Monday, March 19, 2012

‘The Road We’ve Traveled:’ A misleading account of Obama’s mother and her insurance dispute

Narrator Tom Hanks: “He knew from experience the cost of waiting [on health care reform].”

President Obama : “When my mom got cancer, she wasn’t a wealthy woman and it pretty much drained all her resources”

Michelle Obama: “She developed ovarian cancer, never really had good, consistent insurance. That’s a tough thing to deal with, watching your mother die of something that could have been prevented. I don’t think he wants to see anyone go through that.”

Hanks: “And he remembered the millions of families like of his who feel the pressure of rising costs and the fear of being denied or dropped from coverage.”

--series of statements with images of Obama and his mother, Stanley Ann Dunham, in the Obama campaign film “The Road We’ve Traveled”

“The Road We’ve Traveled” is a very slick and impressively produced campaign film—sheer catnip for Obama fans. There are a number of facts and figures that could be challenged, but for now we are going to focus on this sequence. The series of words and images is an excellent example of how such films can create a misleading impression, while skirting as close as possible to the edge of falsehood.

The sequence, in fact, evokes a famous story that candidate Obama told during the 2008 campaign—that his mother, Stanley Ann Dunham, fought with her insurer over whether her cancer was a pre-existing condition that disqualified her from coverage.

But the story was later called into question by Dunham’s biographer. The fact that Obama’s initial claim is not directly repeated suggests the filmmakers knew there was a problem with the campaign story, but they clearly wanted to keep some version of it in the film.



The Facts


During the 2008 campaign, Obama frequently suggested his mother had to fight with her health-insurance company for treatment of her cancer because it considered her disease to be a pre-existing condition. In one of the presidential debates with GOP rival John McCain, Obama said:

“For my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.”
But then earlier this year, journalist Janny Scott cast serious doubt on this version of events in her excellent biography, “A Singular Woman: The Untold Story of Barack Obama’s mother.” Scott reviewed letters from Dunham to the CIGNA insurance company, and revealed the dispute was over disability coverage, not health insurance coverage (see pages 335-339).

Disability coverage will help replace wages lost to an illness. (Dunham received a base pay of $82,500, plus a housing allowance and a car, to work in Indonesia for Development Alternatives Inc. of Bethesda, according to Scott.) But that is different than health insurance coverage denied because of a pre-existing condition, which was a major part of the president’s health care law.

Scott writes that Dunham, who died in 1995 of uterine and ovarian cancer, had health insurance that “covered most of the costs of her medical treatment…The hospital billed her insurance company directly, leaving Ann to pay only the deductible and any uncovered expenses, which, she said, came to several hundred dollars a month.”

Dunham had filed the disability claim to help pay for those additional expenses. The company denied the claim because her doctor had suspected uterine cancer during an office visit 2 ½ months before Dunham had started the job with Development Alternatives, though Dunham said the doctor had not discussed the possibility with cancer with her. Dunham requested a review from CIGNA, saying she was turning the case over to “my son and attorney Barack Obama.”

When Scott’s book was published, the White House did not dispute her account. “The president has told this story based on his recollection of events that took place more than 15 years ago,” a spokesman said.

Now let’s look at what the movie does with this story. It does not directly repeat the claim that Obama’s mother was denied coverage because of a pre-existing condition, fighting for treatment in her hospital room. But look at what it does say:

1. Hanks says the president knew the cost of waiting on reform. (Though disability coverage was not an issue in the health care debate.)

2. The president says cancer “drained all her resources.” (Health insurance paid for most of her bills, so this is not the case of someone being bankrupted by tens of thousands of dollars in bills. Her salary of $82,500 in 1995 was the equivalent of $123,000 today, but Scott says she had little savings.)

3. Michelle Obama says Dunham “never really had good, consistent insurance.” (It is unclear what she means by this, except maybe that Dunham had different jobs, some of which did not provide insurance. But Dunham had good health coverage when the cancer was discovered.)

4. The first lady also suggests the death “could have been prevented.” (Again, it was not an insurance issue. Before going overseas, Dunham was too busy with work and had skipped an important test recommended by her U.S. doctor, dilation and curettage, that might have spotted the cancer earlier. Then an Indonesian doctor diagnosed her problem as appendicitis and removed her appendix. By the time the cancer was finally discovered, it was third-stage.)

5. Hanks says that Obama’s family felt “the pressure of rising costs and the fear of being denied or dropped from coverage.” (Maybe for disability, but not health insurance.)

In the end, the impression left by the film, especially if you watch it (go to the 8:45 mark), is very similar to Obama’s 2008 campaign rhetoric: His mother was denied health-insurance coverage, draining her resources, and with better coverage she might have lived longer. The film suggests this experience helped inspire the president to keep fighting for the health care law, even in the face of advice from aides that he accept a less-than-satisfactory compromise.

Note that none of the quotes in the film actually use the words “health insurance” or “health insurance coverage.” Instead, the first lady says “insurance” and Hanks says “coverage,” which could just as easily mean disability insurance. But that would not be as evocative—or as motivating.

Asked for a response, the Obama campaign referred us to the previous White House statement on Scott’s book.



The Pinocchio Test


We use a “reasonable man” standard here, and we think there are few viewers of this film who would watch this sequence and conclude that Dunham was involved in anything but a fight over health-insurance coverage.

The disability-insurance dispute certainly may have motivated the president, but he has never explicitly stated that. In any case, the filmmakers must have known they had a problem with this story or else they would have recounted it as Obama had done in the 2008 campaign, using phrases such as “pre-existing conditions,” “health insurance,” and “treatment.”

Instead, they arranged the quotes and images to leave a misleading impression of what really happened.


Three Pinocchios

WaPo Fact Checker

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