Next on the list should be the money story—a monster with many tentacles the press has yet to grasp.

Who’s financing the campaign? All the presidential candidates have raised almost $1 billion in campaign contributions, according to Opensecrets.org. Health care interests have been big donors. It’s a good bet most will fight for the status quo. They tend to like things fine the way they are.

How will reform be financed—where will the money come from to finance the tax subsides, for example, that both candidates support to help people buy private insurance? Few news outlets have examined the topic and those that have dabbled in it have tended to tilt the stories with an “oh my god, how are we gonna afford all this” tone, which signals from the start that maybe reform is too expensive and works against serious analysis. If the candidates have been vague about the money details, it’s the media’s job to pin them down and illuminate their vision and leadership.

How will the cost of medical care be controlled? So far, candidates have offered little to prove that their ideas for cost containment will actually contain costs. Nor has the media pressed for specifics. Just how much money to the system will be saved by the much ballyhooed disease management approaches, which have had mixed results, or by the salve called preventive care, which by the way, has upfront costs that someone needs to pay. And exactly how will market competition touted by both candidates lower the price of an MRI?

Because so much is at stake, it’s disturbing to see a new crop of stories predicting that reform won’t happen. Insurance executive turned blogger Robert Laszewski told his readers, “the chance for major health care reform in 2009—or—2010 is a long shot.” Reporting on the annual meeting of the Midwest Business Group on Health, The Chicago Tribune observed that not one person in a crowd of 200 thought health benefits would be expanded one year after a new president takes office. The danger is that these kinds of stories can become a self-fulfilling prophecy. More of them and editors might get the idea the debate is over before it has even started.

It isn’t.

Read parts one, two, three, four, and five of this series.

• 1
• 2