From an October 26 article in TIME
Im sure innocents have been killed, and its a price of waging a war, Biden said at a press conference on Wednesday. But I have no confidence in the number that the Palestinians are using. The President didnt offer further evidence for his skepticism of the Palestinian health ministry's data, which the U.S. State Department has cited both internally and publicly, in the latter case as recently as March. (When asked to provide evidence to support Biden's statement, the White House referred TIME to comments made by U.S. National Security Council spokesperson John Kirby, who on Thursday reiterated the Presidents assertion that the death toll cannot be taken at face value because the Gaza Ministry of Health is just a front for Hamas.)
Hamas has a clear propaganda incentive to inflate civilian casualties as much as possible, Luke Baker, a former Reuters bureau chief who led the organizations coverage of Israel and the Palestinian territories from 2014 to 2017, said in a recent X thread. (Baker declined to comment to TIME.) Like Biden, Baker does not dispute that civilian deaths have occurred. Rather, he says that the extent of the death toll is unverifiable and that those tasked with tracking casualties in Gaza may not be able to do so freely. Any health official stepping out of line and not giving the death tolls that Hamas wants reported to journalists risks serious consequences, Baker said.
https://time.com/6328885/gaza-death-toll-explainer/