This is the second of a series of occasional “Medicare Uncovered” posts that will look at how the media are covering Medicare, the nation’s vast and publicly accountable health system for the elderly, and a political target in ongoing discussions about the deficit.
In mid-December, Bob Corker, Republican Senator from Tennessee, introduced a bill that would radically change Medicare. Called the Dollar-for-Dollar Act, Corker’s legislation would cut $1 trillion from Social Security, Medicare, and Medicaid in exchange lifting the debt ceiling by $1 trillion. The debt ceiling standoff has been averted for the time being but the bill is still important, because some of its provisions could gain traction in the coming months as Save Medicare Fever spreads among Beltway’s policymakers.
The Corker bill, co-sponsored by Tennessee’s other Republican senator, Lamar Alexander, deserved careful media scrutiny then and still does. So far, there has been almost none. State news outlets might be forgiven, since covering the details of complex proposed legislation is not the way we generally cover our local congressman or congresswoman. We usually ask a few questions, let the politicians give their views, and wrap those views into a story.
But the significance of the economic and safety net issues on the national agenda–which affect almost everyone–demands more than business as usual from the press. How the media have so far covered what Alexander admitted will be painful, “bad medicine for many people,” offers an example of why reporters have to move beyond the borders of their comfort zones. If the medicine will taste so bad, then maybe the media ought to be reporting why, and also explore what, exactly, Corker and Alexander are trying to fix–and if his radical treatment matches the malady, and what other possible treatments are out there.
So far, news outlets in Tennessee, at least, have not imparted a whole lot of information about what Corker wants his 242-page bill to accomplish, and what it would do to healthcare in Tennessee and beyond. (CJR’s own primer on the pending legislation, “Parsing Senator Corker’s big bill,” will run tomorrow.)
Explaining Medicare cuts has added meaning for the people of Tennessee. Thousands of them already know what it’s like to lose health benefits. In 2005, then-Gov. Phil Bredesen, a Democrat, cut them off of TennCare, the state’s highly touted program that had aimed at universal coverage. The program, which had little cost control, became too expensive. Many of those who lost TennCare benefits are now on Medicare, or about to be, and need to know how their health insurance may change again.
The Commercial Appeal offered readers only a tiny taste of Corker’s Medicare plans in November (in a piece also published by the Knoxville News Sentinel), when the senator was pushing them in the context of a fiscal cliff deal and outlining his ideas in a Washington Post op-ed. At the end of its piece, the Appeal noted that Corker called for “gradual age increases within Medicare and Social Security” and increasing Medicare premiums for those making more than $50,000 a year in retirement. Those provisions alone were reason enough to take a second look, but the paper did not explain it adequately.
A month later the Knoxville News Sentinel summarized the Medicare provisions in the Dollar-for-Dollar Act in a one-graph description that was more opaque than illuminating:
Its details include reforming Medicare to include competition from health-care options, gradually raising the eligibility age to 67 by 2027, requiring high-income beneficiaries to pay higher premiums and giving flexibility to the states to manage the program.
But: there already is competition in the program, from Medicare Advantage plans, which are private options; higher-income beneficiaries already pay higher premiums; and Medicare is a federal program, not a state one, so it’s not clear what “giving flexibility” to the states would mean.
All this cried out for more explanation, a point made by a blogger, R. Neal, on the website of KnoxViews (“Progressive citizen media for East Tennessee”). Neal noted that Corker’s plan begins to privatize Medicare, much like the proposals made by vice presidential candidate Paul Ryan would, and he asked in a post, “Maybe a policy expert can explain how ‘Total Health’ [Corker’s program for private plans] is different from the existing Medicare Advantage?”
That’s a good question for The Tennessean, the state’s principal newspaper, which so far hasn’t gotten too deeply into the nitty-gritty of Corker’s bill. In a piece published a few weeks before the fiscal cliff deal, the paper presented a longish account that framed some of Corker’s ideas as a political dogfight–conservative Republican issues versus liberal Democratic ones. The lede:
Advocacy groups and prominent congressional Democrats continue to take aim at Republican Sen. Bob Corker’s proposals to raise eligibility ages for the nation’s two biggest entitlement programs, Social Security and Medicare.
There was a lot of he said/she said in the piece, which gave a few bullet points of Corker’s proposal. Readers got brief views from those who like the proposals and from those who don’t, as well as what Tennessee’s other members of Congress think about it. Democrat Rep. Jim Cooper doesn’t like raising the Medicare eligible age because it shifts costs to seniors. Republicans Marsha Blackburn and Diane Black “dodged questions about eligibility age,” The Tennessean reported. As for Corker, the paper said he remained “unfazed” by the negative feedback from critics. “Medicare and Social Security are both headed to insolvency, and the longer we wait to put in place solutions, the more limited and draconian the options become,” he said.
Insolvent? The paper needed to explain that both Medicare and Social Security will have money to pay out most benefits even after the dates that “insolvency” is supposed to happen. Under current conditions, Social Security is good until 2033, and after that it, given no tax or benefit adjustments, can pay out about 75 percent of benefits. Medicare’s hospital trust fund is OK under current conditions to 2024, and after that it can pay out 87 percent of expected benefits. At least TriCities.com, the Bristol Herald Courier‘s site for northeast Tennessee and southwest Virginia, made that point.
The right words and what they mean are crucial in reporting on these programs–especially when the pols want to soften or even disguise what they’re doing. When Corker was pitching his plan at the end of the year, a reporter suggested the plan equals Medicare “cuts.” Politico reported that Corker corrected the journo, saying he preferred to use the word “reforms.” Orwellian speak is alive and well.
Related content:
Medicare ‘bankruptcy’: CNN gets it right
Medicare, Paul Ryan, and beyond: a primer
Medicare Uncovered: the pain from ‘skin in the game’
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.