Twenty!

Healthcarika Misunderstanderson

My paper on health care reform.  Not final but not rough either… proud of it. worth a read:

On November 7th, 2009 the United States House of Representatives passed the Affordable Health Care for America Act, the most recent step toward health care reform in the United States.  The future of the bill remains in the hands of the US Senate, but the future of health care reform has always been in the hands of the American people.  A bold statement, since many Americans are unsure of the appropriate way to go about asking for reform.  It’s difficult to understand what, exactly, the ‘public option’ is, or what ‘single payer health care’ means.  Definitions of the many options of health care reform are blurred by political agendas.  We have come to expect this from the government, especially in a time when governmental trust is a commodity, but we should not expect this from the media.  During a time where media trust is high, and media attention is even higher, the ever-popular ‘fourth branch’ has more influence than ever over social and political change.

Health care is the top priority of most Americans, but it’s not the first time that the movement has been such a high priority.  Health care reform first became a concern in the early 1900’s, during the industrial revolution, after workers demanded wage compensation in case of illness or injury(Hoffman 1).  Health care reform was a desire of many activist groups in the 20th century, such as women’s suffragists who wanted maternity benefits, but Dr. Beatrix Hoffman notes that, “grassroots reformers in labor, civil rights, feminist and AIDS movements have concentrated more on immediate and incremental changes than on transforming the health care system itself” (1).    In the 1920’s, demands for health care reform shifted from wage compensation to access and availability of medical care. The Great Depression served as a platform for considerable social reform, but Roosevelt omitted healthcare from The New Deal, ironically fearful of American Medical Association’s (AMA) involvement.  Through the 1940’s, 50’s, and 60’s, demand for change was muffled by the AMA, who feared that “group medicine and voluntary insurance” was “socialized medicine,” a fear that is echoed by many anti-reformers today.

In 1965, as a result of mass organization and demand for medical coverage in the senior citizen community, Medicare was passed with the Social Security Act.  Through the 1970’s and 80’s, health care reform lost momentum and focus was put on controlling costs rather than implementing changes.  President Clinton’s push for health care reform in the 1990’s fell flat due, in part, to a 1400-page proposal, which failed to gain solid grassroots support (Hoffman 3).  Dr. Hoffman explains that health reform in the 20th century has often been defeated by powerful interest groups, as well as reformers who have “failed to inspire grassroots activism” (3). While President Clinton’s verbose proposal might have failed, it did draw attention to the state of the health care system, an issue that resonated among the millions of Americans who lack coverage.   Lost amidst the policies and controversy of the Bush administration, health care reform is back at the top of the White House agenda, and, albeit ten years later, it seems to have taken grassroots appeal.

Health care insurers began as an ally to workers during the industrial revolution, but have grown to be a thorn in the side of the health care model. It is important to know that America’s current health care model is that it’s not so much a system as it is a health care market.  Health insurance companies operate in the private sector and often hold a monopoly over large areas in the US (Berenson, Holahan, Zuckerman 2)

“The Justice Department considers an industry to be “highly concentrated” if one company has 42 percent of the market. In Arkansas… Blue Cross Blue Shield has 75 percent of the market. If you take government self-insurance plans out of the equation, it’s higher. The state ranks as the ninth most concentrated in the country. Is it any wonder that insurance premiums have risen five times as fast as wages?” (Dumas)

As a result of minimal competition, health insurance companies can charge excessive monthly premiums, deny coverage to patients due to “preexisting conditions”, and drop clients who suddenly find themselves actually needing health coverage.  Because Americans honor the free market system, it feels uncomfortable to think about the government stepping in and regulating the private sector.  Unfortunately, the health insurance industry isn’t much of a healthy, competitive, free-market system. Without government regulations, this unjust cycle will continue.

According to The US Census Bureau, 46.3 million Americans didn’t have health insurance in 2008, a number that rose half a million since 2007 (Heavey).  “The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” said David Himmelstein, a Harvard medical professor who co-authored a recent study. “Even this grim figure is an underestimate — now one dies every 12 minutes” (Harvard).  In 2007 America spent 16.2% of our Gross Domestic Product on health care spending, nearly one-sixth our entire economy (Kaiser 1).  That percentage is double the annual GDP spent on health care in Japan and nearly a third the amount of France.  France has the world’s leading health care system, Japan comes in at number ten, and the richest nation in the world ranks at number thirty-seventh (Reid, 251).  The difference is that these other leading nations all have some form of non-profit national health care insurance.

In the past, health care has taken a back seat to other social movements, but as President Obama rode into the White House on a wave of support for health care reform it has recently become top priority and a social movement all its own.  Unfortunately, upon watching the news, the grass-roots movement appears to be about what many Americans feel is socialism and “big government,” instead of about its actual concern: health care.  Many polls, however, show that Americans strongly favor the public option.  Specifically, A Kaiser Family Foundation tracking poll shows that 68% of Americans favor a “public health option similar to Medicare to compete with private health insurance plans.”  The same poll states that 17% strongly oppose the public option.  This percentage is surprising when the amount of air-time given to violent protesters in health care town-hall meetings, coverage of anti-reformers passionately picketing outside the White House, and, of course, the infamous outburst of Senator Joe Wilson during Obama’s health care address seems to greatly out-weigh news media coverage of pro-reformers.  Furthermore, the important facts like public opinion polls and studies about the health care bill and health care reform get lost in the muck of the debate.  The media has skewed the appearance of health care reform popularity by focusing on trivialities and has failed to report important facts.

The Pew Research Center found that health-related news comprised a mere 3.6% of total national coverage in 2008 while US health policy made up 27% of that percentage (Pew).  In a separate study, the Pew Research Center found that health care reform was a top priority of American adults, but that 72% believed the media was doing a poor to fair job “explaining details of the various proposals” (Remez, Kohut 1).  Representative Joe Wilson’s outburst (“You lie!”) during President Obama’s health care address to a joint session of Congress was a media focal point for weeks on end.  The controversy completely diverted focus from the Health Care Bill to the apologies deserved, the apologies received, and the party conflicts that followed.  Rather than discussing the details of the President’s address or what the health care proposal included, the headlines of most national papers were about Representative Wilson’s outburst.

Details of the various reform proposals aren’t covered by the news media enough, but neither are the more simple, broad definitions of health care reform.  Generalizations, rather than definitions, of key terms such as the “public option” and “single-payer” keep many viewers nodding their heads but not fully understanding the jargon.  This is because too much media attention is devoted to focusing on ideological differences between the Republican Party and the Democratic Party when it comes to health care reform. A News Index survey showed that most media coverage of health care focused on “the politics of the debate” rather than details of the proposals (Pew).  “The complexity [of health care reform] has not been lost on anyone, but even accepting the difficulties, many outlets have shown a dazzling determination to highlight conflicts and legislative timetables while telling us almost nothing about potential changes in insurance and care” (Rainey 1).

Because news media outlets rarely attempt to explain the public option, or how it works, Americans are forced to gain understanding of it based on the context in which it’s being presented. This lends to a narrow understanding of the public option and misunderstanding that there are actually many options for a public option (Berenson, Holahan, Zuckerman 3).  “Between August 15 and September 15, a Factiva search turned up 2,335 stories in newspapers, business publications, and general interest publications mentioning a public plan.  But when it came to telling readers who could actually join the public option, only seventy-six outlets gave the full story” (Leiberman 1).  Rather than looking into these details, many news outlets focus on how some anti-reformers demonize the public option.  When thousands of protestors descended upon Washington to picket against “socialized medicine” the media focused on their angry assembly for weeks, failing to show that those people were representing a mere 17% of American opinion.  T.R. Reid writes in his book The Healing of America, “The debate turned more on slogans—‘socialized medicine,’ ‘big government mandates,’ ‘caring for our children’—than on moral questions of basic human rights.  The ethical issue…has generally not been a part of the conversation in the United States.”  The attention paid to the skeptics of socialized medicine, a minority, casts a dark shadow over health care reform. In reality, those with government-run insurance plans seem to like it, and it’s doubtful that even Rep. Joe Wilson will deny that Medicare is largely popular among senior citizens.

The question is whether it is better to receive misleading coverage or none at all. Virtually every developed country in the world has a single-payer system as their health care model—except for the United States (Reid 23).  The single-payer system has been cast-aside by the American media, as well as the White House, because it doesn’t include the highly profitable health insurance industry.  Administrative costs of health care amount to over 7%, some argue nearly a third, of all health care costs in America.  Medicare spends 2% on administrative costs (Kaiser).  The single-payer system could save nearly $350 billion per year on administrative costs by switching to a public health model like Medicare, but President Obama believes that the single payer system would “disrupt the health care industry” (Taibbi).  Not to say that there is a conspiracy against the single-payer system, but it’s not far-fetched to assume that the stakes are too high, and the profit too great (even for the media) to disrupt this morally and economically corrupt industry.  This is their enormous oversight.  The lack of reporting on the single-payer system is not in the best interest for the American public.  It’s not because of what the media outlets say that displays a lack of journalistic integrity, it is what is left unsaid.  “America has a health care crisis, yes, and so do broad segments of the media, particularly television news.  They have transformed the story of how to fix an overpriced and inadequate care system into an overheated political scrum, with endless chatter about deadlines and combatants and very little about the kind of medical care people get and how it might change” (Rainey 1).

Relying on partisan disputes to dispel rumors about health care is what causes misinformation to be spread even more widely.  FactCheck.org recently analyzed a popular email that contained 48 claims about the health care bill, only four of which were true (Jackson, Robertson, Henig).  Common misconceptions about the health care bill are such things like governmental “death panels”, rationing of health care, and that illegal immigrants will receive free health care.  These claims are false, but the media has portrayed these incorrect allegations as a topic of controversy rather than presenting them as actual falsehoods.  The perfect example is claims that the proposed health care bill included death panels that would decide whether or not to pull the plug on your Grandmother, the rational being that if tax payers were paying for health care, it had to end at some point. “For [White House] deputy communications director Dan Pfeiffer, the more hyperbolic attacks on health care, which were often conveyed as ‘controversy’, flipped an internal switch. ‘When you are having a debate about whether or not you want to kill people’s grandmother, the normal rules of engagement don’t apply’” (Scherer 1).  The media took the breach of ‘normal rules of engagement’ and  ran with it, turning the whole debate into a battle field of ideological what-if’s and will-not’s rather than serving as the informational platform it should be.

Health care reform in the United States is, for many, likely the social movement of their lifetime.  This issue has been around for a long time and it isn’t going away any time soon.  For whatever reason, the media is in avoidance of the real issue at stake.  If main stream media doesn’t step up to the plate to inform the American public about the real issues than sustainable change to the health care system is a distant star.   Presenting falsehoods as controversy gives rise to more controversy and spreads dangerous rumors that could thwart the grassroots mobilization of real reform.  Reporting on health care reform in the main stream media is, in large part, hot air.  American’s deserve to know the options and information about health care reform without having to write a research paper on the matter.  In this case, it’s what we don’t know that can kill us.

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2 thoughts on “Healthcarika Misunderstanderson

  1. Dear Erika Excellent report. You covered the complex issue with real data and fairness. And then there is single payer plan, hopeless at this point. But this is huge and a precursor of the enormity of change coming in the next decade. There is so much money involved from the insurance industry in the congress and without real financial reform of the election process it is such an uphill struggle to make changes relating to the public weal. However there is hope and change will occur. It is snowing on your blog did you know? This deserves an A. You can quote me if you like. Love Grandma

  2. Kyle Brazil says:

    Great write up. From your tweets (and retweeting me) I’ve pretty much known your view is aligned with mine. You point out all the good issues here. Healthcare reform is a battle that will be continually waged for years to come. Even though the final bill that emerges is going to be extremely weak compared to what us true “reformers” would like to see I at least hope it provides a good stepping stone for further advancement. Keep helping to support the cause! It may take some time but we’ll get there.

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