After weeks of making his case for the legislation in broad strokes -- including two similar rallies last week in Philadelphia and St. Charles, Mo. -- Mr. Obama used Monday's appearance to pivot to the personal, as he recounted the story of the cleaning woman, Natoma Canfield -- a health care drama that could not have been better scripted for his purposes if he had written it himself.
Ms. Canfield, of nearby Medina, wrote Mr. Obama at the end of December to say that she had been treated for cancer 16 years ago and had been cancer-free for 11 years. But with her premiums rising -- she paid more than $6,705.24 in 2009 and had just received notification of a 40 percent increase -- she decided to drop her coverage. The president read her letter aloud to a meeting of insurance executives this month, and had hoped Ms. Canfield would introduce him when he appeared here.
Instead, Ms. Canfield's sister family introduced the president, as Mr. Obama explained to the crowd that, after collapsing last week and being rushed to the hospital, Ms. Canfield had received a new cancer diagnosis on Saturday.
"The reason Natoma is not here today is that she's lying in a hospital bed, suddenly faced with this emergency -- suddenly thrust into a fight for her life," Mr. Obama said. "She expects to face a month or more of aggressive chemotherapy. And she is racked with worry not only about her illness but about the cost of the tests and treatments she will surely need to beat it."
I've blogged about Slovic's work before (most recently in the context of Haiti), but I think it speaks to the importance of getting past abstract statistics (CBO reports, deficit projections, etc.) and instead zooming in on a single emotional narrative when making a moral argument. Here's how I describe Slovic's experiment in my book:
The experiment is simple: Slovic asks people how much they would be willing to donate to various charitable causes. For example, Slovic found that when people were shown a picture of a single starving child named Rokia in Mali, they acted with impressive generosity. After looking at Rokia's emaciated body and haunting brown eyes, they donated, on average, two dollars and fifty cents to Save the Children. However, when a second group of people were provided with a list of statistics about starvation throughout Africaâ¯more than three million children in Malawi are malnourished, more than eleven million people in Ethiopia need immediate food assistance, etc.â¯the average donation was fifty percent lower. At first glance, this makes no sense. When we are informed about the true scope of the problem we should give more money, not less. Rokia's tragic story is just the tip of the iceberg.
According to Slovic, the problem with statistics is that they don't activate our moral emotions. The depressing numbers leave us cold: our mind can't comprehend suffering on such a massive scale. This is why we are riveted when one child falls down a well, but turn a blind eye to the millions of people who die every year for lack of clean water. Or why we donate thousands of dollars to help a single African war orphan featured on the cover of a magazine, but ignore widespread genocides in Rwanda or Darfur. As Mother Theresa put it, "If I look at the mass I will never act. If I look at the one, I will."
The same principle applies to our political beliefs. Those rational calculations - the Senate plan will cover 30 million uninsured, etc - aren't enough to budge us from our bias for the status quo. The massive numbers have no emotional heft. But maybe, just maybe, a tragic story will do the trick. Needless to say, this is a deeply problematic way of morally engaging with the world, but it's the way we're built.
C'mon, Obama has used this anecdotal approach from the time he first campaigned for political office.
I don't doubt Slovic's research, but it's superficial when used to explain Obama's (and other politicians) use of emotional anecdata.
While I am very sorry for Ms. Canfield on a personal level, I also have no doubt that she will get the care she needs. Yes, it may cause her financial distress, but I am well aware that there are a number of ways that can be dealt with. None of them include starving to death.
Her personal narrative, as relayed by Obama, has less effect on me than the statistics on starvation in Africa. AND, I feel just as personally helpless about either situation.
The problem with health care reform as currently proposed is that it is just shuffling who pays for it. That solves the cost problem how? Our system of delivery and application of health care is what must eventually be reformed. That will have to take place on a local level, not a national one.
Another problem with our politicians' use of emotional stories is that far too often they present only half the story or a completely false one. In essence, I can't take his word that there actually is a Ms. Canfield in the situation described.
ThatÂ´s remind me of the infamous (but insightful, neverthless) words of J. Stalin:
"One death is a tragedy one million is statistics"
Personal stories are the most powerful form of persuasion.
They're also the most memorable form of persuasion. People remember stories, which may simply speak to their poignancy.
thx for the article. seems to be all about empathy. if we can imagine ourselves in that bad situation, we tend to help. no empathy there when you only see numbers.
smart blog. i enjoy most of your articles really a lot. keep on the great work!
how would this tie into the whole "it's permissible to let someone else die by doing nothing, except when that someone else is someone we know" bit? rather, what would the mayans do?
There must be a host of factors at work determining when and how our empathy is elicited and when and how we choose act on it. For example: the extent to which the victim is similar to me; the likelihood that a similar tragedy could happen to me; the likelihood that my acting will alleviate the problem; the question of whether the victim is "deserving" or in some way responsible for her condition; whether the situation is a one-off act of God (Tsunami, earthquake) or a chronic condition (global poverty) and so on. At any rate, it's immensely hard to create powerful, moving stories about the problems that most affect us as a species--harder, I would suggest, than the suggestion that we make them personal suggests.
I recollect reading in some popular book (that aging memory fails me from recollecting), that people dont come to the rescue of a stranger who is obviously in need of assistance not because they are "cold", but, because they are not trained or having the required reflexes to respond . They walk away "heartlessly". Perhaps in the same way, we respond to images of poverty but not to statistics as we are not trained or have the reflexes to respond .
In many cultures (including ours), storytelling is used to teach. There is cognitive psych research, I believe, on the persuasive nature of storytelling, in that it somehow restricts or bypasses the faculty for counterargument. Statistics, on the contrary, invite counterargument. This may be why it is so difficult to persuade physicians (as Atul Gawande and others have pointed out) that algorithms can be more effective than a physician's personal experience in selecting, for example, whether a patient with chest pains should be admitted for observation or sent home. Although we accord doctors a great deal of authority over our health decisions they are subject to the same biases as the rest of us.
As for politicians' use of the technique, it may seem morally problematic, however if they offer both the statistics and the story, I can accept the story as a compelling example. As you say, it's how we're built, and they are merely acknowledging it. The stakes may be higher but it's no more than what a teacher does to get kids to pay attention in class.
What I find more disturbing is the way that so-called intellectualism (or as you might say, thinking about thinking, or metacognition) is disparaged by many people, and yet at the same time people fear that they are the subject of propaganda that short circuits their ability to reason. It would seem that the best defense against such propaganda would be to strengthen our ability to engage in thinking on multiple levels, no?