PolitiFact chose Sarah Palin's "death panel" comment on FaceBook as its "Lie of the Year" in 2009. In 2010, political scientist (and professional handwringer) Brendan Nyhan continues to bemoan the damaging branding of Democrats' attempts to reform health care.
I've found Nyhan less than scientific in his pronouncements over time, and his 2010 paper on the supposed influence of GOP disinformation on public attitudes about health care reform provides additional grist for the mill. In brief, Nyhan's reasoning suffers from unhealthy dollops of equivocation.
The equivocation occurs in the term "death panel." Nyhan doesn't seem sure what he means by it from one moment to the next, unless he understands it as a semantic grab-bag designed to fill whatever need his reasoning requires. On page one, in the abstract, "death panels" represent the refusal of care to the elderly because of government bureaucracy:
(M)isconceptions also clouded the recent debate about health care reform under President Obama, including the myth that the elderly would have medical care denied by so-called government “death panels.”When Nyhan begins to trace the history of the so-called "Obama 'Death Panel' myth," however, death panels transform into end-of-life counseling that might encourage the elderly to forgo medical treatment (p. 8):
McCaughey had her greatest impact on the debate during the summer of 2009 when she invented the false claim that the health care legislation in Congress would result in seniors being directed to “end their life sooner.”Nyhan goes on to quote McCaughey from an appearance on a radio program with Fred Thompson (R-Ten.). The same statement is later identified as the start of the "death panel" myth on a chart:
Only after the claim was "embellished by Sarah Palin" (8/7/09 by Nyhan's chart) did it begin to resemble the version Nyhan identified in his abstract.
Question: In what respect is the so-called myth spreading if it alters its character almost completely in a few weeks?
Sarah Palin's statements about "death panels," taken in context, cannot easily be dismissed. Though not for lack of trying by the mainstream media and liberal elites like Nyhan:
After coming under criticism, Palin defended her statement by citing the counseling provision identified by McCaughey and academic articles previously written by Obama adviser Ezekiel Emanuel (Palin 2009a). However, independent observers condemned her claim about “death panels” as false (FactCheck.org 2009b; PolitiFact.com 2009c): there was simply no evidence that funding for voluntary end-of-life consultations would create a mechanism for ‘‘‘bureaucrats” to withdraw care from “[t]he sick, elderly, or disabled.”Saying that Palin "defended her statement by citing the counseling provision" is misleading. Rather, Palin's follow-up to her "death panel" post was a reply to President Obama, who had mused that Palin's "death panel" referred to the end-of-life counseling provision in the bill.
The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.”  With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.Palin goes on to make a strong case for herself, not that a person getting the story from Nyhan would have any idea (speaking of spreading misperceptions). Nyhan's next statement went on to acknowledge that health care reform may lead to more restrictive rationing but that those consequences hardly justified Palin's statement about death panels. One wonders what aspects of science or logic permit Nyhan to reliably make that judgment.
Despite Nyhan's acknowledgment of increased rationing, he counts it as a misperception when poll respondents indicate that they believe the government will choose not to treat some people.
I compare misperceptions about the Clinton plan to those about the Obama plan using the following question from a CNN/ORC poll in September of 2009 (2009):Based on Nyhan's admission, doesn't it seem that the 57 percent are the ones probably carrying the misperception?
Based on what you have read or heard about (Barack) Obama’s health care plan, please tell me whether you think each of the following would or would not happen if that plan became law....If Obama’s plan became law, do you think senior citizens or seriously-ill patients would die because government panels would prevent them from getting the medical treatment they needed?41% of respondents said government panels would withhold medical treatment, 57% said it would not happen, and 2% had no opinion.
Not only does Nyhan change the definition of "death panel" midstream, he magically transforms a reasonable expectation into a "misperception."
Nyhan explicitly disavows the fallacy of post hoc ergo propter hoc but can't seem to resist invoking it in practically the next sentence:
(T)he likelihood of support for Obama’s plan decreased from 72% among Americans who did not believe the “death panel” claim in 2009 to 20% among those who did. As noted above, these differences, which hold even among non-Republicans, were not necessarily caused by misinformation, but they do suggest its potential importance for public opinion.
The supposed suggestion relies on the post hoc ergo propter hoc inference, though Nyhan doesn't even provide before-and-after survey data that would support the assertion that attitudes changed after the "death panel" myth took flight. Perhaps, as with the 2009 stimulus bill, we can measure the effect of the misinformation by how much better the surveys would have looked without the existence of the death panel myth.
Implications and Conclusions
The evidence presented in this article suggests that misinformation played an important role in the two most recent debates over health care reform.
I find it very difficult to be impressed by Nyhan's paper.