In Health Care Debate, Fear Trumps Logic Every effort to remake America's health care system since the 1930s has been scuttled by the same technique — scaring the public. The opponents have been different, ranging from the AMA to the insurance industry to conservative ideologues. But the playbook has remained the same. In this 1993 television commercial (above), a couple named Harry and Louise helped sow seeds of doubt in the public about how changes to health care would affect them.
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In Health Care Debate, Fear Trumps Logic

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In Health Care Debate, Fear Trumps Logic

In Health Care Debate, Fear Trumps Logic

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On a Friday morning, it's MORNING EDITION from NPR News. I'm Steve Inskeep.

We're coming to the end of a summer of fierce debate over health care. It may be followed by an autumn of fierce debate over health care. Even if you've only paid passing attention, you probably heard warnings like this from the conservative group 60 Plus.

(Soundbite of political advertisement)

Unidentified Man: Seniors may lose their own doctors. The government, not doctors, will decide if older patients are worth the cost.

INSKEEP: These claims are not strictly accurate, but they do scare people. And NPR's Julie Rovner says experts agree on one thing: fear works.

JULIE ROVNER: Health care historian Jonathan Oberlander of the University of North Carolina says there's one main reason every health overhaul effort for the past century has ended in failure.

Professor JONATHAN OBERLANDER (Health Care Historian, University of North Carolina): The opponents of reform have used fear, and they have used fear very successfully.

ROVNER: As early as 1915, the first time the idea of National Health Insurance was broached, opponents scared the public by tying would-be health care reformers to the U.S.'s biggest overseas opponent of the day.

Prof. OBERLANDER: And they said that national health insurance was a plot by the German emperor to take over the United States, and that was the first time people really used scare tactics in this debate, and that has happened again and again.

ROVNER: When Harry Truman tried to push national health insurance in the late 1940s, American's biggest fear was no longer Germany, so the argument changed accordingly.

Prof. OBERLANDER: And the opponents of reform said that if we adopt a national health insurance, they suggested the Red Army would be marching through the streets of the United States, as this was the first step to communism. And again, they connected health reformers to another country we don't like very much, which was the Soviet Union.

ROVNER: During the unsuccessful effort to remake the health care system during the Clinton administration, the fear opponents raised, was that of rationing -the same fear being raised now. So it's clear that scaring people about potential changes to their health care works to kill legislative efforts. But why? It turned out the reason is biology.

Professor JOSEPH LADOU (Neuroscience, New York University): Once fear is aroused and in your brain, it tends to take over and dominate.

ROVNER: Joseph LaDou was a professor of neuroscience at New York University. He says the reason fear is so dominant an emotion is that it's needed for survival.

Prof. LaDou: Because once you're in a dangerous situation, it's very important that you stay focused and attentive to the events around you that are causing you or potentially causing you harm. So the brain is monopolized. Its resources are totally focused on taking care of the problem at hand.

ROVNER: There's another thing that makes fear such an effective political tool, says LaDou: It's contagious.

Prof. LADOU: Rats have ways of sending out ultrasonic calls to other rats to warn them that, say, a cat is nearby. And these sounds are secret code because they're outside the cat's hearing ability. So it's pretty primitive in nature that we have these kinds of mechanisms for detecting danger, for experiencing danger within the individual, and for sharing that information across individuals.

ROVNER: So in politics, if you want kill something, you should just get people good and scared about what it might do.

Prof. LADOU: It's a good way. I'm not saying it's the best or the only, but it's a pretty good way - pretty effective, yes.

ROVNER: Now opponents of this latest overhaul effort insist that's not their strategy. Here's what Republican National Committee Chairman Michael Steele said on yesterday's MORNING EDITION.

Mr. MICHAEL STEELE (Chairman, Republican National Committee): Look, no one's trying to scare people with sound bites. I mean, you know, I've not done that, and I don't know any of the leaders in the House and the Senate that have done that.

ROVNER: But many top Republicans have refused to disavow statements that have been widely debunked as inaccurate, like the idea that the bills would create death panels to recommend euthanasia for senior citizens. That frustrates political scientists like Jonathan Oberlander, who says he sees history repeating itself in the current debate.

Prof. OBERLANDER: What is it is that fear is crowding out the truth, and the truth ought to count for something in health care reform and in American politics. And right now, it doesn't.

Julie Rovner, NPR News, Washington.

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