Two New Story Lines for Health Care

A march to victory or a rollback of ambitions?

Dear members of the public, take your pick. Will major health care reform will happen, or will there be only baby steps, proving that no comprehensive reform is possible that would establish two things once and for all: that health care is a right, and that everyone is entitled to care and a way to pay for it. Perhaps you are unsure. What you think may have a lot to do with what your local news media is telling you—and the press is reporting two different stories, prognosticating on what the new president might do. Those stories seem to be a lead-in to the kind of horse race journalism that marked the Clintons’ attempt at health reform fifteen years ago.

The first is the rah-rah story that quotes experts, acting as cheerleaders for health reform and building expectations that something big might happen. Yes, Go, Fight, Win! That kind of stuff. Such was the report published by the Provo, Utah Daily Herald over the weekend with its headline: “Experts: Elections mean big chance for health care reform.” The head cheerleader featured was Ronald Pollack, executive director of Families USA, a consumer advocacy group that calls itself the voice of health care consumers. Pollack spoke on a conference call with reporters, state legislators, and health care professionals, telling them that with more Democrats in Congress it will be easier to win support for a reform bill. “You’ve got key leaders in the next Congress and in the new administration who have made clear health care reform as their top priority,” Pollack said. Gee, I thought everyone has been saying the economy is top priority.

“That doesn’t mean we’re going to agree on every issue, but there is very significant congruence on a whole bunch of issues,” Pollack said. By now, readers might be wondering which ones, but the Daily Herald didn’t elaborate. Maybe the paper didn’t see that as the focus of its story. Pollock told those on the call not to let partisanship deter their enthusiasm for a possible solution. “Unlike the past, we can’t let our second-favorite choice be the status quo,” he said. The story did end with a state legislator pulling back the reins. Any major changes in Utah, he said, probably won’t happen in this legislative session; maybe in the next one.

The San Francisco Chronicle published a more temperate assessment. Its story, headlined “Health care improvements have to wait awhile,” intimated that a less ambitious plan might be in the offing instead of the big ideas for which some people had hoped during the campaign. The Chronicle consulted plenty of the usual experts—Michael Cannon from the libertarian Cato Insitute; Drew Altman, the head of the Kaiser Family Foundation; Jacob Hacker, a professor at UC Berkeley who advised the Obama campaign, and has ideas of his own for reform; blogger Robert Laszewski, who runs Health Policy and Strategy Associates; and the oft-quoted Jerry Flanagan from the California advocacy group Consumer Watchdog.

Just what kind of pipeline Consumer Watchdog has to Obama’s health care gods is unclear. Since last spring, Laszewski has claimed that a comprehensive overhaul of the system will not happen. He told the Chronicle that “Because of the deficit situation, I haven’t talked to anyone in Washington, D.C., who believes we will get major health reform a la $100 billion.”

All these stories are just speculation that is more useful to the health care cognoscenti eager to be well positioned for influence in case of serious movement than the general public, who may genuinely care how health reform turns out. Even though election exit polls showed that people cared more about the economy, many still care deeply about this issue. For many Americans, the economy and health care are entwined. Lose your job and you lose your health insurance. The cumbersome, costly COBRA extensions are out of reach for the newly unemployed. Stress from being out of work takes its toll; when sickness results, there’s no way to pay for care.

So we have a suggestion. Instead of the gloom and doom scenarios or the rah-rah stories with quotes announcing that the golden moment for health reform has arrived, let’s report on why the country needs health care reform in the first place. We urge the media to examine what’s really happening to real people. The Philadelphia Inquirer is setting an example for how to do that. My next post will show what the paper is doing.

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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.