Why the Health Reform Rush?

If you’ve been ignoring health care legislation for months, waiting for the moment of truth to arrive — well, now may be a good time to start paying attention. Ted Marmor and Jonathan Oberlander have helpfully encapsulated the current state of play in an NYRB essay. The media have started highlighting voices critical of current proposals, ranging from alarmists to prudentialists to beleaguered governors. They are curiously uninterested in the views of those representing the sizable number of Americans who want more thoroughgoing reform than is currently on the table. That bias is a major reason for a big push on reform now, rather than later this fall or winter.

If the media were up to a real health reform debate, they’d complement every story relating skepticism about reform efforts with a careful investigation of where things are headed given the status quo. For example, on Sunday’s Meet the Press, David Gregory aggressively pressed HHS Secretary Kathleen Sebelius about the possibility that reform would lead employers to drop private coverage because they could shift workers to a public plan. Gregory ignored the fact that employer-based coverage is eroding now. Similarly, media outlets persistently pair as sparring partners incrementalist academic experts with soi disant conservatives who in reality envision radical changes for tax treatment, risk pooling, and coverage determinations in health care. It’s not a fair fight, and the longer it goes on, the more misinformation is likely to be spread about reform.

Most troublingly, journalists routinely let critics of reform take opportunistically partial potshots at legislation. First the critics complain about costs. Then, if a reformer proposes a public plan designed to contain costs, the complaint morphs into worries about “socialized medicine.” When it’s explained that the public plan will be just one of many options, a “slippery slope” appears: if it’s really so cheap, won’t everyone sign up for it? Reformers then point to consumers’ risk aversion and the presumed capacity of private insurers to innovate and attract customers. Unwilling to further investigate the many countries that vindicate that claim, most journalists just balance such arguments with assertions about the “road to tyranny” that any further government intervention entails.

If the media (or the “go-slow caucus”) showed a genuine interest in the health policy issues raised by reform, I’d welcome a months-long Congressional debate on policy minutiae. Instead, we get page after page and hour after hour of political gamesmanship, relating perceptions of perceptions of who’s up and who’s down in the polls. It’s no wonder the MSM is in crisis — it “splits the difference” among viewpoints well to the right of the average American’s views.

The longer the health care debate goes on, the more we can expect “dumbo journalism” about the hard issues at stake. We can rely on the elite media to translate their own frustration at trying to understand multiple, complex bills into reportage on an imaginary public’s anger and skepticism about the same. In short, we can expect more Rush–and that’s why there’s a rush.