TL: Are the members of Congress who are most vocally against a public plan aligned with the industry?

WP: Yes. One of the things they can exploit is to talk about how a government-run plan would wreck the free market system in health care. Many members of Congress believe the free market can still work with health care.

TL: Can it?

WP: There’s no evidence that it has worked since the Clinton plan failed.

TL: Will we see a reprise of Harry and Louise?

WP: No. The industry knows its image is at an all-time low. So the industry can’t be as obvious in attacking a plan as it was in 1994. They will work through front groups and allies to attack it through ads and commercials.

TL: So what’s happening now with all these ads we’re seeing?

WP: What’s happening now is what happens in primary campaigns. We’re seeing a lot of targeted advertising by advocates of reform, aimed at members of Congress who might be persuaded on the wisdom of a public plan. That’s why you’re seeing a lot of advertising in Maine aimed at Olympia Snowe and Susan Collins. Later in the summer we’ll see more national advertising attacking or supporting aspects of the reform bills. It will be like a political campaign, and it will be very expensive.

TL: How should journalists be covering this middle and last phase of the campaign?

WP: They should be looking at what insurers, drug companies, and organized medicine said during earlier reform efforts, and then report on how well they’ve delivered on those promises. Instead of just reporting costs estimates from the Congressional Budget Office about how much a certain plan will cost taxpayers, which is easy to do, they should write investigative and analytical pieces on the costs to society and the economy if reform is not enacted. Is reform an expense we can’t afford, or an investment we can’t afford not to make? What is the ROI—the return on investment?

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.