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#WeLoveTheNHS: Healthcare misinformation targeted on Twitter

The fight over health care reform in the United States has gotten nastier and nastier. Part of what passes for debate has been shrill charges from those opposed to providing health care for the non-independently wealthy that “socialized medicine” is the first step toward government takeover of every possible facet of life.

Britain’s National Health Service has been the target of many of those arguments, with complaints about government rationing escalating to stories of “death panels” and even Fox News claiming that the NHS is a “breeding ground for terror.” The hyperbole boiled over this past week with an Investors Business Daily editorial (since corrected) claiming that “People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Hawking, of course, has lived his entire life in the U.K. He told The Guardian, “I wouldn’t be here today if it were not for the NHS.”

Fox’s Neil Cavuto made the ridiculous leap from the idea that “all eight UK terrorist suspects were either doctors or worked in the health care profession,” to the question “Is it because Britain’s national health care system pays physicians such a low salary that they actually had a shortage of doctors, forcing the country, then, to recruit from foreign countries?” These are easily fact-checked statements that should’ve been caught by any news organization with the slightest concern for reporting the truth, but they weren’t.

The Nation‘s Chris Hayes notes, though, how easy it is for misinformation to spread—especially on TV, where once on a program, you can essentially say what you want and are rarely fact-checked. Indeed, in most of the “objective” media, even if one person on the program disputes another’s statement, that’s simply considered “balance,” and the reporter is absolved of the responsibility to make sure the statements are factually accurate. The other problem with “balance” is that it presents the two conflicting opinions as ones that are held by equal numbers of people.

For many years, the top-down media system kept the circle of voices in the news deliberately small and official. But that system is changing, and unofficial voices are finding new and creative ways around the barriers to getting their voices heard—we saw it with the Iranian election, where the problem was official government censorship. This time around, British citizens were annoyed with the mischaracterization of their health care system, and decided to counteract the misinformation—on Twitter. Writer Matthew Sheret, a British citizen, gives some background on the British reaction:

“Reaction has been a closing of ranks. Graham Linehan on the Channel Four piece put it really nicely, likening it to someone insulting your mother: It’s okay for you to do it, but you’ll kill anyone else who says a bad word. I’d say that recent coverage has shown that responders to VoxPops haven’t really been conscious that there’s a different way of doing things, a lot of people assume that the NHS or something like it is a worldwide standard. It’s only people who have contact with those living in countries with private healthcare systems like that of the U.S. who have a strong appreciation for what the NHS means to them. Untold numbers of writers, musicians and artists know that they can get casual treatment for long and short term problems with little or no financial fallout, while their friends in America cannot run the risk. We’ve had TV news coverage about the reaction to the lies on Fox, and I hear also a very negative reaction from the Conservative Party Membership to the MEP Fox got to spread scare stories on air.

Writer Graham Linehan, who has a sizable Twitter following, decided to create a hashtag for British citizens to use to tell their personal stories about the NHS. Hashtags—a word or phrase with a # sign in front of it—are a way of labeling a Twitter message as part of a conversation. #WeLoveTheNHS exploded, with Linehan’s followers adopting the tag and British Twitterati like actor Stephen Fry (@stephenfry) and writer Warren Ellis (@warrenellis) picking it up. The tag spread, quickly reaching the top of Twitter’s “Trending Topics,” a clickable list of the most discussed topics on the service at any given time that appears in every user’s sidebar. It continued to be a top trending topic for days, and at press time is still going strong.

Stories vary from the pithy (@JimmaeJames: #welovetheNHS i’d rather be taxed for a hospital bed than a bomb.) to the poignant (@spoonbilledsand: #welovethenhs I’ve lived with HIV for fifteen years and friends perished. NHS always did its best. Free and fair to all) to the funny (@sanachnaa If Sarah Palin lived in the UK she would have her foot removed from her mouth for free #welovethenhs).

The spread of #WeLoveTheNHS springs from two features unique to Twitter. Kevin Marks notes that the way following works on Twitter means that “the publics are semi-overlapping – not everyone we can see will hear us, as they don’t necessarily follow us.” The converse being, in this situation, that each person who tweets with the #WeLoveTheNHS tag does it to a slightly different but self-selected audience, and so information spreads outward like ripples in a pool.

The Trending Topics sidebar plays off of people’s desire for popularity and information at the same time: a topic is trending, people don’t know what it is about so they click to find out and then are moved to join the discussion (or, occasionally, to spam). In this case, someone whose self-selected media network was of the Fox News and #tcot (top conservatives on Twitter) variety might see the #WeLoveTheNHS trending, click it, and be confronted with stories from real British citizens who very much appreciate their health care program.

Following relies on that self-selected network, but if you can get a topic to trend, you can reach across networks. Twitter has provided a way to bring unofficial voices into the news—mainstream media have reported on the story of the hashtag—and a way once again for peer-to-peer contact to circumvent corporate media and its vested interests entirely. It probably hasn’t changed the mind of any hardcore ideologues opposed to government-run health care for its own sake, but perhaps the casual observer who clicked on the trending topic, who hadn’t been well-informed on the subject before, learned something about other countries’ health care systems and now feels better able to participate in the debate.

The transnational, borderless character of the Web can be daunting, but Twitter has once again shown its ability to spread information horizontally quickly and efficiently. This time, too, it’s shown that it can be a tool for fact-checking: the voice of the crowd effectively fighting the voice of a privileged few who manage to make it onto U.S. media.

Sadly, nothing like the British NHS has a chance of passing in America, which made all the fearmongering that the right engaged in that much more ridiculous. Still, the media landscape has changed since Bill and Hillary Clinton tried to reform the health care system, and money is no longer enough to control the message. The debate is messier, without a doubt, but it contains many more voices than the last time around, and that’s better for democracy.

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Sarah Jaffe

Sarah Jaffe is former deputy editor of GlobalComment. She’s interested in politics and pop culture, and has a special place in her heart for comics.

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