Pulling it Together: The Media’s Challenge In Health Reform

For many years now the news media has served as the public’s number one source of information on important issues like health reform. People rely on the news media to help them wade through claims and counter claims, understand how policy options will affect them and come to judgment on complex issues. In some cases the broader news media has performed admirably in explaining the sometimes overwhelming complexities of health reform, particularly in recent weeks as many journalists and news organizations have worked hard to disentangle the debate about health reform legislation for the American people as it wends its way through Congress. We policy experts particularly admire how good journalists can explain complex issues simply, which as a field we struggle to do.

But the rise of 24-hour cable TV news, the almost instant news cycle and cable’s many entertaining but ideologically left- or right-leaning shows (I watch them all), as well as cutbacks in traditional newsrooms, and the continuing limitations of local TV news have left the news industry poorly structured to play the vital role the country needs it to play. Too often when the news media should stand apart from the political process it has become just another part of it. There was no better example of this than news media coverage – and especially cable TV and local TV news coverage – of health reform town halls in August which sidetracked the health reform debate. Consider these poll findings:

• Eight in ten people said in a recent poll that they saw or heard news coverage of protests against health reform legislation at town hall meetings. We don’t see that level of public exposure often; not even the health reform ads which run endlessly on cable TV have achieved anything close to that level of penetration.
• Fully half of the American people say in our tracking poll out this week that media coverage of health reform is mostly about politics and controversy.
• As of late September only about a quarter of the public can say that they have figured out how health reform will affect them or their families and almost half say they are simply confused.

Sure the media was just covering real events and bringing people the news when it covered the town hall meetings. And much time was devoted to fact checking claims that were made at the town halls. But the disproportionate coverage of the often wild claims made and of the most extreme elements attending the town halls, even when fact checking them, shifted the entire discussion to the activists agendas on both sides and made it more difficult for average people to answer the basic question they have about health reform: will this help me and my family?

The focus on death panels, abortion, and the threat of rationing and a supposed government takeover of the health system also made people more anxious, even when careful attention was devoted to both sides of the claims being made. It was the health reform equivalent of the old adage about sensationalism and local TV news: “if it bleeds it leads.” The biggest losers were the average citizens activated by the debate who attended the town halls because they wanted to learn or be heard; their views got much less attention. Not enough attention was paid to who was orchestrating the meetings or, since the point was to attract coverage, whether these were real news at all. Too many media organizations, particularly on cable TV and local news where town halls were held, followed staged events designed to attract their coverage or chose on their own to put more juicy stories on air about angry town halls and symbolic side issues. According to one study, cable TV and radio were seven times more likely to cover angry town halls and polarizing issues than major newspapers.

Extensive coverage of the public option, a threshold issue for the left, was more legitimate because the public option is an important issue, but it was disproportionately covered because of its larger ideological symbolism to the right and the left. Excessive coverage of the public option diverted attention from the insurance market reforms and coverage expansions and subsidies, which are the elements of the legislation that will provide the most immediate and tangible help to people. As a result, the critical issue of affordability is only now belatedly emerging. I watched a long segment of Larry King Live devoted to health reform in which Elizabeth Edwards and Tommy Thompson debated the public option as if it was the only issue in health reform. As a result the discussion became entirely about whether health reform was or was not a government takeover of the health care system.

As the Congress winnows the process down from five bills to two bills in the House and the Senate and then one final bill that can be put under a public microscope, there is a new opportunity for the media and a big public information role that only the news media can fill. Our polls show that a third of college graduates, one third of all women, thirty eight percent of blacks, a third of all sick people, and a third of all political independents say they can’t figure out how health reform legislation will affect them. More of the American people currently support action on health reform than oppose it, but public opinion is fluid and the public may still decide that proposed fixes are wrong headed, too expensive or just won’t work. That’s always acceptable in a democracy as long as the debate is about the real issues.

How the media covers health reform as the debate moves into the final stages will be critical in determining whether the public’s final judgments are based on a real understanding of how the proposed plan will affect them and the country or based instead on hot button side issues and public relations tactics used by political operatives to lure media coverage. The media can’t wave a magic wand and change how politics works today, but it is the one great balancer in the system and when it becomes part of the political process and no longer stands apart from it we lose a lot. With so much of the media now configured for instant news and the relentless pursuit of controversy, stoked by spin and manufactured news by partisans on both sides, the many great journalists in the news business working hard to inform the public face a big challenge in explaining the complex issues in health reform.