Who Should We Believe?

The single greatest strength of the Internet is its freedom: from censorship, expurgation, or adjustment. The single greatest weakness of the Internet is that very strength: anyone can put out anything no matter how wrong or biased.

For users of the Internet like me, who seek news and information, the problem is to distinguish wheat from chaff, the truth from... something that smells. Two recent articles highlight our difficulty.

Here on HuffPost, the President of the American Federation of teachers, Randi Weingarten, assured us that the Affordable Care Act (ACA) is working. She wrote the following on April 20, 2013:

"Millions of previously uninsured people have gained healthcare coverage; the law has begun to rein in healthcare costs; consumers are starting to realize savings; patients have greater access to preventive care; and carrots and sticks throughout the healthcare industry are spurring moves to improve quality."

Five days before that in the American Spectator, healthcare economist David Catron blogged that, "The Wheels Come Off Obamacare." He was referring of course to the same ACA as Weingarten. Selected quotes from his article are below.

"This hopelessly Byzantine health care "reform" law is an implementation nightmare." ACA's CLASS [Community Living Assistance Services and Supports] Act had to be "repealed in January." Congress also voted "to repeal Obamacare's job-killing 2.3 percent excise tax." "Even the much-touted Obamacare provision that we were told would eliminate the 'pre-existing condition' scourge is proving to be a bust." "When Obamacare was first shoved down our throats, we were told that it would cost $898 billion. Now the projected cost is over $1.6 trillion. Meanwhile, many of its taxes are now in effect and it is forcing health insurance premiums through the roof."

Two prominent individuals are writing in two respected online venues reporting success and failure of the same law, one that will affect every American, even (especially) those not yet born.

Who is right? They can't both be. How do we peons decide?

Many people start with the person: judging the message by the messenger. You might easily think, "Well, if the president is saying it, then it must be true." Let me offer two recent examples. Then you decide.

President Bush (#43) assured us there were weapons of mass destruction (WMDs) in Iraq. That was the ostensible reason for starting the war. How did that work out? Then there was President Obama claiming that the attack in Benghazi was caused by a silly but offensive video that almost no one viewed, made by a nutty Coptic American.

(I won't lower myself to use President Clinton as an example. I will leave you with two words: Monica Lewinsky.)

Clearly, if you cannot trust a U.S. President to always speak the truth, you cannot use the messenger as an indicator of accuracy of the message.

The answer is simple and hard. As they say in legal proceedings, what does the "weight of evidence" tell you? If the military found no WMDs in Iraq, they probably weren't there. If the military analysis reveals careful pre-planning for Benghazi, it was the opposite of a "spontaneous reaction."

What about ACA? Is it working or failing? Who is right, Weingarten or Catron? What is the weight of the evidence?

There are numerous reports that can give us hard evidence: statistics about what is happening now. Projections about what will happen are not hard evidence.

Health insurance premiums are up so far. That is evidence you can see for yourself in your bills for premium payments. The Pre-Existing Conditions Insurance Plan (a part of ACA) has cancelled all further enrollments. This leaves thousands of people stranded, denied the insurance that they were promised.

Employers are cutting work hours, letting people go (euphemism for pink slips) and certainly not hiring any new employees. Over 30 percent of U.S. doctors can no longer afford to accept Medicaid-insured patients, and the number is rising. Meanwhile, millions are supposed to be added to Medicaid roles. Who will provide their care?

As for ACA cutting costs, you do the math. ACA is now scheduled to spend between $1.7 and $2.6 trillion, which is more than has been spent on the wars in Iraq and Afghanistan, combined. That is spending that must be added to the national deficit.

Go back and look at the quotes by Weingarten and Catron. Then you decide, based on the weight of evidence, who is blowing smoke and who is telling it like it is.

Deane Waldman MD MBA is Emeritus Professor of Pediatrics, Pathology, and Decision Science. He is the author of over 400 published articles and three books: "Uproot U.S. Healthcare;" Cambio Radical al Sistema de Salud de los Estados Unidos;" and "The Cancer in Healthcare" (July 2013).