Could the Media Derail Health Care Reform?

By Niko Karvounis, Health Beat. Posted January 7, 2009.

History Repeats Itself? 

Unfortunately, today's health care reform isn't going to be any more titillating. Comparative-effectiveness research hasn't become any simpler to explain, reimbursement practices are no less tedious to analyze, and the trade-offs that will be necessary to contain costs no less complicated.  Any way you slice it, health care policy is tough stuff, and the media don't seem all that ready, or willing, to cover it appropriately. If we're not careful, once health care reform gets under way, we may again see the media turn to their favorite sport -- calling the political horse race.

Indeed, there are already some troubling parallels between the ‘90s and today's health care landscape. In the late 1990s, health care reform only became big news after underdog candidate Howard Wofford won Pennsylvania's Senate seat with an unexpected 55 percent of the votes -- on a platform of national health insurance. The health care reform story started with politics first and policy second.

Similarly, it's hard to imagine that we'd be hearing so much about reform today if Hillary Rodham Clinton hadn't ran for president, thus feeding legions of political reporters a ready-made narrative of HillaryCare's return. And do you really think we'd have seen a media debate about the importance of individual mandates if Clinton hadn't made the issue a centerpiece of her political attacks on Barack Obama during the primaries?

To be fair, the media do cover health policy outside of campaigns. In fact, Kaiser found that the biggest individual health-related story was the fall 2007 congressional battle over the State Children's Health Insurance Program. And there has been some high-quality policy reporting in recent years, such as the New York Times' "Fixing Medicare" and "The Evidence Gap" series of articles. Clearly, the media can write well about health care policy if they want to; the question is, once health care reform becomes a political issue -- and not just an intellectual policy discussion -- can reporters stay focused? That's not so clear. After all, although SCHIP received a lot of coverage, much of it focused on whether Democrats were "using kids as props" and on the issue's electoral resonance.  

You can already see some juicy political narratives emerging around Obama and health care -- before he was even elected, Obama's health care plan was being called "ObamaCare." Currently, the media are focusing on health care reform as a bitter political fight while warning that the Obama story may turn out to be a case of 'the bigger they are, the harder they fall.' Indeed, the president-elect hasn't even taken office, and the media are already warning that "health care reform [is] up in the air" because "opposition likely will arise," and that "Obama's bid for health care reform could sink or soar" (well, duh). Others warn of too-high expectations in order to set up a dramatic arc of "euphoria" followed by "big disappointment," and the "bursting [of] Obama's balloons."

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Niko Karvounis is a program officer with the Century Foundation in New York City, where he works on issues of socioeconomic inequality and health care. He is a regular contributor to Health Beat, the Foundation’s health care blog.

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