In mid-August, when Paul Ryan burst on the scene with his voucher scheme for Medicare, the 47-year old program suddenly became hot news. Until then, the media had paid scant attention to Medicare, except in the fall when they served up some “how-to” stories for choosing new Medicare Advantage plans. This time it was different. Ryan’s plans for transforming Medicare from social insurance into a private system thrust Medicare policy into sharp focus, for the public and the press.
On the political side, it looked like Medicare might be a winning issue for the Democrats for a while. Their pollsters advised them to talk about it. NPR even reported that the GOP was taking a “risk that Ryan may turn off an important voting bloc: senior citizens.” Indeed, polls showed that seniors didn’t like the idea of vouchers, a theme we picked up in our CJR Town Halls. One Missouri woman told us that Ryan “wants to do away with what we know Medicare to be. I’m not in favor of it at all.”
But then came October. A few days before the election, a Reuters /Ipsos poll discovered that voters over age 50 continued to prefer Mitt Romney, and liked his position on healthcare and Medicare better than Obama’s. Voters 65 and older “leaned heavily toward Romney throughout the campaign,” reported Politico, while The Hill concluded that Medicare, “once seen as the most potent weapon in House Democrats’ campaign arsenal, is turning out to be a dud.”
Which is fine, if the public fully understands the issues. But it is not clear at all that it did, or that the press helped.
Did the media muddy the public’s thinking about the program? Drew Altman, head of the Kaiser Family Foundation, answered that question with another question: Is the point of media coverage “to cover, inform, or educate?” Altman’s frame offers a useful X-ray for examining how the press performed and how, in the coming weeks, it might perform as Medicare (and its cousin, Medicaid) gets snarled in the coming debate over the fiscal cliff.
The press did cover the two central issues swirling around Medicare throughout the campaign—the idea of a voucher plan, supported by Romney and Ryan, and the question of whose plan really cut Medicare. Did Obama cut $716 billion from the program, as the GOP charged day after day? Or would Republicans cut it with their voucher arrangement, which would make beneficiaries pay some $6,000 more each year for their healthcare instead of the federal government picking up the tab, according to a study by the Congressional Budget Office.
Many press stories addressed those two claims. But they did so from a position so close that you couldn’t see the forest for the trees. Nobody seemed to step back and say what Medicare is, who gets it and how it works. Nobody explained that it is social insurance—one giant risk pool, in which everybody gets the same benefits—in which an 86-year old with heart and hip problems generally pays the same as a 66-year old brimming with health.
Reporting on Medicare has been different from Social Security coverage, which, as we wrote in April has been shaped by the elite media, which in turn has often climbed on board the train with deficit hawks, who are hawks are eager to cut the program in the name of fiscal austerity. When it came to Medicare, there was no organization like the Peter G. Peterson Foundation and others that Peterson or his foundation funded to spread his austerity message far and wide, and try to bring the press and policymakers along.
With Medicare, the media seemed freer to examine competing claims.Yet they tended to do that in their customary “balanced” fashion, with lots of he said/she said quotes, which often confused audiences more than it informed. When it came to vouchers, the media readily paired representatives of the Heritage Foundation—which introduced the press to the concept in the mid-1990s, and pushed hard for vouchers at the time—with spokespeople for groups that were more skeptical, thus fulfilling their goal of balance and equivalency, although sometimes a false equivalency.
In the end, seniors didn’t know who was really saving, cutting, slowing the growth, or strengthening Medicare. Many took comfort in the Romney refrain, “My plan makes no change whatsoever for seniors. None. Zero. Zip,” which was semi-true for current seniors, but dodged the fact that he would dramatically alter Medicare a few years down the road, which could indeed harm current seniors as the years went on, if many people chose to opt into a private plan, sending Medicare into a “death spiral.”