ICYMI: Facts aren’t optional

Ronald Reagan paraphrased John Adams when he said, “Facts are stubborn things.” Adams had continued: “whatever may be our wishes, our inclinations, or the dictates of our passions, they cannot alter the state of facts and evidence.”

marketing-analytics-factsMy latest op-ed, title above, appeared in The Virginian-Pilot last Thursday. In it, I discuss something that has been bugging me for a while now: the inability of people to acknowledge the facts. Or, as Einstein put it, “If the facts don’t fit the theory, change the facts.”It’s no wonder, then, that there has been a proliferation of fact-checking services.

Not that it matters. It’s far easier to just attack the fact-checkers than it is to admit they are right, especially when it is something that we already disagree with. That’s part of the reason we have this serious divide in our country. It is impossible to move towards a solution as long as we can’t agree on the facts.

Politicians and advocacy groups cherry-pick facts all the time. We know it – and yet far too many believe the tall tales, anyway. And opinion writers? They completely forget that while you are entitled to your own opinion, you are not entitled to your own facts.

As I sit to write my op-ed each week, no matter the topic, I spend most of the time researching. I found this Malcom X quote to be pretty close to my own process:

Despite my firm convictions, I have always been a man who tries to face facts, and to accept the reality of life as a new experience and new knowledge unfolds. I have always kept an open mind, a flexibility that must go hand in hand with every form of the intelligent search for truth.

Sometimes, my research leads me in a completely different direction than where I started. Sometimes, the “facts” as originally reported turn out to be wrong.

What passes for opinion these days is often no more than a repetition of talking points, which, as I point out in the article, it merely the latest corollary of The Big Lie.  Of course, the ability of groups to tell these lies is directly related to the lack of critical thinking skills these days, a topic I mentioned in an earlier column.

The argument over Medicaid expansion is a perfect example. The fact is that the Affordable Care Act is the law of the land. The fact is that as designed, there is a coverage gap that was supposed to be filled by Medicaid expansion. The fact is that reimbursements to hospitals for uninsured care will be reduced. The fact is that additional federal taxes are being collected to pay for the expansion.  The fact is that the federal government will, using those taxes, pay 100% of the initial cost of expansion and 90% thereafter. Finally, the fact is that SCOTUS allowed the states to decide on whether or not to expand Medicaid.

It is not a fact that the feds will shirk their responsibility. That is conjecture.

So putting on your critical thinking skills cap, what should Virginia do?

This Washington Post editorial gives a hint. Facts aren’t optional.

My column appears in The Virginian-Pilot every week, usually on Thursdays. You can see the columns as they are published here, or navigate to them from the PilotOnline.com homepage by clicking on Opinion and then choosing my name at the bottom of the dropdown list. You can also see the columns by liking my Facebook page. Although my column appears weekly, I am not and have never been an employee of The Virginian-Pilot nor am I paid for my contributions to the paper.

 

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21 thoughts on “ICYMI: Facts aren’t optional

  1. Yes, the money is there and GOP claims and the Federal government will not pay out what is promised are ridiculous. The real problem is that there are nowhere near enough doctors accepting new Medicaid patients to expand the program. Unless Virginia wants to foot the bill for an increase in reimbursement rates, expanding Medicaid will not provide actual health care to anywhere near as many people as are being claimed. The details are always in the fine print.

    Did ACA give people health insurance plans with lower monthly premiums? Yes. Did it actually increase access to health care for everyone who got lower premiums? Hardly, and in most cases it decreased access by drastically increasing initial out of pocket costs.

      1. From 30 seconds of Google searching I found these. I get most of my information from CSPAN panel discussions, I’ve probably watched 3 on this topic.

        https://www.advisory.com/Research/Physician-Practice-Roundtable/Members/Expert-Insights/Medicaid-payment-increase-for-PCPs

        http://www.miamiherald.com/2014/02/18/3944660/pay-boost-for-medicaid-doctors.html

        http://www.chicagobusiness.com/article/20130410/NEWS03/130409786/not-enough-doctors-in-medicaid-state-director-says

        ACA included a 2 year boost to reimbursement rates but many agree that will not be enough even in the short term to attract as many new doctors as are needed to treat all the new people on the rolls.

          1. According to this study, 61% of doctors in Virginia participate in Medicaid and 53% of doctors are accepting new payments.

            Combine that with the doctor shortage in some areas of the Commonwealth that the study details, which no doubt are in the areas with the highest percentages of people who would be covered by Medicaid expansion, and I think its a safe bet that we don’t have enough doctors to treat those people under current conditions.

            http://jchc.virginia.gov/Final%20%20Physician%20Shortage%20color.pdf

  2. One of the things that PowerPoint presentation you linked was attempting to address was the need for additional doctors and the use of non-doctor medical professionals. That doesn’t change the overriding question, though: should Virginia expand Medicaid.

    I think Sen. Walter Stosch lays out the case to expand – and include it in the budget – very well here http://archive.constantcontact.com/fs132/1100515055063/archive/1116818607525.html

    1. I agree we should expand Medicaid, but it would be nice to see an intellectually honest discussion for once. All the Democrats joining in the messaging that Republicans are trying to deny healthcare to hundreds of thousands of Virginians conveniently ignore the fact that expansion only guarantees someone an increasingly slim chance of getting access to healthcare.

      If we expand Medicaid, which I think we will, its going to end with a situation similar to the launch of the ACA website. Tens of thousands of people will be unable to find a doctor and will be very angry with those who made such hefty promises.

      1. Please don’t use “all” – because you don’t know all Democrats. And even reviewing the information you have provided, I disagree the chance of getting healthcare is “slim.” I think it will be challenging – and because of the additional payments to providers for those two years, it might mask the need – but, reading the PowerPoint, it seems that would be with case with or without expansion. Otherwise, why did they do the study?

        I’m not convinced VA will expand it just yet. The sides have dug in their heels on this.

  3. > The fact is that the federal government will, using those taxes, pay 100% of the initial
    > cost of expansion and 90% thereafter.

    No, that is also conjecture.

    The FACT is that, if a State opts in, then it cannot opt out should the feral government renegue.

    1. Nope. It’s not. You are making the same argument that has previously been debunked. The law, as written, requires the feds to pay 100% of the cost of Medicaid expansion initially and 90% thereafter. Look it up.

      And your statement is false – in fact, the provision to disenroll is already a part of the Virginia budget. Read the link from Sen. Stosch.

      1. The law cannot bind another Congress. Just as Congress voted to pay 90% in the future, Congress can vote NOT to pay that 90%. You’re assertion that they will not do that is conjecture.

        Even if the provision to “disenroll” is in the budget, it is not in the Medicare law itself to allow States to do that.

        1. The law does indeed bind Congress – until the law is changed. After 50 votes that have failed, it is no longer conjecture. It is a fact.

          Medicare isn’t Medicaid – and show me in the law where they cannot disenroll. Because that is exactly the plan of several states, not just Virginia.

    2. In any case, it’s SUPER RIDICULOUSLY CONVENIENT that the political party claiming that states shouldn’t opt-in lest the Federal Government cut its Medicaid funding later is the same political party that shut down Federal Government in an attempt to cut its Medicaid funding.

      It’s the political equivalent of some goon walking into your store with a baseball bat and offering to sell you insurance by observing, “This is a real nice business you have, here. It’d be a real shame if something happened to it. . . .”

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