The Debate Over Health Care Reform-What Role Did the Media Play

8/6/2019 The Debate Over Health Care Reform-What Role Did the Media Play

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The Debated over Health Care Reform: What Role Did the Media Play? 1

The Debate over Health Care Reform:

What Role Did the Media Play?

The College of Saint Rose

Alexander S. Englander


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The Debate over Health Care Reform: What Role Did the Media Play? Englander 2

Introduction

There are very few subjects lately that generate as much passion as the topic of health

care reform. The mere mention of health care reform can send people of all political persuasions

into a frenzy of ideas, both fact and fiction. Given the current political climate there seems to be

no other issue that stokes the fires of partisanship as much as the recent debate over health care

legislation. That debate reached a boiling point on March 23, 2010 when President Obama

signed into law The Affordable Care Act of 2010. Questions as to whether this is the best way to

overhaul of the nations health care system and whether this law is constitutional or not will be

fought in the federal courts and in Congress. However, in the court of public opinion, President

Obamas signature legislative accomplishment, one which he campaigned for vigorously during

the 2008 Presidential Election, on the surface, seems to have failed.

The key to a successful campaign is to have a great public relations machine behind the

idea or candidate. Despite coming into office with almost record approval ratings, President

Obama has struggled to pass even the most basic bills sent to Congress. How could a man, who

ran such a disciplined and aggressive campaign for president, barely get enough support to pass a

bill which could aid millions of Americans? As much as the conservatives in this nation like to

say there is a liberal bias in the media, was there a conservative bias which prevented the

President from getting his message across? Why did the media seem fixated on the rumors of

death panels and rationing instead of focusing on all of the positive aspects this law could

accomplish for the people of this country? How come the public option was left out of the final

health bill? Why, when unemployment is near ten percent and middle class income is decreasing

or stagnant, are so many people vehemently against reform which will only aid those who need it

the most?


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In answering the above questions, it will be possible to show how President Obama may

have grossly underestimated his opponents. By not paying attention to his adversaries, they were

able to create a public backlash against the President and the health care law. Many pundits have

speculated this led to the recent mid-term election disaster for the Democratic Party, which

included the loss of the House of Representatives. Answering these questions may also show

how the media was made just as culpable as the President for the wave of negative feelings

toward the health care law. Finally, with the research presented, it may be possible to present

ideas on how to best move forward and show the American public just what will be gained by

the passage of health reform.

History of Reform

The idea of health care reform in this country is not a new one. The general idea of

transforming the health care system in this country has been languishing around the halls of

Congress since Teddy Roosevelt ran for President in 1912. As part of his campaign, he wanted

to make health insurance coverage mandatory for every citizen (Maioni, 2009). Ironically, this

was an idea that Germany had back in the 1850s. However, because of rising anti-German

sentiment and the outbreak of World War One, the idea of health reform died (Lepore, 2009). It would

remain off the national radar, replaced by World War One and the excesses of the 1920s. It

would stay a dormant beast until 1935, when President Franklin Delano Roosevelt would

propose TheSocial Security Act, which was to aid the country and bring it out of the depression,

when health care reform legislation would again be tackled. President Roosevelt wanted to

include some type of reform in TheSocial Security Act; however, due to overwhelming

opposition, it was left out of the final bill (Maioni, 2009). It is interesting to note that the major

opposition to President Roosevelts health care proposals came from doctors and big business.


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These same constituencies that opposed Roosevelt would have a differing opinion of President

Obamas health care reform package. In Roosevelts case, he chose to pass a law without the

overhaul so he could provide for the elderly, unemployed and those who could not provide for

themselves or their families.

Roosevelts idea of national health care was not dead. He revived talk of a health care

overhaul again in 1944 during his fourth presidential campaign. When Harry Truman ascended

to the Presidency after Roosevelts death he quickly took up the cause of providing health

coverage to all Americans. Truman became the first President to speak before Congress on the

issue of health care reform. During his term in office, President Truman would try three separate

times to push some kind of health care reform legislation through Congress; all three times

failing. Among the tactics used by the opponents of health care reform in the 1950s was a

public relations bonanza of calling Trumans ideas socialized medicine, a term that has stuck

to the prospect of any health care overhaul since that time. Back in the 1950s, with the Cold

War beginning to heat up; anything making the slightest reference to socialism was instantly

branded as evil. One could almost draw a straight line from the anti-reform lobby of the late

40s and early 50s straight through to the reform campaigns of Kennedy, Johnson, Carter,

Clinton and now Obama. The country still has a fear of the word socialism and opponents are

sure to use that word at every opportunity to instill the same kind of panic they caused 60 years

ago (Maioni, 2009).

Talk of health care reform died for over a decade as the Cold War raged and Americans

were consumed with the fear of communism overtaking the country. President John F. Kennedy

was the next American leader to take up the cause of health care reform. On May 20, 1962,

President Kennedy delivered a speech at Madison Square Garden sponsored by The National


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Council of Senior Citizens, Washington and the Golden Ring Council of Senior Citizens, of New

York City. In his address, which was given to rally support for the medical care for senior

citizens, the President referred to health care as a problem whose solution is long overdue. His

proposal: Health care coverage for senior citizens to aid those who are 65 and older; this would

eventually become known as Medicare. His defense of the bill, which was being attacked on all

sides; including the AMA (American Medical Association), which lead the fight against

President Trumans efforts in the 1940s, was simple:

This bill serves the public interest. It involves the Government because itinvolves the public welfare. The Constitution of the United States did not

make the President or the Congress powerless. It gave them definiteresponsibilities to advance the general welfare (Kennedy, 1962).

Kennedys words have become the defense of health care reform since. Government is

intervening because it is in the publics best interest that everyone be insured. Kennedys cause

was picked up by his predecessor, Lyndon Johnson, who signed The Social Security Act

Amendments of 1965, which created Medicare and Medicaid (The Social Secuirty Act

Amendments of 1965, 1965).

Authors David Blumenthal and James Monroe ofThe New England Journal of Medicine

published a list of six lessons they believed other Presidents should learn prior to tackling any

other health care legislation. Those lessons were: First, to be committed to the cause of reform.

Second, act swiftly to ensure passage of a law. Third, use the presidential bully pulpit to drum

up support for the legislation. Fourth, use their election and mandate from the electorate to

negotiate up, rather than down. Fifth, do not be afraid to delegate. Finally, do not be afraid of

the budget constraints (Blumenthal & Monroe, 2008, p. 2384). These lessons would be useful

and ignored over the next forty years as other presidents attempted health care overhaul.


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The modern push for health care reform developed, ironically enough, from the policies

of President Ronald Reagan. During his tenure, Reagan fundamentally changed the way

Medicare and Medicaid reimbursements were handled from the original language of the

Medicare Act. Where doctors were previously reimbursed for reasonable costs, President

Reagan replaced that system with a prospective schedule of fees based on diagnostic related

groups (or DRGs) and Medicare beneficiaries were encouraged to use preferred provider

organization (or PPOs) (Maioni, 2009). Ironically, the American Medical Association, who

vehemently opposed health care reform in the time of Presidents Truman, Kennedy and

Johnson, because the organization feared too much government intervention and a socialistic

approach to medicine and health care, now found that a majority of its doctors were spending

more time filling out paperwork and dealing with government and insurance company

bureaucracy than their Canadian counterparts who worked within a publically funded health

insurance system (Maioni, 2009). They also found that insurance companies were becoming

more intrusive as to the types of care doctors wanted to provide their patients, in some cases

preventing patients from getting the care they needed. The AMA was beginning to see how

needed health care reform was.

The next big push for health care reform came after the election of President Bill Clinton.

When President Clinton was elected in 1992 in an Electoral College landslide, the nation was in

the midst of a recession with an unemployment rate of 7.4% (Washington Times). Interestingly,

these were similar conditions that President Barack Obama faced when he entered office in 2009.

Because of the recession, the rise of the uninsured, and limits placed on third party insurers; the

American Medical Associate began a shift in its opposition to health care reform. The

organization began to see that a public/private partnership would benefit not only its members,

but the citizens of this country. The AMA felt this partnership should guarantee full access to


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health care for all, yet preserve the freedom of doctors to do the job of providing care for their

patients. Yet, it was not just the AMA which had begun to change its view of health care reform:

Big Business began to feel the economic burden of providing health coverage for its employees

and began to see the wisdom of a government regulated health care system (Maioni, 2009).

On September 22, 1993, before a joint session of Congress, President Bill Clinton

delivered his now famous address on health care. During his speech, the President made an

impassioned plea for health care reform. In his address, President Clinton foresaw the coming

war over health care reform, and spoke directly to it:

Over the coming months, you are going to be bombarded with scaretactics by those who profit enormously from the current health care

system. Some of the arguments you hear will be sincere. Others will bemotivated by self-interest. And when they tell you that we cannot afford to

change the current system, I want you to stop and think: Who are theytrying to protect: You or themselves? (Clinton, 1993)

He was correct. Eight days after his address to Congress; Betsy McCaughey, PhD., who was a

fellow at the Manhattan Institute, published an op-ed in the Wall Street Journal in which she

claimed that Under the Clinton plan, most Americans will not be able to hold onto their

personal physician or buy the kind of insurance that 77% of Americans now choose (Nyhan

2010). This was contrary to what Clinton had specifically proposed in his address a week prior:

If you currently get your health insurance through your job, under our plan you still will. And,

for the first time, all of you will get to choose what plan you belong to (Clinton, 1993).

McCaugheys claims were refuted several days later in the very publication which she printed

them. The Wall Street Journal printed an article, affirming a majority of Americans concerns:

One of the biggest worries people have about the prospect of health-care overhaul is that theyll

lose the freedom to choose their own doctors (Nyhan, 2010). Yet, the Journal also took pains to

show that Americans would be able to keep their current coverage:


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would they (Americans) still have the freedom to choose the best doctoror hospital care they can find? The answer, health-care advisers say, is a

qualified yes The caveat, advisors say, is that some employees couldend up paying more to get the traditional fee-for-service health care they

now enjoy for little or no cost.

Despite this report by the Wall Street Journal, damage to President Clintons signature

domestic policy was done. Betsy McCaughey appeared on CNN the day after her op-ed was

published to continue to push the untruths she fabricated in her Wall Street Journal op-ed.

Within days, Senate Minority Leader, Kansas Republican Bob Dole and noted conservative

commentator Rush Limbaugh seized on these ideas and began to use them to spread the fear

which President Clinton had talked about in his speech (Nyhan, 2010).

In October 1993, President Clinton presented his 1,364 page Health Security Plan to the

United States Congress. At the same time the President sent his bill to Congress, a little known

compromise bill was also being distributed to members of the Senate. This bill, entitled the

Health Equity and Access Reform Today Act of 1993, drafted by the late Republican Senator

John Chafee, of Rhode Island, co-sponsored by Minority Leader Bob Dole of Kansas, Charles

Grassley of Iowa and 18 other senators, had at its core an individual health insurance mandate

for all citizens, subsidies for those who could not afford insurance and required insurance

companies to carry a patient regardless of preexisting conditions (Chaffee, 1993). Seventeen

years later, this bill would serve as the blueprint to The Affordable Care Act of 2010.

Both Senator Chaffees bill and President Clintons bill died one year later without ever

having been brought to a vote. Clinton, whom many considered to have the best political mind of

the last half of the 20th

century, ignored rule number two from President Johnsons Medicare

debate. President Clinton waited nine months before presenting his health care reform bill. This

allowed his opposition to mobilize and defeat him (Blumenthal & Monroe, 2008). Former


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Speaker of the House, Newt Gingrich believes it was Betsy McCaughey who delivered the first

decisive break point (Nyhan, 2010) to President Clintons health care plans. McCaughey was

helped, by the media allowing her to publish inaccuracies without holding her to a code of ethics.

In January 1994 she published another article, this time in theNew Republic, stating that if health

care passes; you will have to settle for one of the low-budget health plans selected by the

governmentThe doctor can be paid only by the plan, not by you (Nyhan, 2010). If the

publishers of theNew Republic had fact checked her article, prior to publication, they would

have noted what she had written was untrue and the bill actually stated, Nothing in this Act

shall be construed as prohibiting [a]n individual from purchasing any health care services

(Nyhan). Even though the American Medical Association and the powerful AFL-CIO were avid

proponents of reform, opponents were lining up, among them the insurance lobby. The public

relations war waged during the year long debate spelled the end of President Clintons plans to

overhaul the American health care system (Maioni, 2009).

Change

On November 4, 2008 Senator Barack Obama of Illinois was elected the 44th President

of the United States. His election set a number of records for this nation: He became the first

African-American President. He received more votes than any other presidential candidate in

history. He received the most votes ever for a first term President, and he carried several states

that no democratic candidate had been able to carry since the 1964 election of President Lyndon

Johnson (NPR, 2008). The nation was in the midst of the worst economic crisis since The Great

Depression. People were losing their jobs at a rate not seen in decades and Senator Barack

Obama offered a campaign based on hope and a new direction for the nation. He spoke of

changing the tone in Washington D.C. He spoke of moving the nation away from the fighting


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partisanship of the past eight years under George W. Bush and healing the country. Barack

Obama inspired a nation.

During his campaign, aside from fixing the failing economy, his main domestic policy

priority was health care reform. A poll sponsored by the Harvard School of Public Health and

The Henry J. Kaiser Family Foundation conducted in October 2008, found that health care

reform was the third most important issue facing the country. The top two issues were the

economy and the war in Iraq (Altman, et al., 2008). When respondents were asked what type of

health care reform they wanted, 47% stated they wanted A new health plan that would make a

major effort to provide health insurance for all or nearly all of the uninsured BUT would involve

a substantial increase in spending. The next closest response was A new health plan that is

more limited and would cover only some of the uninsured BUT would involve less new

spending (Clark, Pelika, & Rigby, 2010). That response was supported by only 30% of

registered voters. The poll, taken in October 2008, shows Americans were supportive of major

health care overhaul, even given the economic conditions of the country. This also shows that

Americans, knowing what the national debt was prior to the election of 2008, saw that health

care reform was something that was worth the cost.

Knowing that he had a mandate for change handed to him by the people of this country

and knowing that a plurality of Americans wanted change in the health care system, President-

elect Obama was armed and ready to begin the biggest overhaul of the health care system in

history. The bill which would be produced would be the single largest social legislation to be

signed into law since The Social Security Act Amendments of 1965 (Reich, 2010). However, as

much as the nation wanted to see these changes, brewing under the surface was a strong and

united opposition to President Obama and any and all of his policies, chief among them health


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care reform. Before he was sworn in, his critics were already calling for his failure. One of his

most outspoken critics was Rush Limbaugh, who stated on his radio program, prior to Obamas

inauguration, I hope Obama fails (Limbaugh, 2009). And so, before even having taken the

oath of office, before presenting one piece of legislation, before issuing one executive order,

before seeing how this new president would govern; President-elect Obama had critics who were

determined to ensure the failure of him and his presidency. Rush Limbaugh was just the first in

what would become a long line of critics, including Senate Minority Leader Mitch McConnell,

Republican of Kentucky, House Minority Leader John Boehner, Republican of Ohio, Republican

National Committee Chairman Michael Steele, Fox News Commentators Sean Hannity, Bill

OReilly, and Glenn Beck, Karl Rove, and most of the House and Senate Republican Caucus.

Naturally, it is the opposition partys duty to raise objections to what the President wants to do,

but the voraciousness with which they began going after the President-elect set a new, all-time

low for partisanship.

Even though the public elected Obama to help bridge the partisan divide, Senator Dick

Durban, Democrat of Illinois, a close ally of President Obama and senior senator from his home

state, believes Obama had little chance of succeeding, saying in a New York Times interview: I

think his [Obamas] fate was sealedOnce the Republicans decided they would close ranks to

defeat him, that just made it extremely difficult The American people have a limited attention

span (Baker, 2010). Senator Durbins statement is supported by the fact that nearly every piece

of major legislation President Obama has proposed has passed by an almost unanimous party line

vote. When Obama presented theAmerican Reinvestment and Recovery Act, his budget, climate-

change and last but not least, health care reform, the Republicans voted lock-step against the


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President and his proposals (Newton-Small, 2010). This surely was not the kind of change the

American people had voted for on November 4, 2008.

FactandFiction and the Media

In the spring of 2009, after President Obama had seen his stimulus bill passed, he turned

his attention to the cornerstone of his domestic policy agenda, health care reform. Mindful of the

problems faced by President Clinton in his failed attempt at health care reform, President Obama

approached reform differently. He charged Congress with coming up with a health care proposal

that met certain requirements. The instant President Obama charged Congress with coming up

with a health care reform bill, the rumors began. The biggest rumor, one which was played out

during President Clintons failed push for health care reform, was of government rationing and

takeover of health care (Jackson, Henig, & Robertson, 2009). The mere mention of health care

reform sends people into diatribes and rants over rationing. What people fail to realize is that

health care is already rationed in this country (Geyman, 2003). What the news media,

commentators and opponents focus on is the thought of government dictating to a person where

he or she should go for treatment. But the fact is, a persons insurance company already does

that. If a person does not have health insurance, the choices are even more limited.

One of the proposals presented by The House of Representatives, but removed from the

final bill, was a public option health insurance plan (House Committees on Ways and Means,

Energy and Commerce, and Education and Labor, 2009). This would have established a public

insurance company to compete with private companies, which many proponents believed would

increase competition and thus lower the cost of private insurance. The biggest problem

opponents have with thepublic option is if a person were to purchase this government plan,

government would now be in charge of ones health care. Opponents believe this would let the


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government to dictate what type of treatment someone would or would not be eligible for. The

argument is that a bureaucrat could effectively say that grandma is old; she does not deserve

treatment for a broken hip because financially it is too much of a risk. The reality is this: The

law would have established a committee of health care professionals who would decide the types

of plans that would be offered, much like private insurance companies do now.

Another argument opponents use to build the case against a public insurance plan would

ration healthcare is financial in nature. If a person purchased the public insurance option, there

would be a cap on out-of-pocket expenses he or she would pay. A person could choose

anywhere from a basic plan to an enhanced plan (Jackson, Henig, & Robertson, 2009). These

facts did not stop opponents of reform from repeating rumors that were proven to be false. One

such opponent was the Republican Senator from Iowa, Charles Grassley, who endorsed a similar

plan back in 1993. He stated: The public option is just the beginning of an eventual government

takeover of health insurance (Hancock, Grassley: Public Option Will Lead to Rationing, Denial

of Care, 2009). In an attempt to portray this option as far too progressive for Americans,

Grassley fails to acknowledge how health care is already rationed in this country and government

option or not, health care will continue to be rationed.

It was not just political opponents of health reform that were making the case that the

public option was too liberal; the media was portraying this option as being too far out of the

mainstream and the most liberal idea of the entire health care bill (Media Matters for America,

2009). A compromise proposal was floated, which the media called a co-op system of

health care coverage. This idea was presented by Senator Kent Conrad, Democrat, of North

Dakota. The media believed this to be more viable than the public option. A study conducted by

Media Matters for America during June 2009 found the following:


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Out of 26 instances in which the Conrad proposal was presented as acompromise or in which the public plan option was presented as the

progressive position that will likely have to be watered down, in onlysix instances did the reporter or anchor indicate that the public plan itself

represents a compromise for those who advocate a single-payer system.

Media Matters surmised that the mainstream media, where a majority of Americans get their

news, were portraying the public health option as the progressives stance and the Conrad

option as the mainstream or centrist position. But the way the media was juxtaposing these

two ideas, it became easier for them to frame the health care story as not just as a story about the

nations health care system, but as a partisan and political story. This may have aided the

narrative, but the public was being let down and not fully informed about the health care

proposals Congress was debating. In a poll released on August 6, 2009 and conducted by The

Pew Research Center for the People and the Press, 37% of respondents felt the media was doing

a poor job explaining the health care proposals and 33% of respondents felt as though the media

was doing only a fair job explaining how this legislation would affect their lives (Kohut, Keeter,

Doherty, & Remez, 2009). There was obviously some kind of disconnect between the media and

public. What was causing the disconnect between these two groups? Was the media responding

to the public or was the public responding to the media?

The media understood health care reform was and would continue to be the biggest story

of the year. Their challenge was how to make it viewer friendly. In another survey, this one

conducted by theProject for Excellence in the Media, from June 1, 2009 to March 31, 2010,

health care reform was the top issue discussed in the mainstream media, making up 13.9% of the

airtime; talk show coverage of the debate made up close to 30% of the airtime. For perspective,

the second most talked about story covered by talk shows was the economy, coming in at 7%

(Project for Excellence in Journalism, 2010). Even though the health reform debate was being


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covered, traditional journalists were taking a back seat to talk shows like Glenn Beck, Sean

Hannity, Bill OReilly, Rush Limbaugh, Keith Olberman and Rachel Maddow. Their respective

shows were contributing more to the debate than the main stream news outlets likeNBC Nightly

News,ABC World News Tonightor the CBS Evening News. Due to their highly-partisan nature,

these talk shows were not so much informing the public about health reform as they were

debating strategy and reinforcing the ideas already in the minds of their viewers. What the

public needed (but was not being provided) was a substantive discussion about reform and what

it would mean for every single American.

With opinion journalists contributing more to the health care debate than traditional

journalists; is it any wonder the public did not feel it was getting all of the facts associated with

health care? With health care opponents able to stick to their talking points, their message was

being sent out more clearly than supporters of health reform. However, the same Project for

Excellence survey showed liberal talk show hosts spent 44% of their air time devoted to the

health care debate. Conservative commentators on the other hand spent only 26% of their air

time discussing health reform. If the liberal media was covering health reform by almost a two

to one margin over conservative media, how is it there seemed to be so much opposition? This is

where opponents may have won and supporters failed. TheProject for Excellence in Journalism

study noted that opponents of reform had only one goal: to defeat health reform as a whole.

Proponents had two or more goals. The primary goal of all proponents was to ensure that health

care reform was passed into law. However, this is where proponents seemed to split. Liberals

wanted the final bill to include the public option whereas moderates and conservatives in favor

of reform did not want the public option included in the final bill.


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This split was made evident in the news and on talk shows. On his MSNBC show

Countdown, Keith Olberman, while an advocate for health care reform, would regularly chide

lawmakers for not supporting the public option. Olberman, who asserted there was broad

support for including that element of the bill (the public option), scolded the administration,

saying it was time get your head out of the District [Washington D.C.] and back into the

country (Project for Excellence in Journalism, 2010). Olberman went so far as to devote an

entire hour of his show to the health care debate. However, the hour that he devoted to the

debate was one of his Special Comments, an editorial on the state of health care in this

country. While he brought the topic to the kitchen table and personalized the many struggles he

had been through dealing with the health care system, he did not present experts to discuss

exactly what the health care bill would do for people. Instead, his Special Comment could be

seen as just adding another log to fire (Olberman, Coutdown with Keith Olberman, 2009).

It wasnt just Keith Olberman who was chastising lawmakers and the President. Noted

liberal radio talk show host, Ed Shultz regularly would take Democrats to task and mock them.

On his December 9, 2009 show, Schultz spent 13 minutes railing against Democrats for giving

up on the public option (Schultz, 2009). On another show, he called Democrats a bunch of

weenies (Project for Excellence in Journalism, 2010). With proponents fighting one another

about the best way to pass health care reform, it is easy to see how the standard message of those

who were opposed to the bill would seem more coherent and appeal to those who were unsure

about the bill.

An example of how the messaging was getting lost is shown in theProject for Excellence

in Journalism study. The study found that the fore mentioned rumor of rationing health care was

mentioned 2,624 times between June 2009 and March 2010. Meanwhile, one of the benchmarks


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of this reform bill, making it illegal for insurance companies to deny benefits because of a

preexisting condition, received 3,662 mentions. Barely 1,000 more mentions than the least-

mentioned message of opponents. There was obviously a large problem with supporters of

reform being able to stay on message and getting that message out (Project for Excellence in

Journalism, 2010). Even though health care was being talked about more in the liberal press, the

message was being muddled and President Obama was not using the mandate he was given by

the electorate or the power of the presidency to put a stop to the arguing.

This vacuum allowed another rumor to begin; one which would eventually characterize

the entire health care debate. Prior to 2009, health care rations and a government takeover had

become the go-to talking point for opponents; however, nothing will characterize the health

reform debate more than the death panel. This rumor was propagated by health care reform

foe and the woman who almost single-handedly brought down President Clintons health plan,

former New York State Lieutenant Governor, Betsy McCaughey. On July 16, 2009 while

appearing on former Republican Senator Fred Thompsons radio show, former Lt. Governor

McCaughey stated the following: Congress would make it mandatory-absolutely require-that

every five years people in Medicare have a required counseling session that will tell them how to

end their life sooner (Richert, 2009). What Ms. McCaughey was referring to was a part of the

health care bill which advocates funding for what is called Advanced Care Planning.

According to an article published in January 2010 of the Journal of the American Medical

Association, advanced care planning is providing patients and caregivers necessary information

in regards to living wills, roles of a health care proxy and orders involving extreme measures in

prolonging life:

As originally presented in Americas Affordable Health Choices Act HR3200, section 1233 entitled Advanced Care Planning Consultation


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described reimbursement for a clinician visit in which a practitionerexplained advance care planning, living wills, the role of a health care

proxy, and orders regarding life-sustaining treatments. (Fried &Drickamer, 2010)

However, once Ms. McCaughey made her statement on former Republican Senator Fred

Thompsons radio show, this particular rumor had a life all of its own. Brendan Nyhan, of the

University of Michigan, in his paper: Why the Death Panel Myth Wouldnt Die:

Misinformation in the Health Care Reform Debate, traced the myth of the death panel from

Ms. McCaughey through those who endorsed it as show in table one:

Table 1

Tracing the Spread of the Death Panel MythSpeaker Media Outlet Date

Betsy McCaughey The Fred Thompson Show July 16, 2009

Betsy McCaughey New York Post op-ed July 17, 2009

Sean Hannity The Sean Hannity Show July 17, 2009

Laura Ingraham The Laura Ingraham July 17, 2009

Rush Limbaugh The Rush Limbaugh Show July 21, 2009

Betsy McCaughey Wall Street Journal op-ed July 23, 2009

Rep. John Boehner (R-OH) Press Release July 23, 2009

Rep. Michelle Bachman (R-MN) House of Representatives Speech July 27, 2009

Peter Johnson Jr. Fox News Channel July 27, 2009

Rep. Virginia Foxx (R-VA) House of Representatives Speech July 28, 2009

Washington Times Editorial July 29, 2009

Sarah Palin Facebook posting August 7, 2009

Glenn Beck The Glenn Beck Program August 10, 2009

Rush Limbaugh The Rush Limbaugh Show August 10, 2009

Sen. Charles Grassley (R-IA) Town hall in Winterset, IA August 12, 2009

Rush Limbaugh The Rush Limbaugh Show August 13, 2009


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now being covered. Keith Olberman may have said it best in his Special Comment on October

7, 2009:

What about which we are truly driven to such intense, ineffable, inchoate,

emotions? Because ultimately, in screaming about health care reform-proor con-we are screaming about death. This is ultimately about death.About preventing it, about fighting it, about resisting it, about grabbing

hold of everything and anything to forestall it and postpone it even thoughwe know that the force will overcome us all, always will, always has

(Olberman, Coutdown with Keith Olberman, 2009).

How a person handles death and all that surrounds it is very personal. By saying President

Obama would decide who lives and who dies, Sarah Palin was able to humanize an enemy

without a face. Nobody likes death. People try to avoid death at all costs. No matter how

ridiculous it sounds that our government would advise the elderly and infirm on how to end their

lives to save money, it is because of peoples fears of death that this rumor and the health care

debate became such a hot topic, with tempers flared on both sides.

SensationalorSubstantial

The unfortunate thing about the death panel rumor, aside from that started to begin

with, was how poorly the media handled it. Instead of setting the facts straight, reporting the

truth and moving on, the traditional media decided to report the more sensational side of the

story. The Washington Times, a conservative newspaper, ran an editorial reminding its readers

of the Aktion T4 program of Nazi Germany in which children and adults with disabilities, and

anyone anywhere in the Third Reich was subject to execution who was blind, deaf, senile,

retarded, or had any significant neurological condition (Rutenberg & Calmes, 2009). The

editorial did not come right out and say Obama was going to have a similar program, but the

undertones of the editorial were clear: Barack Obamas health care plan was dangerous.


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Even more liberal and celebrated journalists have had their say about the Obama death

panel. On Bill Moyers show The Journal, he led an in-depth discussion about the rumored

death panels. Although he was speaking about how the discourse of our nation had tumbled

out of control, does it not still bring validity to Mrs. Palins original statement? Yes and no. The

way in which Moyers was covering the story was completely different than say Glenn Beck or

Rush Limbaugh or Sean Hannity. The audience Moyers reaches is also very different than those

who watch Fox News and its primetime lineup of talk shows. Rather than fanning the flames of

intolerance and hatred, Moyers was attempting to get to the root of the issue and to educate

people. Whereas Glenn Beck and Sean Hannity are not trying to educate, they are trying to

incite. That seems to be the biggest problem facing proponents of health reform. The media no

longer wants to educate the public. The media just wants to report the sensational. In an

interview conducted with Cecelia Lynch, Vice President of Nursing at Ellis Hospital in

Schenectady, New York, Mrs. Lynch addressed the issue of education in health reform. From

her standpoint she felt it was the job of the media and health care agencies to educate people

about the new law. But how can the media educate if they are not impartial?

When a passenger jet crashes, the first thing media outlets do is to put pictures of the

crashed plane on the air. Society loves the pictures. Society wants to see what happened.

Society, on a whole, does not care about how the plane crashed; it cares about the macabre, the

people on the plane. What happened in the moments before the crash? People want to know who

was on board. What were their stories? Unfortunately, as soon as everyone is identified and the

wreckage is cleared, the story leaves the front page and most people forget the tragedy ever

happened. A year later, when the cause of the crash is made public, the story may receive a

mention toward the end of the nightly news. But, where were the news crews prior to the plane


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crash? How come the media was not reporting on problems during the manufacturing of the

aircraft? The reason why: its a boring story (Calderone, 2009). People just take for granted that

the airplanes and cars they travel in are safe. If they arent, they assume the right people will

make them safe. The health care reform story is essentially the same. It is a boring subject to

report on. But, when a Sarah Palin or Michelle Bachman or Betsy McCaughey says something

outlandish and inflammatory, it adds spice to the story and the media is all over it. Such is what

happened with the death panel rumor. However, as big of a story as the death panels and

health care reform were, the media became part of the narrative as well.

In varying articles from outlets such as The New York Times and The Seattle Times to

NPR and Health Beat Blog, some journalists have been taking a look at how the health care

debate was covered in the media. More specifically, how the media became part of the story.

OnNPRs weekly show On the Media, Mark Jurkowitz, Associate Director of theProject for

Excellence in Journalism stated that while print and network outlets contributed approximately

20% of their time and space to the health care story, a vast majority of the coverage had been on

radio and cable news networks. He was able to draw a direct correlation between the amount the

public new about the health reform bill and where they received their news from. Those who

receive their news from the mainstream television networks,ABC, NBC, and CBSor from the

newspaper, were more likely to be better informed about the health care bill than those who

watched cable news (Jurkowitz, 2010). In the week health reform was actually passed and

signed into law, only 22% of time allotted for discussion of health reform was spent on how the

new law would impact someones life (Holcomb, Nikitin, Santhanam, & Sartor, 2010). The

remainder of the time was spent discussing the political implications and how different members

of Congress were being threatened.


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In his article for the websitePolitico, Michael Calderone spoke with various reporters,

commentators and media insiders about how the health care reform debate was playing in the

media. The consensus among those who were interviewed was that health care reform was not

good television, as stated above. As host Dillon Ratigan said: Health care is bad for ratings

(Calderone, 2009). Just like the fictional planes manufacturing problems prior to the crash,

when speaking about public policy, peoples eyes glaze over when terms like public option or

bundles payments get tossed around on the air (Calderone, 2009). Thats why Sarah Palins

death panel wouldnt go away. It was too good of a story for the media to pass up. It helped sell

the networks. Although the politicians who were proponents of reform and involved with the

debate did not want to give credence to Ms. Palins lie, they were forced to when members of the

opposition party began relaying this lie to their constituents, as Sen. Charles Grassley did during

the August Congressional recess (Hancock, Grassley Responds to Backlash Over Euthanasia

Rumor, 2009).

In his article, How to Kill Those Pesky Death Panel Rumors, Farhad Manjoo says the

best way to fight the rumor was to just ignore it. After all, he argues, if a person hears something

over and over again, even though it is known to be false, he or she may start to believe that its

true. By ignoring the rumor, he believes it would have dropped from the public conversation.

Yet, if President Obama had been more willing to come out of the gates fighting; and had he

used his bully pulpit as Blumenthal and Monroe said any president must use, would there have

been the need for such drastic defense? One might be able to argue that President Obama and his

advisors, rather than going on offense allowed the debate to be dictated to them, rather than the

other way around. Because they were playing defense, the administration began fighting rumors

and fallacies they obviously wanted to see disappear. However, what would the media have


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done without the death panel, rationing, or other rumors? Would the media have been able to

focus on more substance, without having to deal with those rumors? It is hard to tell. With the

broadcast networks devoting less time and money to traditional newscasts, and cable networks

becoming dominated with opinion journalists, one could argue that no, a substantive debate over

health care reform would not have happened without a major change in the culture that now

dominates broadcast and cable news.

Conclusion

There will be other issues debated in this country, such as; tax reform, financial

regulation reform or climate change, to name a few, that may not grab the attention or the ratings

like death panels, socialism and health care rationing; but these are important to the running of

this nation. For the population to be fully educated the media must present all sides of the story

and not just the one side perceived to be what their audience wants to hear. Opinion journalism

does have its place in our culture; we are a free society. One of the fundamental building blocks

of this nation is the freedom of speech. People have the constitutional right to say and think what

they believe. However, one must never forget the difference between facts, opinions and

downright lies.

The recent health care debate can be characterized by the rumors and lies that were

propagated by opponents of the law. From government takeovers to health care rationing to the

death panels, all of those rumors were found to be false, yet still managed to find their way into

the public consciousness. It is not known whether, if ignored, those rumors and others would

have died a quick death. This debate will also be remembered for the role the media played. Not

only was health care the story, but how the media handled the story also became part of the

narrative. By shedding its traditional role as outside and impartial observer and informant, the


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media may well have crossed a line which will take years to cross back over. Polls conducted

throughout the year long legislative process continually showed the public did not believe it was

being informed about what the law would do for them. These same polls also showed an

American public deeply disturbed by what they were seeing and hearing in the media, which

raised even more questions about the proposed legislation.

Most of what the public sees happening in Washington D.C. and from lawmakers they

see through the lens of the nightly news. If the only thing the news is showing is sensational,

raucous storytelling, than one would be left with an impression that government is not working.

In this age of opinion journalism, where cable news is either right or left, it is now, more than

ever, the responsibility of the traditional media to stand firm and tell the story through an

unbiased eye.

Finally, through the research conducted and presented, it has become clear that even

though the media reports on stories that show the nation divided and fractured, it may just be the

best way to sell the news. In actuality, the country, while angry about the direction they perceive

the nation heading, is not as divided as one might expect. The election of Barack Obama was not

a close election. He won in a landslide. He received more votes than any other presidential

candidate in history and bested John McCain by almost 10 million votes. When the nation voted

Barack Obama into The White House, they voted for the policies he had been advocating for

during a two year campaign. Among those policies they endorsed with their vote was health care

reform.

The media, by focusing on sensational and not substantive stories about reform has done

a great disservice to the public as a whole and called into question journalistic integrity. There

are many people in the industry who take pride in being the voice of the people and being able to


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tell the American story through an unbiased and impartial lens. With large conglomerates

running everything from newspapers to radio to television, the neutrality of the media can be

seen as having fallen by the wayside. Because of these perceived biases, the public does not feel

it is being educated properly. The only way to fix these problems is for the media to take a long

look at how they are presenting itself to the American public.

The debate over health care reform may very well go down in the history books as one of

the most fractured times in the modern history of our country. However, as fractured and

chaotic as the dialogue was, Congress was able to pass a law reforming the nations health care

system. With the Republican takeover of the House of Representatives in January, 2011 it is still

very unclear where all the pieces will land. What is for certain is that those rumors helped to

define the debate over health reform and they may be all that is remembered for a long time.


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The Debate Over Health Care Reform-What Role Did the Media Play

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