[Part Two] Empty Talk Express: The Problems with McCain's Health Care Plan

This is the second entry in a series examining John McCain's health proposals and how they have been covered in the press. Read Part I here.

The sound bite you hear most often from John McCain about his health care proposals is that he wants to put families in charge of medical decision making. In "Straight Talk on Health System Reform -- 'A Call to Action'", a document published on his Web site, McCain says "the key to health care reform is to restore control to the patients themselves." At first glance, it's hard to argue with that premise, and so the sound bite sounds good. It plays well in Peoria, as Richard Nixon's operatives used to say. But what's under the hood here? If putting patients in charge is the cornerstone of McCain's health initiatives, shouldn't the media have been evaluating his premise?

The truth is they've been MIA on this one. There's been virtually no examination of what McCain means by his lofty sound bite, and how that sound bite squares with reality. He has used it to imply that government bureaucrats should not be in charge of health care, forgetting that managed care organizations now make many decisions about what treatments people get and who gives them. Last April, when he announced his health care plan, stories like the one in USA Today's On Politics blog quoted him saying: "My approach to transforming health care is to put families in charge." Since then, the topic has scarcely surfaced, giving more credence to McCain's Great Escape from press scrutiny.

One story that did appear comes from the Cybercast News Service (CNSNews.com), an online news service whose parent organization is the Media Research Center, which specializes in media criticism with a right wing point of view. The Center's chairman, L. Brent Bozell, has long been active in conservative Republican politics. The news service's Web site says that CNSNews.com is "an effort to provide an alternative news source that would cover stories that are subject to the bias of omission and report on other news subject to bias by commission." Its mission is also "to fairly present all legitimate sides of a story and debunk popular, albeit incorrect myths about cultural and policy issues."

Of course, what's legitimate to the Center may not seem that way to another observer. But a recent news service story, headlined "McCain: Health Care Choice for People," gave a pretty fair nuts-and-bolts description of the highlights of McCain's proposal, and even included comments from a spokesperson from "the liberal Center for American Progress Action Fund." The end of the story featured a familiar McRefrain: "families should be in charge of their health care dollars and have more control of care." The kicker amplified the point, noting that McCain would use competition to improve the quality of health insurance and impart greater variety to better match people's needs.

The story's last few paragraphs provided a perfect opportunity for CNSNews.com to make the connection between family decision-making practices and the consumer health information business -- a mushrooming industry searching for keys to the kingdom of health care consumerism. The CNSNews.com story, like all the others that mentioned McCain's emphasis on family decision-making, didn't make the link. Too bad -- a very good story lies therein.

If health care competition is to work, shoppers need information -- good information that will help them pick an insurance policy, doctor, hospital, or whatever. Then, there must be an incentive for shoppers to act on this information, instead of just sticking with their default options. Finally, the theory must work in practice -- prices go down and quality goes up because people choose the best options for them. But real-world data indicates that buying health care may not be the same as buying an iPod, and that the empty talk about putting families in charge of their health care decisions may be just that -- empty talk.