How Corporate Media, Sellouts in Congress and Industry Bigs Have Hijacked the Health Care Debate

By Joshua Holland, AlterNet. Posted July 29, 2009.

If you can frame the terms of a debate, you've gone a long way toward winning it before you've begun. Tragically, Republicans, the health care industry and business-friendly "Blue Dog" Democrats have largely been able to do exactly that, with a substantial assist from the corporate-owned media.

They've successfully focused the health care debate on the short-term costs to the federal government's bottom line, obscuring the potential impact that a meaningful realignment of the health care system would have on the economy as a whole. In so doing, opponents of reform have hoodwinked much of the public into believing that investments in America's national health care system will wind up costing individuals more than they had gained from the effort.

In fact, they've done such a good job that much of the discourse has revolved around what is arguably one of the least-relevant aspects of the proposals being debated in Congress: whether they "cost too much" or are "deficit neutral" in terms of their impact on the federal budget over the next 10 years.

Much of that discussion has been fueled by a series of estimates issued by the Congressional Budget Office -- estimates based on incomplete drafts of the legislation now moving through Congress. Yet, by and large, the mainstream media have dutifully repeated the spin without mentioning that the critics are touting the CBO's preliminary projections as definitive and final.

Even worse, a study of cable news reporting by the media watchdog group Media Matters found that when the CBO issued a follow-up to an earlier, more pessimistic projection of the bill passed by the Senate Health, Education, Labor and Pension (HELP) Committee, it went all but unreported by the cable news networks. CBO projected it would cost $611 billion, while an earlier estimate -- which was dissected eight ways to Sunday by the same cable networks -- suggested it would run an even $1 trillion.

There are also benefits contained within the proposals that are impossible to score in limited budgetary terms. For example, if the House bill were passed as it stands today, it would all but eliminate health-care-related bankruptcies by capping the amount of out-of-pocket expenses with which a family or individual can be burdened. A group of researchers from Harvard studied over 2,300 bankruptcies filed in 2007 and concluded that more than 6 in 10 were due to medical causes. What is it "worth" to our society to ease that kind of pain? It's not in the purview of the CBO to say.

That's just one of several reasons why the budgetary impact over 10 years of a program of long-term reforms is such a poor metric for judging its value. First, the very same preliminary CBO estimates that are being used to gin up fear of a budget-busting boondoggle that will saddle our grandkids with debt for generations to come also suggest that the proposals would extend health coverage to tens of millions of uninsured Americans. Why such a significant improvement in the health and economic security of so many real people should be expected to come at no cost to the government's balance sheet is a mystery.

Second, it fundamentally obscures the actual terms of the debate in Congress. Leaders in both the House and Senate have promised that the final legislation will be fully-funded -- "deficit neutral" -- and the battle lines have in fact been drawn not only around what form the final bill will take, but also how to pay for it. 

Moreover, the narrative is based only on the impact of the proposals on the federal budget in isolation, all but ignoring the larger effect that fixing the system (if done right) might have on the economy as a whole. Under consideration are various proposals designed to rein in the spiraling cost of health care across the entire system.

So these are not sunk costs, but investments that analysts expect will have a significant payoff. A study by David Cutler of Harvard and the Rand Corp.'s Melinda Beeuwkes Buntin estimated that just three elements within the larger proposals offered by Democrats so far -- all of which come with start-up costs in the beginning -- would result in $550 billion in savings to the larger health care system over the next 10 years (PDF).

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Joshua Holland is an editor and senior writer at AlterNet.

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