So here’s the Obamacare/government shutdown situation.
On the one hand, the US government has pretty much shut down due to some radical Republicans who vowed they wouldn’t fund government operations until Obamacare is thrown out. They want to do that because, they insisted, Americans hate Obamacare health insurance plans so passionately.
On the other hand, so many Americans want to know details of Obamacare health insurance plans–more than 4 million unique visitors in the first 24 hours–that traffic pretty much shut down the federal Obamacare info site healthcare.gov and some state sites too.
Do Americans hate Obamacare? For a lot of them, the answer is a definite yes. Do Americans hate the Affordable Care Act (aka ACA)? Nope. Although their answers might be different if they knew ACA = Obamacare. Jimmy Kimmel’s street interview video asking those questions has by now gone viral. If you haven’t seen it, prepare to be amused. And dismayed.
What polling tells us about American attitudes toward the ACA
The video is not science, but polling has some claim to being so. Allison Kopicki, at the New York Times ACA tracking blog In Practice, analyzed a Kaiser poll showing that 43% of respondents do not like the ACA (while 33% do and 17% Don’t Know.) But Kaiser broke down the “unfavorable” data and an interesting fact emerged: Of the 43% who disapproved, only 33% said the law goes too far. (Just to be clear, this is 33% of the total n, 1500 adults, not 33% of 43%.) Of the remaining 10% of respondents who were negative, 3% said Don’t Know, which for me means they should be added to the 17%, bringing the Don’t Knows to 20%–1 out of 5 respondents.
And the remaining 7% of respondents? They disapprove of the ACA because it doesn’t go far enough. Are these folks upset because the insurance offered often has high deductibles and co-payments and/or insists on participation in a network that limits choice of doctors and hospitals? Are they advocates of a nationalized single-payer system like the rest of the developed world? We don’t know from the data, but in any case they shouldn’t be counted among those who hate the whole idea of the ACA.
Kopicki agrees: “So when we account for those who disapproved because they wanted more expansive reform, the poll shows that support for the law and opposition to it are much more even: 36 percent oppose the law, and 40 percent are in support of some form of federal health care transformation (if one includes the 7 percent who want a more expanded version).”
My arithmetic would reduce the opposed numbers even more and bump up the favorables a bit: I would say the poll shows only 33% unfavorable, 43% favorable, and 20% undecided. Other polls show that people who say they don’t like Obamacare turn out to favor its individual provisions, so some–maybe many–of Kaiser’s undecideds would end up in the favorable column were they better informed. I assume also that some proportion of the 33% unfavorables are, like Jimmy Kimmel’s interview subjects, ignorant of Obamacare details but didn’t want to admit it to pollsters. So they reflexively echoed the opinions of others, perhaps from the media. At least some of them would plausibly end up favorable if they only knew.
Kopicki also describes other polls suggesting that opposition is not the monolith some have said. In short, there is no factual, scientific, numerical basis whatever for the claim that “the American people” oppose Obamacare. Au, as they say, contraire.
Now, about those inaccessible health insurance exchange web sites
Jammed. So much so that even people who have been able to get on the sites often haven’t been able to get to the insurance plan-picking stage. As I write, insurers are not yet seeing a big volume of signups.
The shutdown atmosphere encourages paranoia, so it crossed my mind to wonder whether we were seeing something like a denial-of-service attack by ACA opponents. Although I kept reminding myself that the Republicans lost the 2012 election partly because they were geekless as well as clueless, suggesting that sophisticated electronic mischief might be beyond them.
Nicole Perlroth at the Times says attacks are not the issue. “The real issue, security experts said, was not that users couldn’t access the site, but that databases could not keep up with the influx of requests. When users tried to register their accounts, they would encounter annoying error messages, such as one many users encountered informing them that the answers to their security questions were not sufficient.”
So the chief explanation appears to be traffic, traffic, traffic. The Obamacare IT folks had planned for a more modest start; they were completely unprepared for the demand. UPDATE: If you long for details, see Timothy Lee’s interview with a consultant involved in setting up the insurance exchanges at the tech blog The Switch. The consultant said, “Everybody who’s on the inside has really expected it to be pretty rocky at the start. It’s a very large undertaking, and there are so many players involved. Such fixed deadlines.”
Fixed deadlines in part for political reasons. The Administration could not do a phased state-by-state rollout of the sites, for instance. That’s the sensible way to create a very big online presence with a mind-boggling number of moving parts. But the exchanges had to be debuted in entirety on October 1.
OTOH, immense demand is a good sign. Right?
Web site issues shouldn’t be a big deal. They will get fixed, and there’s plenty of time to get insured. The insurance doesn’t take effect until next year, and the signup deadline isn’t until Dec. 15. Also, everybody who goes online has intimate experience of the technical messes, frustrations, and outright rage web searches can inspire. So we should be cutting Obamacare some slack. Right?
But alas, it is a big deal, and the slack allowed is minimal. Public relations matters deeply here. Every disappointed searcher, every frozen browser, every incomprehensible error message is a mark against the whole enterprise and will be exploited mercilessly by ACA opponents. Even the friendlies are slamming the administration for inadequate site performance; see Ezra Klein and Evan Soltas at Wonkbook. Not to mention Jon Stewart, Stephen Colbert, David Letterman, and all the other late night talk show hosts. Who will exploit the signup problems not only mercilessly but also mirthfully. Which may be even worse.
What can the psychology of risk perception contribute to shutdown analysis?
David Ropeik’s post at How Risky Is It, Really attempts to mine the psychology of risk perception and ideas like cultural cognition to explain the origin of what he calls the irrational behavior that led to the shutdown. These ideas may help explain voter behavior, but I don’t think they explain what’s going on among Republicans in the House of Representatives.
The radical Republicans who brought us to this pass are not irrational at all. They are from Congressional Districts where a majority of voters do hate Obama and Obamacare, and who want less government and are happy to shut it down.
These districts were gerrymandered–such a gorgeous word, so happy to have a chance to use it–after the 2010 Census, engineered in a way that guarantees a solid Republican majority in each of them in each and every election. The Congresspersons from those districts, the ones who have provoked the government shutdown, are simply securing their own re-election by doing exactly what their constituents want. Perfectly rational behavior. It would be irrational to do otherwise.
The ideas Roepik discusses may well illuminate some of the nuttier and/or disingenuous opposition to Obamacare, and perhaps have a lot to say about voters, especially the voters behind the radical Republican caucus.
But the politicians are doing what they’re told and being loved for it by the only people who count for them: the voters who have the power to take away their handsome salaries–not to mention a handsome augmentation, still in effect when last I heard: generous employer-provided health insurance.
The bad news is that voter love like this makes a politician near-impervious to pressure for change from outside his district. He cares not a whit for public opinion, business interests, the pain to other people, the damage to the economy, whatever. Pfui to them all.
No hope this will change until after the 2020 Census–and then only if several states are at that point in different political hands. If the Democrats by then have booted Republicans from governorships and state legislatures, they will get to draw new District lines, which is required by law every ten years. (In which case, of course, it will be Democrats who gerrymander the heck out of their districts, making as many as possible safe for their own.)
The government shutdown’s effects on science and medicine
What are some shutdown effects on science and medicine? Knight Science Journalism Tracker Paul Raeburn has tracked a number of pieces that will fill you in on what’s not going on, for example at NIH and in agricultural and conservation science. Lauren Morello provides a pretty comprehensive roundup of the impact on science activities in government agencies at Nature News. Same place, Erika Check Hayden explores how the government shutdown affects non-government research, such as biotech companies and academic researchers. ScienceInsider is running briefs on this and that related to the shutdown’s effects on science.
Among those Paul mentions is Maryn McKenna’s post at Superbug, which describes the shutdown’s effects on public health matters, food safety, and disease. For example, the Centers for Disease Control and Prevention won’t be doing its usual countrywide monitoring of seasonal flu–just as the flu season begins. Since CDC’s work goes on outside the US too, global health issues will also be affected.
Superbug is part of the Wired blog network. We are told that Wired’s bloggers will be tracking the shutdown’s effects on research and other matters scientific. As I write, they hadn’t all posted, but find the whole network here. A Wired staffer rather than a blogger, Brandon Keim describes the impact on basic biomedical research by quoting an email from a government researcher. UPDATE: Tracker Paul Raeburn describes Keim’s piece in some detail, concluding that it shows the shutdown is worse for biomedical research than we have thought.
Evolutionary biologist Jonathan Eisen put up a montage of closed government science-related web sites on Picasa. PubMed isn’t there because it is open, hurray, but with minimal staffing, boo, which probably means refs may not be updated and other services are curtailed.
At the Ocean Conservancy’s Blog Aquatic, the aptly named Jeff Watters–can he possibly be real?–rounds up the shutdown effects on, duh, the oceans. I suppose I must mention that the national parks are closed, because everybody else does. But here I will note that Shutdown Day was Yosemite’s 123rd birthday, and Google doodled the event. The birthday, not the shutdown, and a very un-Googlelike design it is.
The journal PLOS ONE says reviewing of papers will be affected because some reviewers are government employees. Doubtless that is the case at other journals too.
UPDATE: Science writers are beginning to feel the shutdown’s effects on their fact-gathering. Matt Shipman explains at SciLogs.
Not just about science, but partly so and also amusing, is Bahar Gholipour’s roundup of 15 weirdest outcomes of the shutdown at LiveScience. Bucking the media obsession with The National Zoo’s now-offline Panda Cam, Gholipour has made it only #2 on the list.
Meantime, opinion elsewhere is puzzled. At ScienceBase, Brit David Bradley wants to know, “So . . . remind me, what’s a legitimate, moral argument against a new system that aims to be cheaper and ensure everyone gets healthcare?”
Where/when will it all end?
Mike the Mad Biologist is polling readers about when they think the shutdown will end. Your turn.
Myself, I have no clue. But I wouldn’t wager sooner rather than later. Ezra Klein and Evan Soltas explain why at Wonkbook. This has now become a macho one-upmanship contest about who is disrespecting whom. Klein and Soltas say, “[O]ne side or the other has to clearly lose in order for the shutdown to end. And neither side wants to lose. Nobody wants to be disrespected.”
At Wonkblog, Dylan Matthews asked a game theorist to explain what is going on, but I didn’t find him terribly illuminating. I look forward to analysis from psychology and neuroscience and behavioral genetics and other science POVs.
Friday music, HT to Paul Krugman
Who doesn’t love the Beach Boys?
The question is, which side is the fuel-injected Stingray and which the 413?
Updated: The Science and Politics of Shutdown by On Science Blogs, unless otherwise expressly stated, is licensed under a Creative Commons Attribution 4.0 International License. Terms and conditions beyond the scope of this license may be available at blogs.plos.org.