Who Will Do the Best Job on Health Care?

Neither candidate, say 40 percent of the voters. What gives?

A friend of mine asked if I thought Joe Biden was spinning health care to the Democrats’ advantage during last week’s debate. Was he telling the truth, she asked? Was John McCain really going to tax the value of health insurance benefits from employers? I thought you would know, she said, and I told her that Biden’s remarks on this point were indeed accurate. Oh, she replied. Now comes a new poll part of an ongoing series of polls by the Harvard School of Public Health and Harris Interactive, that helps explain her confusion. The public still does not know what each candidate’s proposal will do for the average Jack and Jill, and the press is partly to blame. That’s distressing, given the millions of words that have been written about health care this year!

“The poll shows that journalists are not getting there in telling people how issues affect their personal lives,” says Harvard professor Robert Blendon. For much of the year we have been pushing the media to tell how the candidates’ plans would affect ordinary people. Now, numbers support what we’ve been observing: the sparse coverage has translated into voter confusion.

Blendon’s survey asked voters how they think the candidates’ plans will affect them personally, rather than how they think the plans would affect the nation as a whole. When polls have asked the latter question, Barack Obama leads by 16 to 21 percentage points; in this survey, Obama’s lead narrowed to only six percentage points. Why? Either people see no difference between the two plans, or they don’t know how the plans would affect them, or they sense that McCain’s plan is better for them in some practical way. They see his plan as more benign—free from government involvement and unlikely to require a tax increase, Blendon explained. Forty percent of voters say there’s no difference or they don’t know, and that number can be attributed to the poor job we in the media have done explaining the very significant differences between the two plans.

To jog your memory: McCain’s proposals could ultimately eliminate the employer-based system, the bedrock of U.S. health care, by offering tax credits to encourage people to buy their own insurance in the individual market, where prices are very high and insurers easily deny coverage for pre-existing conditions. Obama would build on the current system by expanding public programs like Medicaid and offering up a new public program, where people without coverage could buy a policy.

The poll results on Medicare are particularly interesting, again reflecting the media’s dereliction of duty. Medicare is the campaign’s sleeper issue and one the candidates, and therefore the people who cover them, have studiously avoided. The candidates don’t want to talk about Medicare’s looming funding crisis, which will only be resolved by more taxes or reduced benefits—not exactly popular things to chat about during an election campaign. Since the candidates aren’t wading into that swamp, neither is the press.

But look at what seniors say about the candidates’ health plans. Neither candidate has focused on Medicare, and that is reflected in the numbers, says Blendon. Although Medicare is very important to seniors, they don’t know much about how the candidates’ plans might affect their Medicare benefits. Almost half of all seniors see no difference between the plans, or don’t know which is best for them. Among those who do see a difference, 27 percent say McCain’s plan is better for them and 27 percent say Obama’s plan is.

CongressDaily reports that some health care policy experts predict that the next fiscal crisis could hinge on the long-term financial stability of Medicare and health care in general. If they’re right, the media need to get cracking, or else the public will again be caught unawares.

Has America ever needed a media watchdog more than now? Help us by joining CJR today.

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.