The Biggest Adversary

by dday

I watched Obama's speech on the economy this morning, and I thought he laid out the scope of the problem and the consequences of inaction pretty well. He also cited the source of the crisis - "profound irresponsibility" and the final judgment on failed laissez-faire policies. And he's signaled that he's perfectly willing to let the package's total grow as it makes its way through Congress. You can read the whole speech here.

Republicans obviously have their own thoughts on this, and they'll try their best to derail the bill and increase the tax cuts relative to the fiscal spending. Whatever - they know nothing but obstruction. What's got me concerned is the gasbag reaction immediately following Obama's speech. On MSNBC, the first talking head pronounced that this was "the University of Chicago lawyer" Obama, not the soaring rhetoritician of the campaign. Non-Senator Tweety Matthews agreed that economic talk doesn't look good on TV because it's not "visual" enough. And Richard Wolffe, trying to sound knowledgeable, cited some of the specifics Obama offered as stimulus projects - moving to electronic medical records, weatherizing federal buildings - and intoned "it's not going to cost a trillion dollars to get electronic medical records."

Oh dear. This brings me back to a post that Jamison Foser cited this week by Niko Karvounis of the Century Foundation, about how the media's lack of expertise or even interest in policy matters could easily derail progressive initiatives by failing to offer a counter-balance to right-wing lies. Karvounis focuses on this question with respect to health care.

Right now, health care reform is an abstract goal that everyone wants -- excitement and anticipation are high. But as the substantive process of health care reform gets under way, two things will happen: first, ideas will be crafted into policies -- concrete plans of action and complex administrative measures, and second, politicians will become involved in the reform process. Policy can get pretty complicated; so the public will rely on the media to help it navigate the ins and outs of the issue. Once politics begins to shape policy discussions -- that is, once politicians enter the picture -- it's all the more important to keep the focus on policy, because it's at this point that policies have a real chance of being implemented. Americans should know their options.

Unfortunately, reporters aren't health care policy experts. In fact, they rarely ever talk about the issue. In a December report, the Kaiser Family Foundation found that, out of 3,513 health news stories in newspapers, on TV and radio, and online between January 2007 and June 2008, health care policy made up less than 1 percent of news stories and just 27.4 percent of health-focused stories. Instead of talking about issues like coverage, prescription-drug care, costs or public programs, the media prefer to report on specific diseases and conditions (cancer, diabetes, obesity and heart disease) and potential epidemics (contaminated food and water, vaccines, binge drinking). Together, these two topics made up 72.6 percent of health coverage.

This is less than ideal. When Congress begins to talk about health reform in earnest, the important news that will affect all of us will be about policy and institutional changes. The media need to be good at covering this stuff -- yet as the Kaiser report shows, newscasters, reporters and editors have very little experience (or interest) in discussing such issues. Worse, history shows that when health care reform efforts are actually under way, the media ignore policy in favor of more sensational stories.

During President Bill Clinton's efforts at health care reform in the 1990s, for example, media reports disproportionately focused on politics rather than policy. In their 1998 book Politics, Power, and Policymaking: The Case of Health Care Reform in the 1990s, Missouri State University professors Mark Rushefsky and Kant Patel found that that in 1993 and 1994 -- the height of public debate over Clinton's plan -- the New York Times reported just 257 stories about policy considerations (proposed reforms and solutions, analyses of options) and a whopping 549 on politics (personalities, disagreement, partisanship). When the nation's health care system was at stake, spats received more coverage than substance.

It's very troubling and can be easily extrapolated to this stimulus package. The media will cover it as a wrestling match, with the twists and turns being entirely filtered through the lens of surface politics. The right will send its passel of spinners to talk about "pork-barrel spending" and "unnecessary" art museums and bike paths being built with the taxpayer's money, and the chattering class will glory to their front-row seat at the prizefight. But the truths and the falsehoods never get sorted out. That goes double for health care, where a host of right-wing myths crop up in almost any media report about the issue.

Karvounis is hopeful - more than he should be IMO - that the media can talk intelligently about these issues. I do think that the public has more access to intelligent analysis about the merits of policy, but that's nowhere to be found among mass media. And ultimately, that's still where most people get their news and where most editors and executives take their cues on what to report. This is an extremely important point:

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.

Traditional media has very set narratives for how they view policy fights, and they believe the public wants to view those fights along those lines. In the brawl, reality is subsumed in favor of the he-said/she-said approach. It's going to take a supreme communicator to break through that very ingrained structure. But it'll take more than that. The rot in our traditional media is very widespread.