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.”
The result of this “balance” were stories like those we critiqued at the end of July, when Obama gave a talk in Florida about vouchers and Romney quickly followed up in a radio interview contradicting the president. We reported that New York Times coverage of the Florida visit gave readers dueling quotes from the candidates, plus a lot of filler that “added nothing to people’s understanding of the Medicare issue.” There were too many stories like that one.
On the “$716 billion cut” to Medicare—Romney’s charge—the press did inform the public but failed to educate it. As we and many others have written; The Affordable Care Act did reduce government payments to healthcare providers—mostly to hospitals, the result of a bargain between the hospitals and the administration. And it did cut the fat out of payments to Medicare Advantage plans that policy experts agreed wasted taxpayer dollars. Over time these cuts also may well cause some plans to eliminate some benefit frills, like gym memberships. But the ACA did not cut hospital and medical benefits, the guts of Medicare coverage. The cuts, according to the administration, were meant to slow the growth in Medicare spending and preserve the life of Medicare’s hospital trust fund. Beneficiaries did not comprehend that. Instead, they worried that they would not get medical care. The specter of rationing and death panels appeared once again, resurrected by health providers anxious about their incomes. Romney himself raised the issue in the first debate, claiming that 50 percent of doctors say they won’t take any more Medicare patients because of the Obama cut. To us, the figure sounded absurdly high, but the notion lived on.
Nuanced and lengthy pronouncements from the fact-checkers may also have muddied the waters, because their own evaluations of the claims were muddy. When PolitiFact rated a Ryan claim that Obama was really raiding Medicare as “mostly false,” and then rated the claim by a group opposing Medicare saying that Medicare ‘cuts’ in the healthcare law will hurt seniors as “barely true”—and later “mostly false”, when PolitiFact changed its naming scheme, what are seniors to think?
“The truth squads played right into the agenda of opponents of Medicare,” says Altman. “When you do that, you respond to the agenda set by politicians and they are very artful about it.” The challenge, he says, is to think about what needs to be covered and not just to check this fact or that.
In other words, did their coverage educate? Bonnie Burns, a policy specialist with California Health Advocates says, “no.” Medicare seniors, she said, still have no clue what Medicare Advantage plans are, even if they have one. Despite the zillions of words written about these plans, Burns says, many seniors still don’t understand that it is private insurance they have, not traditional Medicare, and insurance companies can do what they want when it comes to hiking rates and dropping coverage.
It’s not totally fair to blame the press for failing to educate voters about Medicare and the choices the candidates presented about the program. Politicians themselves share some of the blame. They have not done a good job explaining what Medicare is, and is not. Democrats never made the case that sometimes the government can do things better than the private market, says Nancy Altman, co-director of the advocacy group Social Security Works. Republicans never were pushed to make a case that the reverse is true when it comes for insurance for the elderly.