Jonathan Gruber is an economist from MIT. Jonathan Oberlander is a political scientist from the University of North Carolina. Both are health policy experts—and, from what we can tell, both know their stuff. But the press has counted on Gruber rather than Oberlander to give gravitas to their stories. A Factiva search on Monday showed that from January 1, 2009 until January 25, 2010, Gruber got 386 media mentions, compared to thirty-seven for Oberlander. The relative obscurity of Oberlander prompted us to feature him last May in one of our Excluded Voices posts.
Since the beginning of the health reform debate, Campaign Desk has noticed that the media relies way too much on the same sources, who utter the same thing again and again to different news outlets. The problem with this, of course, is that a particular view of the world spreads widely, perhaps reinforcing that view as the correct one—which it may or may not be, depending on the facts and on which side of the river you call home.
Gruber has been the cheerleader-in-chief for the Massachusetts health care plan, which is the model for federal reform. He sits on the board of the Connector, the state’s policy brokerage service, and thus has something of a vested interest in positively spinning the reform efforts there. Last year on the PBS NewsHour, he told how premiums for individuals buying their own coverage in Massachusetts had dropped dramatically. But he didn’t mention how premiums for workers in small businesses had risen to sky-high levels in order to make that possible.
According to a Wall Street Journal op-ed by then-Gov. Mitt Romney, written shortly after the law passed in 2006, Gruber’s econometric research predicted the state would need “far less” than the $1 billion in its free care pool in order to subsidize the insurance residents were required to buy. We now know the state has come up short, and has had to raise taxes and increase copayments and premiums for those receiving subsidies to help cover the shortfall.
So much for assurances! That hasn’t stopped Gruber from giving them in the nation’s news columns and on the editorial pages. In November, he was quoted on The Atlantic’s Web site saying it’s “really hard to figure out how to bend the cost curve, but I can’t think of a thing to try that they didn’t try.” He said the bill drafters made the best effort anyone has ever made. Around the same time, New York Times columnist David Leonhardt let Gruber offer his thoughts on cost containment. In one column, Gruber said that the Senate bill did considerably more to control costs than he had expected.
As the excise tax on the so-called Cadillac health insurance plans became the financing method of choice to subsidize the uninsured, Gruber again became the media’s go-to guy for comments. In July, he penned a Times op-ed arguing to eliminate the tax exclusion for employer-sponsored insurance. Some experts believe that the excise tax on Cadillac plans is the first step toward wiping out the exclusion in the future.
In late December, he wrote another op-ed, this time for The Washington Post, arguing that the excise tax provides the necessary financing for subsidies, induces employers to buy more cost-effective health insurance, lowers U.S. health care spending, offsets a bias in our tax system that favors expensive insurance, and raises wages by $223 billion over ten years—another carefully researched prediction, perhaps? Gruber appeared again on the News Hour in early January, where he said the excise tax is “generally viewed as one of the very few things we know can actually help with health care cost control, which is an important goal of this bill.”
Jonathan Oberlander also had something to say about cost containment. Along with Yale professor emeritus Theordore Marmor, and Case Western University professor Joe White, he wrote an article for the Annals of Internal Medicine detailing other options for cost containment, and describing approaches such as health IT and comparative effectiveness research that probably wouldn’t save much money. The authors drew little attention from the media. In a second article, appearing in The New York Review of Books, Oberlander and Marmor talked about the potential for a public plan to control costs, a hot topic for most of the year. They got notes from friends and acquaintances, especially from London, Marmor told me. From the U.S. press, he said, only Tom Hamburger of the Los Angeles Times had called.
In the last few weeks, as Gruber made the media rounds talking about the excise tax, came revelations that he had a sole source government contract, worth nearly $400,000, to analyze health reform proposals for the Department of Health and Human Services. The administration has recently embraced the excise tax. Gruber told Fox News:
NONE of the work I have done in public, or any public declarations I [have] made, has been in any way funded by the administration. That funding was strictly for internal work that I did for the administration and, via the administration, for Congress. All externally visible work and comments, such as my editorials or public reports, have been done on my own time.
Paul Krugman rushed to defend him, writing:
Gruber is a real authority, and the obvious person to fill a needed role. He should have taken more pains to reveal that role. But there was nothing corrupt about the arrangement.
News outlets hastened to offer full disclosure. Gwen Ifill on PBS identified him as a “paid consultant to the Obama administration.” Times public editor Clark Hoyt noted in his column that, in addition to the July op-ed, Gruber had been mentioned on at least twelve other occasions in the Times after he began consulting for the administration. Op-ed writers for the Times must sign a contract obligating them to tell editors about such relationships, and Gruber had signed one. At the end of the online version of the op-ed, it now says had the paper known about his consulting job it may have rejected the piece—or, if the editors had known, insisted on disclosure.
Full disclosure of conflicts of interest, real or perceived, is important. But simply saying Gruber is a paid consultant to the White House is not the crucial take-away from l’affaire Gruber. It’s that the media has been unimaginative or unwilling to find a broader range of sources for their stories. Maybe they wanted to promote Gruber’s line, or maybe they have just been lazy. Either way, the public loses without a fuller picture of the topic at hand.
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.