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Persuading opponents to support Medicare for All

July 22, 2020

Topics: Quote of the Day

By Gordon Pennycook, James Allan Cheyne, Derek J. Koehler, and Jonathan A. Fugelsang
PsyArXiv, Preprint, Last edited June 24, 2020


Does one’s stance toward evidence evaluation and belief revision have relevance for actual beliefs? We investigate the role of having an actively open-minded thinking style about evidence (AOT-E) on a wide range of beliefs, values, and opinions. Participants indicated the extent to which they think beliefs (Study 1) or opinions (Studies 2 and 3) ought to change according to evidence on an 8-item scale. Across three studies with 1,692 participants from two different sources (Mechanical Turk and Lucid for Academics), we find that our short AOT-E scale correlates negatively with beliefs about topics ranging from extrasensory perception, to respect for tradition, to abortion, to God; and positively with topics ranging from anthropogenic global warming to support for free speech on college campuses. More broadly, the belief that beliefs should change according to evidence was robustly associated with political liberalism, the rejection of traditional moral values, the acceptance of science, and skepticism about religious, paranormal, and conspiratorial claims. However, we also find that AOT-E is more strongly predictive for political liberals (Democrats) than conservatives (Republicans). We conclude that socio-cognitive theories of belief (both specific and general) should take into account people’s beliefs about when and how beliefs should change – that is, meta-beliefs – but that further work is required to understand how meta-beliefs about evidence interact with political ideology.


Our 8-item actively open-minded thinking about evidence (AOT-E) scale was strongly predictive of a wide range of beliefs, values, and opinions. People who reported believing that beliefs and opinions should change according to evidence were less likely to be religious, less likely to hold paranormal and conspiratorial beliefs, more likely to believe in a variety of scientific claims, and were more political liberal (in terms of overall ideology, partisan affiliation, moral values, and a variety of specific political opinions). Moreover, the effect sizes for these correlations was often large or very large, based on established norms (Funder & Ozer, 2019; Gignac & Szodorai, 2016). The size and diversity of AOT-E correlates strongly supports one major, if broad, conclusion: Socio-cognitive theories of belief (both specific and general) should take into account what people believe about when and how beliefs and opinions should change (i.e., meta-beliefs). That is, we should not assume that evidence is equally important for everyone. Furthermore, our findings provide clear support for the perspective that reasoning facilitates sound judgment, thereby undermining the idea that intuition commonly dominates reasoning. We also found essentially no support for motivated reasoning. Regardless future work is required to more clearly delineate why AOT-E is more predictive for political liberals than conservatives.



By Don McCanne, M.D.

This study revealed that people are sharply divided on open-minded thinking about evidence (AOT-E); that is, they are divided on believing whether or not beliefs and opinions should change according to evidence. More specifically, they find that AOT-E is more strongly predictive for political liberals (Democrats) than conservatives (Republicans). Since these differences are relative rather than absolute, we shouldn’t try to reach for a theory of all things here, but we can use this to try to understand why there is resistance to supporting Medicare for All when the evidence is overwhelming that it is a vastly superior model of health care financing when compared to the highly dysfunctional system under which we are suffering.

So now that we know that the political opponents to Medicare for All by and large do not believe that the evidence supporting the superiority of the model should be used to change their beliefs or opinions which cause them to reject the model, what should we do? We have expounded on the benefits of Medicare for All until we’re blue in the face, yet we don’t seem to budge their side. Should we abandon trying to present the evidence? If so, then what else can we do? Do we simply wait until they have an epiphany? That doesn’t seem to be working either. Should we ask them what we can do to help sway them? But if they already reject the evidence, then they certainly are not looking for other ways to be swayed.

Donald Trump just shifted from ridiculing face masks during the COVID-19 pandemic to recommending that people use them, based on the evidence. Evidence? Has anyone presented him with the evidence favoring Medicare for All? Wouldn’t it be worth a try?

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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