Would the GOP turn away from the uninsured?

NPR identifies the party’s new thinking

NPR’s Julie Rovner deserves a shout-out for identifying what may be the GOP’s new thinking about healthcare—abandon the goal of covering more people with health insurance, and, as a political strategy, paint that goal as some kind of Robin Hood class warfare.

It’s hardly a secret that Republicans don’t like the Affordable Care Act, and that in its place they have trotted out old nostrums like malpractice reform, high-risk pools, and interstate insurance sales as their cures of choice. And also that policy experts believe none of those do much to cover the uninsured. In a segment Friday on NPR’s Morning Edition, and in a post published by Kaiser Health News, Rovner pushed further. In the process she took on no less a figure than Senate Minority Leader Mitch McConnell.

A few weeks earlier McConnell had told Fox News Sunday host Chris Wallace that the uninsured “were not the issue.” Rovner rebroadcast parts of that interview, in which Wallace—admirably—pushed McConnell hard on the question of what the GOP will offer the uninsured. He asked a second, then a third time: “What specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?” McConnell tried to reframe the discussion. “The question is, how can you go step by step to improve the American healthcare system?” he said. “It’s already the finest healthcare system in the world.” (Actually, that old claim—made by pols on both sides of the aisle—has been disputed repeatedly by studies like thisand this, from such reputable organizations as The Commonwealth Fund and the Organisation for Economic Cooperation and Development (OECD).

Wallace let that one slide, instead choosing to press that pesky problem of the uninsured in the US. He asked the senator for a fourth time about the uninsured: “You don’t think the 30 million people that were uninsured is an issue? To which McConnell answered:

Let me tell you what we are not going to do. We are not going to turn the American healthcare system into a Western European system. That is exactly what is at the heart of Obamacare. They want to have the federal government take over all of American healthcare. We need to clean up the healthcare the federal government is already responsible for before we start immodestly trying to take over all of American healthcare.

For the record: Wallace might have noted that European systems don’t leave millions of people uninsured, as Obamacare does. And that the Affordable Care Act also leaves the provision of insurance and the provision of healthcare in the hands of private businesses. But put that aside.

The point I’d like to make is that Rovner’s good reporting took the story further, in both her radio piece and her blog post. First, she set the record straight about the number of uninsured. “By the way there are closer to 50 million Americans without health insurance; 30 million is the number the health law is estimated likely to cover,” she correctly reported.

Then she went on with her thesis: The Senate minority leader “isn’t the only top Republican saying covering the uninsured should no longer be the top priority.”

She noted that Utah Republican Sen. Orrin Hatch told attendees at a conference of the conservative American Enterprise Institute that it was a disgrace that so many Americans had no health insurance, “but we cannot succumb to the pressure to argue on the left’s terms.” She noted that Dean Clancy, the legislative counsel for Freedomworks, a group that supports and trains Tea Party activists, says the primary “goal should be reducing costs and expanding individual liberty.”

Rovner reported that “Clancy is only one of the many policy types who are trying to convince more Republicans to put expanding coverage on the back burner.” She singled out Michael Cannon, the health policy guru at the Cato Institute, which bills itself libertarian. Cannon questioned why everyone should have health insurance:

The idea that government should guarantee health insurance to everybody passes as really gospel in health policy circles, without any serious consideration, without any sort of examination of why is it that we want people to have health insurance. Is health insurance the best way to serve those goals; Could there lower cost ways of achieving those goals? People need to have the freedom not to have insurance if the marketplace is to function properly.

Rovner included quotes from supporters of the health reform law, who argued that making the marketplace function better is a “big smokescreen.” And this: she reported that GOP analysts see the argument against universal coverage as an effective political tactic that is “like class warfare.” How? “Republicans want to paint the healthcare law as requiring people who already have health insurance to help pay for those who don’t.”

There was a tiny bit of he said/she said in the pieces, but Rovner weighed the arguments, and a reader/listener came away with a clear understanding of her thesis.

A few months ago NPR released a new ethics document that aimed at ending he said/she said stories that offer false equivalence—presenting “all sides” of an issue to create an appearance of balance rather than the best version of the truth. NPR’s ombudsman Edward Schumacher-Matos told me the document was an “evolution” of existing policy. He said sometimes reporters had been “hiding behind the rules,” and “so long as you didn’t violate the rules it was okay…He said/she said is a perfect example.” Judging from Rovner’s stories, the document is evolving in the right direction.

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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. Tags: , , , ,