Two months ago, the idea that a news cycle would be dominated by the distinction between a “public option” and a “health care co-op” would have seemed laughable. But that unlikely turn of events has come to pass this week—and the dynamic that brought us to this point reveals some not-entirely-flattering insights about how the press operates.
First, the good news: the coverage of the public option debate reflects the sort of attention to policy detail the press is often chastised for neglecting. And for the most part, the terms of the debate have been articulated fairly clearly—a reader who’s taken the time to do more than scan headlines should have a sense of what the “public option” entails, and if the idea of a “co-op” remains muddled, it’s because, as The New York Times recently pointed out, the lawmakers pushing it have been a little unclear themselves.
But what’s remained hazy in much of the coverage is just what the difference between these two choices amounts to—what all this sound and fury signifies. In part, that’s because there’s real uncertainty involved in projecting how either approach would play out. But it’s also because the press’s interest is not chiefly in the specific policy decision, but in the political disputes that policy brings to light.
Here’s how that dispute has come to be: The idea of a government-run public insurance option was proposed as a way to create competition and drive down costs. When Republicans, industry groups, and conservative Democrats all said they wouldn’t support it, the idea of non-profit “co-ops” was floated as an alternative. But liberal activists and Democrats in Congress—hungry for a decisive win after eight years of Bush/Cheney and a mildly disappointing start to the Obama administration—have vowed that they won’t support reform that doesn’t include the public option. This created a scenario in which, in the unlikely event nobody backs down, reform will fail. Meanwhile, the White House seems to have been caught flat-footed.
This is juicy stuff for political junkies, and its themes—conflict! power struggles! standoffs and showdowns!—are right in the media’s wheelhouse. But the fact that the actors in this political drama have decided to go to war on this issue does not necessarily mean it’s worth going to war over—and those of us watching the debate count on the press to tell us what’s beneath the fuss. By instead amplifying the political contest, the coverage just gives transcendent (if passing) significance to an underlying policy debate that, in the end, may be of only moderate importance.
A few skeptical observers, though, have begun to push back against the idea that the public option is the sine qua non of health care reform, including, most forcefully, Steve Pearlstein. In today’s Washington Post, Pearlstein writes:
The public option is nothing more than a political litmus test imposed on the debate by left-wing politicians and pundits who don’t want to be bothered with the real-life dynamics of the health-care market. It is the Maginot Line of health-care policy, and just like those stubborn French generals, liberal Democrats have vowed to defend it even if it means losing the war.
Pearlstein is writing with the freedom that comes with being a columnist, of course. But there’s no reason that straight news coverage can’t include both skepticism about the dominant narrative and an independent assessment of the likely outcomes of competing policy proposals. As long as the press is relying on others to set the agenda, though, that’s not likely to happen.