Just before Christmas, a CNN poll asked Americans whether they favored or opposed the health-reform bills moving through Congress. Forty-two percent favored them, 56 percent were opposed. This and other polls released last fall also suggested that most Americans lacked a basic understanding of the changes being proposed. Arguably, the two are connected. How many people were opposed to the legislation because they either didn’t understand or misunderstood it? A clerk at a store in West Virginia told the Charleston Gazette that she tried hard to follow the twists and turns of health reform. “I know it affects me,” she said, “but I can’t find out what it’s going to be.” A friend of mine admitted that she had stopped trying to figure it out. A small business owner in Manhattan concluded: “The press has done a horrible job of translation.”
Press coverage of the effort to reform health care has been largely incoherent to the man on the street. The three hundred or so posts I have written about health-care reform for CJR.org over the past two years tell the story of media coverage that failed to illuminate the crucial issues, quoted special interest groups and politicians without giving consumers enough information to judge if their claims were fact or fiction, did not dig deeply into the pros and cons of the proposals, and gave tons of ink and air time to the same handful of sources.
By now it’s a familiar critique—the press did not connect the dots, there were too many he said-she said stories, not enough analysis, and so on. And yet, after a decade in which the inadequacies of traditional press strategies—objectivity, top-down coverage, the primacy of the “scoop,” etc.—became ever more apparent to those of us who care about these things, those very strategies failed the country again on a story of monumental importance to every citizen.
Traditional journalism as practiced by the nation’s major news outlets, even as it has been recreated on the Web, is just not good enough for a story as big and complex as health care. Such stories demand a new paradigm, and while I don’t pretend to know exactly what that paradigm is or how we get there, the ways the press failed on the health-reform story provide some clues.
Traditional journalism relies on official sources to tell the story, and on health care those sources framed the narratives they wanted the public to hear. The “stars are aligned” refrain, heard from advocacy groups like Families USA and others, conveyed the idea that the chief stakeholders all supported reform. But what those stakeholders supported was “reform” that for the most part let them continue with business as usual. From the Democrats came the narrative of “affordable, quality health care”—empty, focus-group tested words that misled millions of Americans into thinking reform would bring health insurance to everyone and health care that was both cheaper and better. From Republicans we got the predictable fear-mongering about “government-run health care,” but few alternate solutions. The president himself gave us the “you can keep what you’ve got” assurance that left many people wondering, “If that’s the case, why should I care?”
Playing follow-the-newsmaker leads to he said-she said reporting, which does audiences a particular disservice on stories about contentious, difficult issues like health care—the truth is complicated and requires more explication than clashing quotes can deliver.
I had hopes for this article.
Then the author show that he had no true understanding of the problems in journalism; For Pro healthcare viewpoints it was "a narrative" - for anti-healthcare viewpoints it was "fear mongering.".
There you have it: Democrats are "narrative", Republicans are "fear mongering". This displays an internal bias that most journalists just can't see. It is a fatal flaw to journalism... that with the presence of internet reporting just simply is not believable anymore.
And this author, with his potential liberal bias, just doesn't understand... people KNOW , what is in the healthcare bill; that is why they reject it.
#1 Posted by Bill Sanford, CJR on Tue 23 Mar 2010 at 10:39 AM
The author also describes the pro health care "narrative" as "empty words" that "misled" the people. If the author has a liberal point of view, surely she's aware of it, and I'd argue she's done a pretty good job of mitigating it.
As for Republican "fear-mongering," the example she cites is "government takeover" rhetoric, a claim that is -- at best -- only partially true, yet was repeated over and over again. Why? To make people afraid of the bill. That's fear-mongering by definition.
I think this is a good article, that raises an interesting question. I feel like I do know what's in the health care bill, and I'm sure I got that impression from the media ... but I had to wade through a lot of misinformation and bad reporting to get to it. As a whole, the media need to cut down on this last part. But as an intelligent news consumer, I feel I also have a responsibility to seek out the facts, realizing my own biases and attempting to compensate for them in the same way journalists do: http://tentrentingonmars.blogspot.com/2010/03/on-media-bias-and-reader-bias.html
One of the best pieces I've seen so far about "what's in the bill," or rather, "how will the bill affect you?" is this interactive graphic from the New York Times: http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html
Too bad it didn't come along until after the bill was passed.
#2 Posted by Ian, CJR on Tue 23 Mar 2010 at 11:51 AM
Right, there you have it: A whole article written off because of two words. And I'm not sure how this author's "potential liberal bias" reveals that she doesn't understand that people know what's in the health care bill.
People don't. Further, people aren't rejecting it as uniformly as you'd have lawmakers believe. Whether or not people should accept or reject the bill when its contents have been less than clear is a different issue.
#3 Posted by laura k, CJR on Tue 23 Mar 2010 at 12:39 PM
Americans were at a disadvantage because we went into this flat-footed. The topic is complex but there are basic rubrics about the economics of health policy that are tricky but understandable, if explained well. Unfortunately, most of us learned as we went along but that was too late to counter the sophisticated players who captured the process very early. FDR used his Fireside Chats to ask Americans to pull out their maps as he explained the geography of WW2. Obama could have asked Americans to pull out their pay stubs and explain how our payroll deductions finance American healthcare, but instead he used his powers to restrict the public conversation.
The very hard part was deciding whose information to trust. For example, Kaiser Foundation's site is a very good primer but I didn't catch on until late because I mistook it as a mouthpiece for the insurance company. If the KFF site had been better promoted as a common ground syllabus for the nation to read up and prepare for this important debate (as in, if the President had suggested it and if we had trusted their information), the public conversation would have been more productive.
But good information did get through, eventually. Although like everything in American healthcare, the resources are there but you have to seek them out with dogged persistance, not be discouraged. And similar to American healthcare, that process can be draining and feel futile.
Hopefully the media and the public will continue; build upon the resources and knowledge developed in this first phase. There are deep flaws in the new "law of the land". But unlike the people of Massachusetts, the rest of the nation need not experience the downsides as mysterious objects that fell from the sky. This time we might have stronger vocabulary to explain why it's not working, ask better questions of our leaders, and demand better solutions. Or not. But possibly.
I discovered this site through Bill Moyers. He's leaving soon. I also get very good information from Democracy Now. C-Span is good. NYT's can be good. Uwe Reinhardt speaks in riddles but his information is solid. I avoid the toxic news networks. The Daily Show watches Fox News so the rest of us don't have to. I'm still disturbed that I learned from Kathleen Sebelius's appearance on the Daily Show that people with employer-provided insurance would not have been able to choose the public option. Looking forward to the day when I can watch Jon Stewart just for laughs, not for news I need to know.
#4 Posted by MB, CJR on Tue 23 Mar 2010 at 05:18 PM
Certainly the Republicans engaged in fear mongering: death panels, government takeover, etc.
One reason the journalism hasn't been very easy to understand is that the issues themselves are complex. The most helpful articles are the ones that include some kind of matrix laying out the bills' features. Maybe journalists should point readers to the Kaiser Family Foundation, which produces these charts and keeps them updated.
#5 Posted by David E. Williams of the Health Business Blog, CJR on Tue 23 Mar 2010 at 10:12 PM
Seriously, Your suggestion to solve the problems with American journalism is to write lots of little stories? I give you credit for suggesting journalists stay on a topic day after day until they actually know something about it. But less column inches in an information vacuum is not the answer. Better journalism is the answer. Citing sources is the answer. And as you say, taking a stand when a source is plain lying is the answer.
#6 Posted by Timothywmurray, CJR on Wed 24 Mar 2010 at 06:54 PM
Why don't people just read the bills--that's where you find accuracy. I got online and read the Healthcare so-called reform bill, myself. I never listen to the corporate-media's biased analysis of anything of importance. People need to start doing their own research. As with Bush, the media reports what's dictated, by Washington. The word comes down, "from above", so to speak.
#7 Posted by Linda, CJR on Thu 25 Mar 2010 at 04:17 PM
Many in Massachusetts knew early on that the plan in their state was not working, and, in fact, left them worse off than before. As Candidate Obama said to Tim Russert and also on the stump standing in front of Ted Kennedy and MA Gov. Deval Patrick: people in MA are worse off than they were before. They are paying penalties and still have no insurance. Then he stopped saying this and started using vague references to a Medicare-like this, and affordable health care that, and everyone would have choice. My red flag went up, and I didn't vote for him b/c I smelled a rat. (Didn't vote for McCain either - I wrote my name in.)
The "Medicare-like this" was the public option charade that Trudy Lieberman has aptly described in several of her articles including the one above. Trudy's in-depth series on the Massachusetts plan was excellent b/c it broke a large, convoluted mess into mangeable segments while at the same time shining a light on the serious flaws. She interviewed the people involved - the powerbrokers as well as the people being adversely affected. No other publication, blog site or TV talking head did justice to the health care debate b/c none of them had any real understanding of how this worked. Trudy talked to people, read documents and asked the questions politicians and bureaucrats didn't want to answer. In fact, I often asked myself when I heard Rachel Maddow and Chris Matthews blathering on about how much they liked health care reform and spending the rest of their time dissing Republicans if either of them had actually read any of the bills, or, more importantly, looked into the MA plan which was the model for Obamadontcare a/k/a Obamacare. I personally handed Howard Fineman an envelope filled with factual information and articles, but he wouldn't go there.
Despite the efforts of some in MA to inform Rachel, Chris, Ed Schultz and Keith Olberman about the unreported truth, we were ignored. Yet, we could have told Americans how this complex and poorly-thought-out policy actually works on the ground - in the trenches - in our daily lives. It doesn't, or, perhaps, more fairly put: how many is it OK to exploit in order to benefit a few?
Note: I am not being partisan by having made the comment above. It is what happened, and these are the people who did the ignoring. To be fair and balanced, I will mention Romney who is now faced with explaining why he supports the MA plan a/k/a Romneycare but opposes Obamacare. I read a few interviews as did others who are up to speed on the MA saga. We couldn't stop laughing, albeit, in disgust, at how he dodged the questions when he wasn't giving a disingenuous response. We know. We watched this terror roll out in MA with Romney AND Kennedy (don't leave Ted out - he was a major player - "bipartisan" was one of the marketing tools), and we live it everyday of our lives.
People in this country are going to be appalled when they find out the real deal. They won't find affordable, quality care at the Exchange. Those are just empty talking points. They will find what MA residents have been faced with for nearly four years: the cheapest plan that the gov't has decided you can afford is too expensive and not affordable to use. Premiums have continued to rise while this was sold to MA taxpayers on the basis that health care costs would decrease, and insurers would be so happy to have so many new customers that they would decrease the premiums. My local paper published an article about those happy insurers lowering premiums while MA Connector board members touted this nonsense. Anyone with half a brain knew that there would be no decrease in premiums b/c the insurance was compulsory.
However, reality trumps what the spinmeisters said. For example, in the case of my friends in the next town - a self-employed couple earning on average $41,000 gross - the cheapest unsubsidized so-called discount plan went from $513 per month to $666 to $832 in about one
#8 Posted by dianne, CJR on Sun 16 May 2010 at 04:15 PM