Could the Media Derail Health Care Reform?

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

Meanwhile, how many of these stories have spelled out, in detail, the rules of reform under Obama's proposal? Relatively few (although you can learn about it here). 

There's no question that health care reform won't be easy; Obama definitely has his work cut out for him, and the public should know it. But already the media seem to be licking their chops at the political controversies they see in the near future. Discussions of health care reform are already being wrapped in Obama's political persona, with reports cautioning that partisanship may slay the Uniter and that the Chosen One may come up short. If we're seeing this sort of coverage now, you have to wonder if the media will have the wherewithal to focus on policy once health care reform becomes a long, procedural slog as legislators debate some of the 115 discrete options for reform that the Congressional Budget Office has recently outlined. 

But it's important that the media rise to the occasion. As Rushefsky and Patel put it, "the mass media may not tell us what to think, but they are very successful in telling us what to think about." News helps us figure out what's important and what's at stake. A dearth of good policy stories will mean that the public isn't understanding the challenges, trade-offs, compromises, etc., that really shape health care. The public will misunderstand the terms of the debate as purely a clash of parties and personality -- as a question of whether "ObamaCare" will succeed -- instead of story about structural changes and policy choices that will affect all of us. We shouldn't focus on how much we like or dislike the politicians involved in health care reform; the focus should be on the strengths and weaknesses of their proposals.

Unfortunately, as Health Affairs Editor-in-Chief Susan Dentzer notes in a new New England Journal of Medicine commentary, "journalists sometimes feel the need to play carnival barkers, hyping a story to draw attention to it." But instead of constantly focusing on political soap operas, journalists should be "credible … communicators more interested in conveying clear … information," and they should write stories that, "rather than being rendered in black-and-white, use all the grays on the palette to paint a comprehensive picture of inevitably complex realties."

The Upside

So is there any chance that the media will in fact report such realities when it comes to health care reform? There are reasons to hope. The Times' best work and the Wall Street Journal's solid reporting on the health care industry offer models for other reporters. Many of these stories interweave policy analyses with accounts of personal, very human stories, proving that talking about policy doesn't have to be boring.

Better still, today's reporters have unprecedented access to a wide range of health care policy experts who actually know what they're talking about. Thanks to the Internet, people like Merril Goozner, Matthew Holt, Roy Poses, Kevin Pho, Bob Laszewski and Ezra Klein (to name just a few) have a stronger voice than ever, and they're helping to shape the public debate. We also have folks like Gary Schwitzer at the University of Minnesota regularly reviewing media reports for accuracy and comprehensiveness (in fact, Schwitzer's HealthNewsReview.org and its grading of medical health stories provides a good model for reviewing health care policy stories). In other words, it's easier than ever for a reporter to write a good health care policy story, because there's an organized community of people itching to help them.

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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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