The Obama
administration is trying its best to ram a health care reform bill
through Congress by July 31. Senate Majority Leader
Harry Reid, D-Nev., announced on July 16 that he hopes to see a
Senate bill passed before recess begins early August, although some
lawmakers have since suggested that might not be possible. The
House is also frantic to pass its own legislation.
Either bill
would remake approximately one-sixth of the entire U.S. economy. But
that change will happen to a largely uninformed public. Although
President Barack Obama campaigned on health care reform, the network
media failed to supply crucial analysis of his health care agenda
leading up to these pivotal votes.
Since the
inauguration, the network news media have promoted President Obama’s
attempts to muscle through health care reform legislation. From
exposing the “unhealthy details” of the current system, to openly
calling it a “national shame” that the U.S. does not have universal
(government) health insurance, the three networks have joined
Obama’s campaign for change.
In 224 stories
on ABC, CBS and NBC, the networks favored proponents to critics by a
margin of more than 2-to-1 (243 to 104). Networks also left out one
major criticism – the “exorbitant” cost of Democrat reform proposals
– from most reports.
ABC touted
Obama’s proposals as the “UnHillary approach” on March 5, citing the
diversity of groups represented at a health care summit that day.
According to “Good Morning America” co-anchor Robin Roberts, the
president was bringing “all the major players in health care to the
table.
Only 9 percent
of stories (21 out of 224) cited estimates of $1 trillion or more,
even though the Congressional Budget Office (CBO) estimated one
Senate proposal would cost $1.6 trillion.
The networks
only brought up Massachusetts health care reform in one story and
entirely failed to report the flaws of a government health care
program in Hawaii. They also glossed over the shortcomings of
Medicare – a government-run health insurance program already bound
for insolvency.
Each network had
its own way of spinning the debate for Obama. On ABC, medical editor
and longtime universal care proponent Tim Johnson blatantly cheered
for big-government solutions. ABC also aired a primetime special
giving Obama time to promote his health care agenda without debate.
CBS, particularly the “Early Show,” brought on administration
officials to promote for government-run health care, but often
didn’t supply an opposing view.
NBC, the best of
the three, utilized a third approach: airing stories about extreme
medical hardship or praising certain hospitals for already doing
what Obama has called for – like implementing electronic medical
records.
On June 11 and
12, after Obama had spoken in Green Bay, Wis. at a town hall meeting
about health care reform, the three networks gave a perfect example
of how little substance mattered in their reporting. The three
focused their health care stories on Obama’s “cool” factor rather
than substantive policy.
In that speech,
Obama admitted the cost of Medicare and Medicaid are “one of the
biggest threats to our federal deficit” and promised Americans would
be able to keep their doctors “no matter how we reform health care.”
He also promised that reform would not add to the deficit.
None of the
networks examined those claims or pointed out the irony of looking
to the government to cut costs since government programs are largely
responsible for skyrocketing health care expenditures. Instead, they
seized on a heart-tugging story of a father who allowed his
10-year-old daughter to skip school to attend the event.
Obama wrote a
note of permission for the girl, who “Today’s” Natalie Morales said
was “Probably the most popular and coolest kid in school.”
By focusing on the permission slip, all three networks ignored an
opportunity to critically analyze Obama’s health care agenda.
Networks Ignore
State Failures, Despite Similarities to ObamaCare
Just two years
ago, the state of Massachusetts instituted its own health care
reform plan. That program included some of the same “reforms” the
Obama administration wants to implement nationally (mandatory
insurance coverage for example).
The
Massachusetts “experiment,” as Michael Tanner of the Cato Institute
called it, has been cited by many journalists and politicians as a
model for health care reform since its inception. But between Jan.
20 and June 24, only one of the network stories on health care
mentioned the Massachusetts attempt to lower costs and achieve
universal coverage. That lone story featured former Mass. Gov. Mitt
Romney praising his state’s efforts which he said were “working.”
Neither Romney
nor interviewer and “Early Show” co-host Harry Smith pointed out any
problems with the government health care program in Massachusetts in
that June 24 discussion.
All three
networks neglected to examine the failures of the Massachusetts
model to insure everyone in the state and to lower costs.
Tanner called
the program an “object
lesson in how not to reform health care,” since the state still
has at least 167,300 uninsured, or 2.6 percent of the population
(other estimates suggest that number might be as high as 200,000).
The program also faces huge deficits while state health care costs
have continued to rise faster than the national average.
Shortly before
the Massachusetts plan was passed in 2006, James Roosevelt Jr.,
president and chief executive of Tufts Health Plan, told The New
York Times that “I think that will help both improve the quality of
health care and lower the cost.”
Supporters of
the program claimed it would reduce the price of individual
insurance policies by 25-40 percent. But according to Tanner
premiums rose by 7.4 percent in 2007, 8-12 percent in 2008 and are
projected to rise 9 percent in 2009.
ABC, CBS and NBC
also ignored the failure of the nation’s first universal health care
program for children. It was implemented in Hawaii in 2008, and
cancelled after only seven months.
According to the
Heartland Institute, Keiki Care, as the program was called, “all but
supplanted private health insurance coverage for the state’s
children.”
Dr. Kenny Fink,
an administrator with Hawaii’s Department of Human Services, told
Fox News in October 2008: “People
who were already able to afford healthcare began to stop paying for
it so they could get it for free. I don't believe that was the
intent of the program.”
That is exactly
what many critics of Obama’s health reform plan have warned. They
caution that a public insurance plan would “kill private insurance”
because people would dump private insurance for the government
program.
While Obama
claims that a public option insurance plan like Medicare would
increase competition in the health insurance market, many
conservative health care policy experts strongly disagree.
A public option
would create an uneven playing field, according to analysis by the
Heritage Foundation. Heritage’s Greg D’Angelo said that public plans
“undercut” private insurers with lower premiums from lower
reimbursements to care providers. They concluded, based on Lewin
Group data, that
107.6 million people could lose private employer coverage under
such a plan. That number is equal to one third of the entire U.S.
population.
Obama wants
‘Medicare-like’ public option, but Medicare’s in Ruins
President Obama
has plainly stated his desire to see a public option insurance
program in any health reform bill passed by Congress.
On June 15, he
told the
American Medical Association (AMA) “one of these options needs
to be a public option that will give people a broader range of
choices.” In that same speech, Obama tried to calm fears that a
public option would have a payment structure similar to Medicare.
“Now, I know
that there's some concern about a
public option. Even within this organization there’s healthy
debate about it,” Obama told the doctors. “In particular, I
understand that you're concerned that today's Medicare rates, which
many of you already feel are too low, will be applied broadly in a
way that means our cost savings are coming off your backs.”
All three
networks admitted that a public option plan, like the president
wants, would be “similar to Medicare” which is the existing federal
health insurance program for people 65 or older.
But only 5
percent (11 out of 224) of the health care stories mentioned
Medicare and critical remarks were rare. Only two stories focused on
Medicare/Medicaid fraud, which costs taxpayers $60 billion per year,
according to ABC’s “World News.”
But not even
that ABC report asked how the federal government would prevent fraud
from occurring in yet another, much larger, government program.
According to
Obama, the rationale for health care reform is to reverse “the
rising cost of health care.” Yet, Medicare is one of the very
reasons health care costs are exploding – a fact the networks didn’t
point out, even though the president himself admitted it.
On June 11, a
few days before Obama addressed the AMA, he spoke at a town hall
meeting in Green Bay, Wis. “For the government, the growing cost of
Medicare and Medicaid is one of the biggest threats to our federal
deficit,” Obama said.
A study from the
Pacific Research Institute found that since 1970, the cost of
Medicare has risen
34 percent more per patient “than the combined costs of all
health care in America apart from Medicare and Medicaid.”
The author of
that study, Jeffrey H. Anderson concluded that government-run health
insurance is not the solution. “Costs have risen faster under
government-run care,” he said.
According to
ABC’s universal coverage proponent Johnson, doctors are ambivalent
about Medicare and don’t want a public option plan because it will
mean lower reimbursements:
“The biggest
concern quite frankly is economic. Medicare, which is a public
option plan for the elderly, pays about 20 percent less to the
doctors than private plans do. And doctors are fearful that a
widespread public plan will do the same. They have a love-hate
relationship with Medicare by the way. They like predictability and
the simplicity of the forms but don't want to take the lesser
amounts that are typically offered by a public plan.”
Johnson didn’t
address the problems Medicare has created for patients like
Barbara Plumb when doctors decide to opt out. Plumb, a Medicare
recipient, found out that her gynecologist was opting out of
Medicare (a result of lower reimbursement rates and “too much”
hassle) according to The New York Times. When she asked her
primary-care physician for a recommendation the doctor said she
didn’t know any gynecologists who would take Medicare.
A 2007 AMA
survey of physicians found that
60 percent of doctors planned to limit the number of new
Medicare patients they would accept, according to an ABC News.com
story from 2008. Dr. Michael Aaron told ABC News that more and more
specialists are opting out of Medicare: “We are also having an
access problem. If we need to refer someone to a specialist, a large
number of those doctors are also opting out of Medicare.”
Networks
Exaggerate the Uninsured Problem 80 Percent of the Time
Network
journalists have helped sell the “need” for health care reform for
years by complaining about the crisis in the number of uninsured
Americans. But that “crisis” has been amplified by inflated numbers
and lack of detail.
Robin Roberts
claimed on “Good Morning America” April 29 that “50 million
Americans” are uninsured, as did Natalie Morales on June 11 “Today.”
That figure is off by roughly 14 million people – just for starters.
While the Census
Bureau said that there are 45.7 million uninsured people (including
nearly 10 million non-citizens) in the U.S., network reporters and
anchors continue to falsely claim that there are 47 million to 50
million Americans uninsured.
Between Jan. 20
and June 24, 80 percent of ABC, CBS and NBC statements about the
number of uninsured were inaccurate. Only NBC “Nightly News” and ABC
“World News” never got it wrong – by not citing the national number
of uninsured at all.
In addition to
inflated statements about the uninsured, reporters rarely broke down
the data to shed light on who might be in real need of government
assistance.
According to the
Census Bureau, the overall number of uninsured included nearly 10
million non-citizens and more than 17 million people who made at
least $50,000 per year (the median household income is $50,233).
Two economists
working at the National Bureau of Economic Research concluded that
25 to 75 percent of those who do not purchase health insurance
coverage “could afford to do so.” Additionally, an Urban Institute
study found that 25 percent of the uninsured already qualify for
government health insurance programs.
So how big is
the problem really? Liberal non-profit Kaiser Family Foundation
estimated the number of uninsured Americans who do not qualify for
government programs and make less than $50,000 a year between 8.2
million and 13.9 million. (The 8.2 million figure included only
those uninsured for two years or more.)
The network
media made it seem that Obama’s “sweeping” plans for reform would
solve that problem. ABC’s John Hendren said on June 14 that
supporters of Obama’s plan “note that the President’s plan would add
45 million uninsured Americans to the health insurance rolls.”
But one Senate
plan to “reform” health care currently under consideration
(sponsored by Sens. Kennedy and Bachus) would still leave roughly 36
million people uninsured according to the CBO and reported by The
Washington Times – despite its $1.6 trillion price tag. Only two
network stories admitted that plan would leave about that many
people uninsured (one report cited 35 million, the other 36
million), despite Obama’s campaign promises to achieve universal
coverage.
Obama Sets Tone
and Timing of Networks’ Health Care Coverage
Obama campaigned
for health care reform to solve rising costs and “lack of
accessibility” as far back as 2006. It was a focal point of his run
for president, so the media had plenty of warning that health care
reform was a major part of his agenda.
Almost as soon
as Obama took the office of president he made health care reform a
top priority. And the network news media have followed his lead and
reiterated his perspective about health care at critical points
since Jan. 20. ABC, CBS and NBC barely covered the topic until Obama
pressed the issue and then – as if on cue – ramped up the number of
stories.
On Feb. 24,
Obama addressed a joint session of Congress and the American people.
In that speech, he made it clear that health care reform would not
be postponed.
“I suffer no
illusions that this will be an easy process. It will be hard. But I
also know that nearly a century after Teddy Roosevelt first called
for reform, the cost of our health care has weighed down our economy
and the conscience of our nation long enough. So let there be no
doubt: health care reform cannot wait, it must not wait, and it will
not wait another year," Obama adamantly declared.
That week also
marked the first spike in health care stories on the networks under
president Obama. ABC, CBS and NBC aired 27 stories about health care
that week, nine more than they had run in the previous five weeks
combined.

ABC’s “Good
Morning America” ran an attack on private insurers Feb. 26 – two
days after Obama’s speech. That piece was a horror story about
Charles Tucker, a man who developed MS only to have the insurance
company reject his claim.
“GMA”
interviewed John Morrison, the former Montana insurance
commissioner, who accused insurers of using “hired gun physician
opinions in order to deny claims.” That story featured three people
attacking insurers to one defender: Susan Pisano of America’s Health
Insurance Plans.
At the very end
of the story, Chris Cuomo admitted that the company was now paying
Tucker’s claim.
The next week,
Obama launched HealthReform.gov and hosted a White House forum on
the issue on March 5. The networks’ response was to air 28 stories
about health care between March 1 and 7. Obama also gave a mid-day
speech on May 11 about health care reform. The networks devoted 17
stories to the issue that week (May 10-16). On “Good Morning
America” the day of Obama’s speech, Diane Sawyer called it “D-Day”
for health care reform.
Beginning with
the second week of March and leading up to June 7, coverage ranged
from one health care story in a week to as many as 17.
But Obama’s big
“kickoff” for the health care reform debate came on June 5. The
networks took it as a cue to increase coverage of the issue. Between
June 7 and June 24 the networks aired 81 health care stories (23, 27
and 31 per week).
ABC even decided
to air a primetime special with the president from the White House
on June 24, “moderated” by anchors Charles Gibson, Diane Sawyer and
medical editor Tim Johnson.
By letting Obama
set the health care news agenda, journalists abandoned the “act
independently” tenet of their own code of ethics. According to the
Society of Professional Journalists (SPJ), journalists “should be
free of obligation to any interest other than the public’s right to
know” and should “avoid conflicts of interest, real or perceived.”
Dr. Tim
Johnson’s soft-spot for socialized medicine
From advertising
for the left-wing group Families USA – which promotes universal
health insurance – to decrying the “tragedy” of the current health
care system, ABC supplied the most egregious examples of
cheerleading for ObamaCare during the study window.
Some of ABC’s
reports were balanced, but those were outweighed by medical editor
Tim Johnson’s crusade for universal government-run health insurance.
Though he only
appeared in nine stories, Johnson’s blatant advocacy and ABC’s
reliance on him as an “expert” on health care reform resulted in the
worst coverage of the three networks.
Diane Sawyer
gave Johnson the title of “expert” on March 2, but his expertise was
limited to only one side of the health care debate.
From the
beginning of Obama’s health care reform launch, Johnson’s agenda
lined up with the president’s. On March 2, Johnson said that Obama
would get his way on “universal” coverage.
“I think there's
going to be an intense, partisan debate. But ultimately, David,
there is just one fact I want to let everybody hear: We spend more
than twice as much, per person, on health care in his country as the
average of all other industrialized countries, yet we're the only
one that doesn't have universal coverage. That's a
national shame and I think ultimately that's what's going to
unite Democrats and Republicans,” Johnson said.
Just a few days
later on March 6, Johnson declared that he was “blown
away” by the president’s “grasp of the subject, how he connected
the dots, how he answered the questions without any script.”
More recently,
Johnson lauded the president’s “tender moment” with AMA doctors in
Chicago. His glowing praise for Obama’s health care agenda comes as
no surprise though.
Johnson also
supported the Clintons’ health care proposals in the 1990s and even
told “20/20” viewers that “the
Clintons are almost heroes in my mind for finally facing up to
the terrible problems we have with our current health care system
and bringing it to the attention of the public.”
Advocating the
‘future’ of medicine: electronic medical records
There was one
particular aspect of Obama’s reform agenda that reporters avidly
praised: electronic medical records. Network reports called them
“the electronic future” and a step that would save lives.
ABC’s Andrea
Canning said they were “one solution” to medical identity theft on
June 14. She then quoted Obama’s claim that health IT will “reduce
medical errors, save lives, save money, and still ensure privacy.”
CBS and NBC
reports talked to doctors and patients at Inova, a Virginia hospital
chain, and New York Presbyterian Hospital in stories promoting
electronic records systems. ABC’s Tim Johnson praised similar
efforts at the Mayo Clinic. Ironically, on July 20 the Mayo Clinic
warned that proposed House legislation “misses
the opportunity to help create higher-quality, more affordable
health care for patients. In fact, it will do the opposite.”
While reporters
like Robert Bazell of NBC said that this is “part of almost
everyone’s view of the future of medicine,” critics of electronic
medical records were ignored.
Deborah Peel,
the founder of the patient’s rights group Patient Privacy Rights,
expressed her concerns to USA Today June 12 saying, “The concept is
wonderful, but because we have absolutely no control over personal
health information in electronic form, they're very
dangerous. There's essentially no laws to stop (companies) from
data-mining that information and using it in a way that you would
never want.”
A number of
newsmakers and celebrities – from George Clooney to Rush Limbaugh to
Farrah Fawcett – have had their medical information compromised. In
Fawcett’s case, the “Charlie’s Angels” star had her most personal
medical information leaked to tabloids as she battled cancer.
Cost can also be
a huge obstacle to adopting electronic medical records. According to
USA Today, upfront costs can be as much as
$36,000 per doctor.
Is there an
alternative to government-run care?
Conservative
health care policy experts argue that government is the root of
problems in the U.S. health care system, so increased government
involvement is not the right solution.
Instead, they
propose making the health care market freer. Dr. David Gratzer,
senior fellow at the Manhattan Institute and author of “The Cure:
How Capitalism Can Save American Health Care,” advocates
deregulating the health care system. He says that Congress should
make it possible for people to buy health insurance across state
lines, allow companies to band together to buy insurance and end the
tax discrimination against the self-employed.
Gratzer says
those three solutions would utilize competition to
lower costs and increase coverage.
Michael Cannon,
Director of Health Policy Studies at the Cato Institute, also said
there is a way to drive down health care costs with a free market
and proper incentives.
“Let individuals
control their health care dollars, and free them to choose from a
wide variety of health plans and providers. If Congress takes those
steps, innovation and market competition will make health care
better, more affordable and secure,” Cannon wrote July 16.
How would that
happen? Cannon advocated
two big changes, including giving Medicare enrollees vouchers to
choose any health plan and “keep the savings if they choose an
economical plan.” Second, Cannon said Congress must give the same
tax breaks to people purchasing their own insurance as those
receiving job-based insurance coverage.
Another
prominent health care policy expert, Grace-Marie Turner, founder of
the Galen Institute and a BMI adviser, told the Senate Committee on
Commerce, Science and Transportation July 16 that private sector
innovation is “vital to progress in health care” and more “adept”
than government programs.
Turner cited a
number of
employer innovations, including Safeway’s wellness incentives,
Target’s use of health savings accounts” and Wal-Mart’s wide array
of health plan options for its employees.
Methodology
The Business &
Media Institute analyzed stories and briefs including the term
“health care” from morning and evening shows on ABC, NBC and CBS
between Inauguration Day (Jan. 20, 2009) and the day of ABC’s
primetime health care town hall (June 24, 2009). BMI assessed the
non-journalist voices in each story and categorized them as
proponent, opponent and neutral. Proponents were anyone whose
comments were used to support government-run care and critics were
the opposite.
Conclusion
Since Obama’s
inauguration, the network media have limited debate over health care
reform.
Network
reporters violated the standards of their own profession by not
balancing proponents and opponents of ObamaCare, downplaying huge
costs, letting the administration drive coverage, not exposing
government health care failures and in some cases openly advocating
for universal care.
The SPJ Code of
Ethics states that journalists should “support the open exchange of
views, even views they find repugnant,” “give voice to the
voiceless,” and “distinguish between advocacy and news reporting.”
They should also “avoid conflicts of interest, real or perceived.”
But that wasn’t how many network journalists handled the essential
health care debate.
More network
stories needed to be like Sharyl Attkisson’s CBS “Evening News”
report on June 23.
Anchor Katie
Couric included a healthy dose of skepticism toward Obama’s claims
as she introduced the story: “Meanwhile,
in a CBS News/New York Times poll, 72 percent of Americans say they
favor a government plan that would compete with private insurers.
But at the same time, nearly two-thirds are concerned that would
reduce the quality of their own
health care.
And some experts believe they’re right to be worried.”
Attkisson included the president’s claim that “the government is not
going to make you change plans under health reform.” But unlike many
network journalists, Attkisson clarified the claim saying “That’s
technically correct, but what the president didn’t say is that
reform could lead your boss to change your health care plan.”
Her report also included ObamaCare critic Cannon, who explained that
Obama’s plan would cause employer premiums to rise “and employers
might respond by dropping coverage entirely” effectively ousting
people from their insurance plans.
Recommendations:
Before Obama
signs a trillion-dollar-plus health care “reform” package into law,
the networks owe it to the public to improve their coverage of the
issue. Here are some recommendations to accomplish that:
-
Be Honest
about the Cost:
Any
government plan is going to come at a huge cost to taxpayers. It
is the responsibility of reporters to ask what those costs will
be and who will be forced to pay them. Journalists should also
be skeptical of cost estimates from the government since they
have been unreliable in the past.
-
Talk to
Critics:
In the case
of health care, proponents of ObamaCare or other
government-health care plans were included nearly three times as
often as critics. In some cases, critics were given only a
few-second sound bite while three or four sound bites from the
president were used in the same story. The networks need to
include more people skeptical of such plans and treat them
equally.
-
Expose the
Shortcomings of Government Programs:
Instead of
advocating a new government solution, reporters should be
examining problems with health care in Massachusetts and Hawaii,
existing federal programs like Medicare and other countries.
-
Find
Alternatives:
Conservative health policy experts advocated less regulation,
tax code changes and more freedom of choice. Networks should
include such experts and their proposals, not just the
administration’s proposals.
Back to the Executive Summary