.

BAICKER: I think most of my papers are dull. So this seemed (laughter) important and a major scientific contribution, and that's exciting. On the other hand, I felt disappointed for the cause of expanding health insurance coverage.

MALONE: The thing you're discovering as a scientist is bad for the thing that you want as a citizen.

BAICKER: Yes. And that's really hard as a person who is both of those people at the same time.

GOLDSTEIN: I have to say, this is a thing that I love about science. It is this whole system of thought and action that is designed to change people's minds.

MALONE: Sure, you have some belief about the world, some story that you're telling yourself, and that's fine. But then you test that belief. And if it doesn't hold up, you change your mind. You come up with a new story.

GOLDSTEIN: And obviously, this is an idealized version of science. I know it doesn't always work that way. But sometimes it does. Right? It worked in this case. Katherine Baicker changed her mind.

MALONE: Here is her revised story about what happens when people get Medicaid.

BAICKER: Wearing my economist hat, I couldn't really be all that surprised, which is what made me realize my prior view was more of a hope than anything else, because one of the basic things we know from economics is that when something costs less, people use it more. The emergency department is no exception. It used to be really expensive to go. Even though they couldn't turn people away, they could still issue a big bill at the end. And so uninsured people were reluctant to use the emergency department because they couldn't pay for it.

MALONE: Once people get insurance, they don't have to pay anymore, so they go to the emergency room more often.

GOLDSTEIN: The other results of the study were mixed, but it did show that there were several ways in which people on Medicaid did seem to be better off. They reported being in better health. They were less likely to get into financial trouble. And Baicker still thinks that giving Medicaid to more people is a good idea. She thinks it's worth the money. But she says that is her view as a citizen not as a scientist.

(SOUNDBITE OF ADRIAN QUESADA AND SKINNY WILLIAMS' "WHEN THE LIGHTS COME ON")

GOLDSTEIN: OK. So just give it to me. Do you have them in front of you? Or do you know them - do you have them memorized?

KAL TURNBELL: I have them memorized, but I'll read them out in order as they are.

GOLDSTEIN: OK.

TURNBELL: So rule A is...

MALONE: This is Kal Turnbell. He's 21 years old, and he's helped come up with a set of rules that has done something miraculous, created a place on the internet where people can calmly and rationally change other people's minds. It's a group that Turnbell founded on Reddit called Change My View.

GOLDSTEIN: He founded it about four years ago. It now has more than 300,000 members. It has been the subject of multiple academic studies where people are trying to figure out how a thing like this could actually happen. And Turnbell says the magic for this group, the secret sauce, is these rules, rules that have taken years to figure out. And he walked us through them.

TURNBELL: So rule A is, explain the reasoning behind your view, not just what that view is.

GOLDSTEIN: Here's how Change My View works. People go there, and they post something they believe, some view that they have.

MALONE: We pulled some real examples of these - the minimum wage should be abolished, or Communism isn't that bad, or Voldemort from "Harry Potter" is actually kind of a crappy villain. That person wrote six paragraphs explaining the reasoning behind their Voldemort view.

GOLDSTEIN: And the idea behind making people explain the reasoning behind their view is - if you want to change people's minds, it's not enough to know what they believe. You have to know why they believe it.

MALONE: OK, next.

TURNBELL: Rule B - you must personally hold the view and be open to it changing.

MALONE: Turnbell told us that he wants Change My View to be a destination for people who hold views that they're open to changing but that they're maybe embarrassed or uncomfortable talking about in real life.

GOLDSTEIN: Yeah. Like, a couple of examples of views people have posted recently, one of them - if you date outside your race, you are a race traitor.

MALONE: Another one - Christianity, Judaism and Islam are all generally evil.

GOLDSTEIN: The people who posted those two - they both changed their views.

MALONE: The next two rules are basically housekeeping. Rule C is about formatting.

TURNBELL: Rule D - no metaposts.

GOLDSTEIN: In other words, fourth rule of Change My View, do not talk about Change My View on Change My View.

MALONE: There's a whole other subgroup for that.

TURNBELL: E - only post if you're willing to have a conversation with those who reply to you and are available to start doing so within three hours of posting. We don't want you to just hit and run with your posts.

GOLDSTEIN: You're entering a relationship here.

TURNBELL: Yeah.

MALONE: And these are committed relationships. On some of these posts, people go back and forth and back and forth for, like, 50, 80 pages - Hundreds of comments.

GOLDSTEIN: Good. Next.

TURNBELL: Don't be rude or hostile to other users.

MALONE: When you started the subreddit, did you have a lot of these kind of personal attacks?

TURNBELL: Yeah, mm-hm, I'd say so.

(LAUGHTER)

MALONE: This rule - sure, obvious - but it's paired with another rule that's a little bit more surprising.

GOLDSTEIN: This other rule says you are not allowed to reply to someone's view by just confirming or validating what they already believe.

TURNBELL: People were just coming in and saying - yeah, I agree with you; no reason to change this view.

(LAUGHTER)

TURNBELL: You know, that's - just - it was unproductive.

MALONE: And these two rules, the don't-be-a-jerk rule combined with the you-must-disagree rule, they show just how difficult it is, what Turnbell's doing. Civil discourse here is on a razor's edge. Like on one side, the thing can spiral off into fighting. And then on the other side, it spirals off into agreeing, into - like an echo chamber.

GOLDSTEIN: All right, last rule we're going to talk about.

TURNBELL: Award a delta if you've acknowledged a change in your view.

MALONE: A delta, the Greek letter that looks like a little triangle.

GOLDSTEIN: And is the symbol of change.

MALONE: And this is basically like a Change My View merit badge.

GOLDSTEIN: And so the way it works is like this. Say I show up and post my view - you know, Bob Dylan is underrated. And Kenny, then you show up and you...

MALONE: And I say, underrated? They gave him a damn Nobel Prize.

GOLDSTEIN: (Laughter) And I say OK, fair enough. Maybe he is appropriately rated.

MALONE: (Laughter).

GOLDSTEIN: You have changed my view, and now I award you a delta. And what has happened on the group since they introduced these is deltas have become this status symbol. And what I find really interesting about this is I feel like they have flipped upside down the way status works in this kind of debate because I feel like, typically, the way you get status in a debate is not actually by appealing to the other side, to the people who you're nominally trying to convince. What you're really doing is, like, showing off for your team.

So you get status for, like, a sick burn or a good comeback or whatever. But those are not the kinds of things that actually change other people's minds. And so what the deltas have done is transformed the way you get status. There is, like, a leaderboard for the people who get the most deltas, who change other people's minds. So in this group, the way you get to be, you know, a big deal is by really changing other people's minds.

MALONE: And that's it. Those are the ten rules. And taken together, they really seem to work. People come in. They post their views on things that are controversial or silly or whatever, and then there is this civil conversation on the internet without name-calling. And sometimes, people change their views.

MALONE: I mean, do you feel like you've come up with rules, you know, for the world and not just for your subreddit?

TURNBELL: I mean, yeah. That's what - when I look at these, I think this is the kind of thing that people should follow when they're trying to persuade other people or just in general conversations. And having rules - to some people, that sounds a bit, like, authoritarian or something. But they're not really rules. They're kind of advice because this is what works, and this is what doesn't work. And that's kind of what we're saying.

MALONE: I mean, they are rules. But you're saying they're for our own good.

TURNBELL: Yes.

MALONE: You're saying, if you want to change somebody's mind, these rules are going to help you. Trust me, kid.

TURNBELL: Exactly.

GOLDSTEIN: In a minute, we'll have the third and final chapter. And that chapter, I think, is a lot more interesting than it would sound if I described it now.

(SOUNDBITE OF ADRIAN QUESADA AND SKINNY WILLIAMS' "WHEN THE LIGHTS COME ON")

GOLDSTEIN: Cory Doctorow is one of these people - has, like, 7 different jobs or whatever. He writes novels. He's one of the editors of the website Boing Boing. And he is one of the biggest names in the fight over copyright law in this country. Doctorow thinks that copyright law is broken - that the way it works now is bad for society, bad for people who do creative work. But...

MALONE: Doctorow did not always feel this way. And the arc of how he changed his mind is really illuminating. And it's a useful way to think about copyright. The arc starts with Doctorow's first sort of professional identity as a science fiction writer.

CORY DOCTOROW: I've started writing science fiction when I was a small kid - like, literally when I was 6. And I started sending it to magazines when I was 16 and selling it when I was 17.

MALONE: One of his first published stories was called "Craphound." And it was about an alien who loves yard sales.

DOCTOROW: You know, I was a baby writer. And so what I knew about copyright was what I'd learned from other writers. So I thought that copyright was a thing that authors got because they made something new with their brains and that they had a moral right to it and that by holding onto that moral right, they could also make sure that big, rapacious companies didn't rip them off.

GOLDSTEIN: He thought copyright should probably extend forever. Like, if you build a house, you can pass it on to your children. They can pass it on to their kids and so on. Why should it be any different if you write a book?

MALONE: Doctorow went off to college, became a programmer and started a company that, in some ways, grew out of that view of copyright.

GOLDSTEIN: This was the era of Napster, you know, the program that made it super easy to download music for free on the internet. And the idea behind Doctorow's company was let people download files on the internet, but put rules on how and whether they could share those files. For example...

DOCTOROW: You're allowed to listen to this once when you download it from someone over the internet. But if you want to listen to it again, you've got to pay some money to unlock it again.

MALONE: To make this technically possible, Doctorow's company was going to use what's called digital rights management. This is DRM. Basically, this is a way to encode these kinds of rules into the software.

GOLDSTEIN: Doctorow's company raised $19 million. He starts flying around the world to speak at conferences. And it was on the road to one of those conferences - this one was in Hong Kong - that he had his conversion experience.

MALONE: He was traveling with a corporate copyright lawyer who was going to go to the same conference. They sat down in coach. Doctorow was on the aisle. The lawyer was in the middle seat.

DOCTOROW: It was in the days in which, you know, iBooks were - looked like toilet seats and had a battery that lasted for 30 minutes.

GOLDSTEIN: That's a laptop - for our younger listeners.

DOCTOROW: Yeah, that's right. And so 30, 45 minutes in, we had nothing to do but eat airplane food and argue about copyright.

MALONE: They're 30,000 feet over the Pacific. The copyright lawyer starts in on Doctorow. He says, your view about copyright is naive, overly simplistic. In fact, this whole way of thinking about creative work is is wrong.

GOLDSTEIN: Look, the lawyer said, we don't have copyright because there's some kind of moral right of ownership that people have to their creative works because, for one thing, that idea doesn't even make sense. You know, the way creative stuff works - everybody is always taking stuff from everybody else. This is true, you know, in music. Like, rock 'n' roll was basically the blues. And, in fact, it goes all the way back. Everybody has always done it.

DOCTOROW: They call Brahms's first Beethoven's 10th.

(LAUGHTER)

GOLDSTEIN: That's good.

MALONE: And so the lawyer says, look. Your stories are full of ideas you've borrowed from other science fiction writers.

GOLDSTEIN: You know, all the people who wrote about aliens before you - do they have a moral right to own all stories about aliens?

MALONE: And Doctorow says something like, ah, no? Maybe not?

DOCTOROW: So by the time we got off the plane 12, 15 hours later - however long the flight is from San Francisco to Hong Kong - I had serious doubts. And then wandering around Hong Kong for the next two days when we weren't at the conference, going to the - because we were all horribly jetlagged, too - so, like, going to the Temple Street Market at 2 in the morning to eat, you know, tentacles and shouting about copyright.

GOLDSTEIN: It's my dream trip, by the way.

DOCTOROW: (Laughter).

GOLDSTEIN: The lawyer convinces Doctorow that copyright is not about some moral right to property. It's much more practical than that. In fact, it's spelled out explicitly in the U.S. Constitution. The new, transformed Cory Doctorow can quote it off the top of his head.

DOCTOROW: To promote the useful arts and sciences, Congress shall create monopolies of limited times, right? So not because you get property rights on everything you make but to promote the useful arts and sciences.

MALONE: In other words, the point of copyright is to get people to make more stuff because it's good for society when people make stuff, when they write songs and books and make movies. More is better.

DOCTOROW: And in the end, I realized that copyright was a policy that's created to encourage certain kinds of creativity and that the limits on copyright, like how long it lasts or when people can use your work without your permission - those aren't just off to one side of copyright. They're as important as the exclusive rights that the creator gets.

MALONE: The conference ends. Doctorow goes home. And before long, he decides, what my company is doing, using digital rights management, putting all these copyright rules into computer code - it's not doing what I thought it was doing. It's not really encouraging creativity. It's not really helping little artists. It's mostly helping big companies.

DOCTOROW: And I wrote a letter to the investors and told them I wasn't going to work there. I was quitting.

GOLDSTEIN: He goes to work for this foundation that pushes for less strict copyright rules, starts arguing publicly that the details of copyright law serve big corporations more than little artists. He says copyright protection should be shorter. He is essentially out in public, arguing the exact opposite of what he believed before.

MALONE: This makes him a star among a lot of tech nerds. But a lot of his pals in the science fiction world - much less impressed.

DOCTOROW: My writing teacher once threatened to punch me in the face in a panel about copyright years later. And there's another writer who I think literally hates me over this. And she's still one of my heroes. It sucks to have people say that I have done something to deprive the children of working artists of their due. I think they're wrong, though.

GOLDSTEIN: One thing that's striking to me about Doctorow's story is I feel like he changed his mind in part because he is one of these people who has all these different jobs and sort of moves in all these different worlds. You know, if all his friends were writers, say, I feel like this story would have been really different. I feel like he probably would not have changed his mind.

MALONE: Cory Doctorow is still writing. He published a novel earlier this year. Another project that he's working on - trying to get companies to stop using digital rights management, DRM. In other words, he's trying to get rid of the exact thing his old company was built on.

GOLDSTEIN: You never call. You never write. Contact us. Email us at planetmoney@npr.org. Look us up on Facebook or Twitter.

MALONE: Today's episode was produced by Sally Helm. Bryant Urstadt is our editor.

GOLDSTEIN: Alex Goldmark is the supervising producer.

MALONE: Special thanks to Liz Weeks, who talked to us about Change My View.

GOLDSTEIN: And if you're looking for something else listen to, check out Invisibilia, the show about invisible forces that shape human behavior. The last few episodes of the third season are coming out right now. And in the shows, they're looking at, like, the ideas we have about ourselves. You know, is there one true version of the self? You can find Invisibilia in the NPR One app or wherever you get your podcasts. I'm Jacob Goldstein.

MALONE: And I'm Kenny Malone. Thanks for listening.

(SOUNDBITE OF ADRIAN QUESADA AND SKINNY WILLIAMS' "CITY SIXTIES")

MALONE: One last thing. NPR has just launched a brand new podcast. Here to tell you about it is the host, Sam Sanders.

SAM SANDERS, BYLINE: Hey, y'all. Sam Sanders here. These days, I feel like I can't make sense of the news until I've talked it out with my friends. So I made a new show where we do that every week. It's called It's Been a Minute. That's my way of saying let's catch up. Find It's Been a Minute now on the NPR One app or wherever you get your podcasts. Thanks.

(SOUNDBITE OF FLEVANS' "FLICKER")

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.