By Trudy Lieberman
A few weeks ago a former New York Times reporter who had won a Pulitzer during his career at the paper told me how Barack Obama could move closer to universal coverage. He could let younger people buy into Medicare and the rest could get coverage through the Federal Employees Health Benefit Program that the reporter said was government insurance like Medicare.
"Really?" I asked and then told him that the FEHBP program is a menu of insurance choices from private insurers offered by an employer, which in this case happens to be the federal government.
It offers federal workers a large array of private policies the way IBM offers health benefits to its workers. "I didn't know that," the ex-reporter replied.
Shortly after that, a Fulbright scholar who had just spent a year in the United States told me that Obama planned to give everyone free insurance. "Really?" I asked again and explained there is nothing in the offing that resembled the national health care system in his country; in other words, free insurance supported by taxes and available as a matter of right.
The U.S. press had given him that impression, he said.
If two, smart, savvy people interested in the topic got the wrong message about Health Policy, what about all the ordinary people we are supposed to be informing?
Have they gotten mistaken impressions as well? What do they really know about Health Policy?
Trudy Lieberman
For the past year I have reported on media coverage of Health Policy for cjr.org and can safely say that the coverage has been punctuated largely by several themes that have contributed to erroneous assumptions on the part of our audiences.
We have:
Followed the candidates' script. Most stories followed the lead of those running for office and didn't veer too far away from what they were saying. If a candidate said a rival was advocating "socialized medicine," that charge got reported, often without analysis saying that no candidate was proposing that. If candidates said they were proposing universal coverage, there was little examination of what the term actually meant; that what the candidates had in mind was a scheme to make it easier to buy private insurance from commercial carriers, leaving most of the current system unchanged.
Left out ordinary people. Sure, there were plenty of stories with anecdotal leads, but few stories that examined how the candidates' proposals would affect different kinds of people with different economic circumstances and different kinds of coverage problems. Putting the candidates' plans under a microscope reveals how they would work or not work for those in whose name the battle over reform is being waged. But for the most part, news outlets didn't do this, and they instead left broad impressions like the ones my friends had gotten.
Used the same sources. Every group involved in Health Policy has a dog in the fight – whether it's to get quoted and accumulate media hits, show funders that they're making a difference, or to protect their company bottom lines. Advocacy groups, like lobbyists, need to stay in business and using the media helps them do that. But when we go to the same well for studies, quotes, and comments, we run the danger of presenting the same story line, the same media message, the same notions of acceptable discourse, perhaps crafted by PR folks or media trainers.
Running to the same people and groups who are readily quotable may be easy, but it is not necessarily good journalism. No wonder that the public has little understanding of what's at stake. There are plenty of sources reporters have not contacted. In the coming months, AHCJ will help you find them.
Ignored the money angle. We journalists have been taught to follow the money. The story is where the money is. In health care that's especially true since the U.S. health system is all about money. But there have been surprisingly few stories examining the campaign contributions of special interest groups that will have a big say in the outcome. Opensecrets.org has chronicled the cash. It's a good source for story ideas and analysis, but it's underused. Wouldn't it be a shame if we have become so accustomed to special interests paying for elections that we can no longer see the money stories?
All these themes could arise again in the next couple of years as the reform debate moves along and Congress focuses on the issue. In our recent Talking Health webcast, I asked our journalist experts Julie Rovner of NPR and Marilyn Werber Serafini of the National Journal what journalists could do between now and the time things get going in Washington.
Rovner had a great suggestion: Learn as much as you can about health care and the likely topics that are sure to surface. It's a good bet that the pols and interest groups will toss around the Federal Employees Health Benefits Program. Learning exactly what this is and how it works will help even Pulitzer Prize winners understand that it's not a national health insurance program.
Trudy Lieberman is president of the AHCJ board of directors. She is director of the Health and Medicine Reporting Program for the Graduate School of Journalism at City University of New York.
