Hillary Rodham Clinton is a prodigious consumer of information about healthcare, but one document she doesn't seem to have read (or at least profited from) is a Canadian report titled "Once Upon a Time
Otherwise, she might not have told campaign audiences about Trina Bachtel, a pregnant Ohio woman without health insurance who, Clinton said, had been turned away twice by a hospital that demanded she pay $100 to be examined. In this telling, Bachtel lost her baby, then was airlifted to another hospital, where she died. "It hurts me," Clinton said, extracting her political message from the tragedy, "that in our country, as rich and good of a country as we are, this young woman and her baby died because she couldn't come up with $100 to see the doctor."
What hurt Clinton's campaign was that several "facts" in the story did not hold up. The hospital where Bachtel's child was stillborn told the New York Times that the woman was insured. In fact, she was under the hospital's care and had never been refused treatment.
Critics cite this episode as further evidence that Clinton, already embarrassed by a false memory of braving sniper fire in Bosnia, is a serial fabricator. But she is only the latest politician to succumb to the occupational hazard of packaging policy as parable. The Canadian report argues that debates about healthcare are especially conducive to storytelling because medical decisions involve "choices to be made, obstacles to overcome, breakthroughs, setbacks and conclusions that occasionally warm the heart and often break it."
That is why John Edwards, who withdrew from the 2008 race, was so fond of this anecdote (which at least was firsthand): "A few weeks, ago I met a man named James Lowe in Wise, Va. James spent the first 50 years of his life without a voice -- literally without a voice -- because he didn't have healthcare. All he needed was a simple operation to fix a cleft palate." Edwards also liked to retell a story from this newspaper, in which a patient died amid an argument with her insurance company over an experimental treatment. In real life, the story was as complicated as it was wrenching. In Edwards' version, it was good versus evil.
But it isn't just healthcare that invites parabilization. When Ronald Reagan campaigned for president on a welfare-reform platform, he didn't rely solely on analyses of welfare dependency done by conservative think tanks. No, he told audiences about a welfare recipient in Chicago who supposedly had 80 names, 30 addresses and 12 Social Security cards and was "collecting veterans benefits on four nonexisting deceased husbands. ... She's got Medicaid, getting food stamps, and she is collecting welfare under each of her names." In invoking the chiseler who came to be known as the "welfare queen,” Reagan was trying to harden hearts, not melt them. And his example was slapped with many more coats of imaginative paint than Clinton's.
"Anecdotalizing" comes naturally to human beings. But politicians in a democracy have a special reason for telling stories: They suggest that a candidate takes cues not just from pollsters and policy wonks but from real people. In his 1995 State of the Union address, Bill Clinton boasted: "I may be the only president who has actually had the opportunity to sit in a welfare office, who's actually spent hours and hours talking to people on welfare. And I am telling you, people who are trapped on it know it doesn't work."
Voters want to hear about heroes, villains and victims, not bell curves and pie charts. But there is danger in the politics of anecdote, and not just the risk of error. It lies in the extrapolation of policy from the details of a single example. As a Yiddish proverb puts it, "For example is not proof."