It was a long time ago, but the basic facts are still relevant. I was driving to a meeting of AIDS researchers and sharing the driving with the editor of a pharmacy trade magazine. We arrived, checked in at the hotel, then split. She went to the bar to find people to interview, I went to a meeting to be able to say I’d been there. We met later that day, and she was in the company of a reporter who was covering the meeting for a well known newspaper. The paper wasn’t top rung, not the Washington Post or New York Times, but it was a well known and highly respected paper all the same. She was a general assignment reporter, who had been thrown this assignment because her room-mate had AIDS. To her credit, this was at a time when many people still believed the myth that you could get AIDS from casual contact, so she knew more than 80% of the population, but it wasn’t nearly enough to communicate the latest findings with her readership.
I spent the afternoon giving her the stock lecture: Introduction to HIV Disease. As a former boss of mine used to say, “I taught you everything I know but you still don’t know nothing.” I never read her reports on the conference, but I have an idea how they came out. When a reporter doesn’t have a solid grasp of the subject, you wind up with false equivalency reporting – he said/she said stuff. The reporter gets two sides of an issue, quotes both, and as a result the reader (unless she’s an expert herself) gets the impression that both positions are equally valid. That’s the kind of thing that gave Paul Ryan (R-Wis.) a reputation as an expert on economics and budgeting. It also serves climate change deniers and those who reject the theory of evolution. Some papers try to improve things by having other reporters evaluate claims made by politicians. That would be useful, if the checkers knew the subject well enough to judge. If they don’t know the truth, or don’t have enough nerve to report it, the system fails.
So here’s a headline from PolitiFact, which is supposed to police false claims in politics: “Wisconsin not leaving any federal funds on the table by rejecting Obamacare expansion of Medicaid, Scott Walker administration official says.” Well, that’s true, that’s what Kitty Rhoades, Wisconsin’s secretary of health services said. She was defending Gov. Walker’s decision to turn down the expansion of Medicaid that would be federally financed under the Affordable Care Act. The expansion would cover persons up to 133% of the poverty level, and would mostly be financed with federal money. The Legislative Fiscal Bureau, which is regarded as an honest and neutral judge on fiscal matters, estimated that opting out of the Medicaid expansion would cost Wisconsin $119 million in its 2013-2015 budget and as much as $459 through 2021. The RAND Corporation published its own report which said “With fourteen states opting out, we estimate that 3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion. These effects were only partially mitigated by alternative options we considered.”
Gov. Walker disagreed. Gov. Walker’s plan would provide Medicaid coverage to people up to 100% of the poverty level. For people between 100 and 133% of the poverty level, they would buy private health insurance through the exchanges which are a key part of the Affordable Carew Act. These people would be entitled to subsidies on their insurance purchases and the subsidies would bring in $776 million to $784 million in federal money.
What Gov. Walker fails to understand is that one of the defining features of being poor is that you don’t have any money. While Medicaid doesn’t require patients to lay out cash, the insurance available through the exchanges does, both for the policies and at the physician’s office and the pharmacy. Consumer Reports conducted a survey of how people are trying to live on a limited income and found that 63% of responders delayed a medical visit, and 62% refused a medical test because of the price. Others cut tablets in half or skipped doses to cut drug costs. In 2010, Harvard medical school published a report saying that 20% of new prescriptions go unfilled. The people whom Gov. Walker is counting on to bring in all that Federal reimbursement money won’t, because they don’t have the money to buy insurance, even with the promise of reimbursement. Walker’s numbers are false, phony and fake, but PolitiFact wimped out at “mostly false.”
When reporters and fact checkers don’t know the subject, they try to find a balance, even if there is none. PolitiFact isn’t much use if they don’t know the facts themselves.