Missing: Single-Payer in Pennsylvania

What David Brancaccio, and the rest of the press, left out

The Pennsylvania primary may be over, but one of the campaign’s hottest and most fiercely contested issues—whether the state on its own can reform health care and cover some portion of the uninsured— is not. Right before the primary, David Brancaccio on his weekly public affairs show NOW recognized that this reform debate is very much alive in Pennsylvania. Called “Health Care Meltdown: Looking for Solutions,” the NOW segment began by citing an all-important and alarming stat—health-care costs in the state are running 11 percent higher than the national average, and they’re rising twice as fast as the average wage. To personalize the numbers, Brancaccio offered up Philadelphia coffee bar owner Joe Cesa, who said he could not afford to cover his baristas, though he does help them pay small doctor bills. To personalize the numbers even more, NOW presented a couple in the insurance business, Diane and Sean Doherty, who pay $1,000 a month for coverage and still face higher deductibles, larger co-payments, and more out-of-pocket expenses. Many Americans feel similar pain.

What to do about all this? NOW’s message: Pennsylvania Governor Ed Rendell, a Democrat and Clinton backer, is trying to fix health insurance with what Brancaccio called “a bold but controversial new experiment in health-care reform that could offer a glimpse at things to come nationally.” Brancaccio told his audience that the one thing they needed to know about the governor’s plan was that it would cover nearly 70 percent of the uninsured, even those with preexisting conditions. There’s nothing wrong with the governor trying to fix a serious problem, but a bold, new experiment? Has Brancaccio not heard that a similar plan was pushed by California Gov. Arnold Schwarzenegger last year, only to die an agonizing death when an independent state agency declared that it was way underfunded? Has he not heard of the troubles in Massachusetts, a state struggling to provide health insurance to everyone under a similar kind of law?

Brancaccio failed to include context that would have helped viewers understand whether the Pennsylvania governor really has a novel plan that might work. Instead, he larded his show with bites from Republican legislator Karen Breyer, who appeared on camera not once but eight times, subtly and not-so-subtly pumping the governor’s compromise approach. As a Republican, she may have added balance, but to me she seemed like a Rendell cheerleader. Brancaccio did say the governor’s plan was controversial and showed one state senator alluding to the huge costs of funding any reform. Brancaccio also laid out the proposed funding sources—the usual suspects: tobacco taxes, federal dollars, premiums paid by the newly insured—without mentioning they were basically the same ones considered in California and Massachusetts.

Context wasn’t Brancaccio’s only omission. He gave no airtime to the state’s active single-payer movement, a serious grassroots group called Healthcare for All Pennsylvania, which has more than four thousand members who have been holding rallies, forums, and panels to promote a state-funded system that covers everyone. It’s one of the most active single-payer organizations in the country and has been challenging the governor’s plan. It hasn’t gotten a lot of press. This spring when the single-payer bill was up for a hearing in the state House of Representatives Health and Human Services Committee, a state representative who supports the governor’s approach called a press conference down the hall at the same time to talk about future anticrime legislation, which drew away the capital press corps. Only the Philadelphia Evening Bulletin published a story about the hearing.

Legislative maneuvering happens in the rough and tumble of politics, but on national television, one might expect higher standards of fairness. By chance, a medical student named Kevin Hauck walked into Joe’s Coffee Bar as the NOW crew was filming, and he was interviewed for the show. Hauck, who is also a board member of Healthcare for All Pennsylvania, said he talked about the single-payer plan, but those comments didn’t make the final cut. Instead the segment showed Hauck talking about a doctor bargaining with an uninsured patient over which lab tests to perform and saying, “This is really an issue about patients and about getting treatment.” No kidding. A researcher for the show did interview several people who support a single-payer plan but told one of them that the show was going in a different direction. The closest NOW came to giving a nod to that approach was a comment from Brancaccio: “Reformers contend it [the governor’s plan] falls far short of providing what they consider the holy grail of health-care reform: universal coverage.”

Slanting a story by omission is not cool. Shutting out an important viewpoint hardly fosters robust discussion of a subject that every American has a stake in. Chuck Pennacchio, who heads Pennsylvania’s single-payer group, vows that the fight to educate the state about their plan will continue “through word of mouth, fliers, e-mail, and bloggers,” old fashioned tools and new ones. But what does that say for the mainstream media?

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Trudy Lieberman is 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. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.