In mid-January, for instance, USA Today botched a piece about whether the House and Senate bills would really cut costs and generate enough savings to cover subsidies for the uninsured. The story began with a conservative economist questioning whether the projected long-term savings were realistic. Then came a quote from the director of Families USA who assured us that the projected savings were “more than realistic.” There was a paragraph explaining that the Senate bill calls for $438 billion in cuts to Medicare and Medicaid over a decade and that almost half of those cuts would come from trimming Medicare payments to doctors and hospitals. Next the paper noted that a Department of Health and Human Services report said some of the proposed cuts “may be unrealistic” and could actually reduce access to care. That was followed by a fellow from the Urban Institute who suggested it would be “very hard” politically to get the cuts through. Then came a comment from a fellow at the Center on Budget and Policy Priorities, who said that in the past Congress had in fact adopted cuts to Medicare and that those cuts were “part and parcel of most major deficit reduction efforts in recent years.”
Huh? This tangle of competing claims, without any attempt by the reporter to help the reader understand who is more and less right, is not only useless to someone trying to decide how to think about these issues, but also utterly dispiriting.
Traditional journalism craves controversy—even if it’s manufactured or beside the point—and the health-reform story produced a doozy: the public plan. For months press coverage focused on the politics of a public plan—who wanted it, who was against it, its chances for passage. Meanwhile, with a wink to the special interests who supported him financially during the campaign, President Obama didn’t fight for a public plan, and let the insurers, doctors, hospitals, and the business community (with a crucial assist from Joe Lieberman) kill it in the Senate. Even so-called supporters of the public plan, who made a lot of noise, knew it was essentially a bargaining chip. It was a charade the press should have exposed more forcefully and then dug into the true controversy: whether the health-reform law in Massachusetts, the model for the national bill, was working as well as the state’s officials and other cheerleaders maintained. When MIT economist Jonathan Gruber, the über-cheerleader for national reform, said on PBS’s NewsHour last fall that Massachusetts residents who must buy their own health coverage were getting lower premiums as a result of the state’s reform, he didn’t mention (and host Gwen Ifill didn’t ask) that those lower premiums were made possible because employees of small businesses were paying much higher premiums. Small business owners are now getting hit with increases of 20 to 45 percent or more. Indeed, red flags in Massachusetts did not fit the “its time has come” narrative the press and the newsmakers had embraced—though when Republican Scott Brown stunned Democrats by winning Ted Kennedy’s Senate seat in January, it became clear that the press should have paid more attention to those warnings.
Traditional journalism tends to be reactive, and the ill-effects of this were never more evident than with the “death-panel” debacle. Instead of bringing audiences around to a serious discussion of end-of-life care, the press let right-wing ideologues set the agenda with misinformation before eventually doing the stories that refuted the outrageous claims of Sarah Palin and others. But it was too little, too late. More than a month after the notion surfaced, I interviewed a volunteer at a sandwich booth at a Labor Day Italian festival in Scranton, Pennsylvania, who told me he was very worried about what he called the end-of-life committee. “I have heard all the arguments,” he said, “and nobody has convinced me it doesn’t exist.”