For almost 4 decades, we have witnessed the fact that there is no simple solution to our healthcare problems. Real healthcare reform is far more than just a political football; it is incredibly complex and majoritarian goals often fail to match society\’s subscriptions to ideologies.
It\’s a shame, because around the world (and especially in the U.S) healthcare is in a crises–not necessarily because the actual care is poor, but because from a financial standpoint, sustainability cannot be achieved in the for seeable future. Unfortunately, rising cost problems are often oversimplified in the media, and people will gravitate to news organizations that will spoonfeed them exactly what they want to hear. In other words, individual priorities are what matter to people, not necessarily the actual cost problem. This is nothing new, of course, but the argument here is that this kind of selfishness is what\’s preventing the legitimate reform we need.
For example, the recent healthcare reform legislation passed in March will cut almost $500 billion over 10 years from Medicare. The media oversimplified and completely failed to explain the fact that the cuts were being made to the automatic funding increase that Medicare receives every year that most government economists say is relatively wasteful. Specifically, 7% of the annual automatic increases in funding Medicare receives will be cut, and over 10 years the cuts will total $500 billion. Therefore, 93% of the Medicare\’s annual funding increase will remain in place.
Inevitably, seniors were upset with the 7% cut, and one could argue whether that is justified or not. However, the media has a responsibility as a gatekeeper and \’watchdog\’ to provide people with accurate information (and evidence to support it). As an intern for a U.S Congressman in the midst the healthcare reform debate, I was stunned at the level of misinformation circulating, as well as the level of intolerance in regard to ideas that may be somewhat foreign. When major change is needed, there is always a component of the public that is strongly opposed to it, simply because it\’s change. What I didn\’t realize is that group of people makes up a fairly large portion of constituents.
I used to believe that when people have a problem, they would simply examine their available options and select the best one that best addresses the issue. Unfortunately that doesn\’t happen, and instead people bind themselves to whatever system or ideology they\’ve subscribed to, even if it means sinking with a broken ship.
The element of intolerance to other ideas is certainly nothing new to human nature, but it is badly failing us in healthcare because it prevents rationality. And when rationality is lost in the discussion, solutions become too distant and disappear from mainstream thought.
Another component to why we have a massive dilemma in healthcare is because, as previously noted, selfishness and our individual priorities are not applicable to real solutions. Healthcare absolutely does not function when it is treated like a free market. To the contrary, capitalism functions primarily because of the greed (priority) and motivation of individuals.
We\’re kidding ourselves when we pretend that healthcare is a free market. If a man suffers a concussion in a car crash, he is rushed to the emergency room and treated according to the immediate diagnosis of whatever doctor is on call. He isn\’t capable of negotiating what the best or cheapest treatment or procedure, therefore he\’s not in a position to maximize his own utility. One could argue that the insurance market is free enterprise-based, but ironically, if the man that suffered a concussion lacks any health insurance, society picks up the tab when he\’s being treated in the emergency room.
Furthermore, there is a consensus that we have a lack of competition within healthcare. Bloomberg columnist Clayton Christensen makes a case that people like myself who argue that there is a lack of competition are simply framing the problem incorrectly. He writes, \”Economists are wrong in asserting that competition controls costs. Most often innovation and competition drive prices up, not down, because bringing better, higher-priced products to market is more profitable… It\’s because we have such competition, not because we lack it, that health costs are rising by 10% a year.\”
Basic macroeconomics explains that competition is what drives market signals and prices. Monopolies and cartels will restrict consumers\’ choices and equilibrium shifts not because consumers exclusively demand the product be made by the cartel, but because no other options are available. Likewise, insurance companies that dominate a certain area have the ability to fix premiums inefficiently, and the consequence for the consumer would naturally be restricted supply. Monopolies also have the advantage of negotiating with manufacturers, while the competition lack the tools to do so as well. This unfortunate situation exists in healthcare, and it\’s a massive problem within the realm of rising costs.
The public relies on the media for help navigating the complexities of public policy, and the media normally does that quite well. However, health care reform isn\’t typical public policy, and the media is actually aware of this.
In a December report, the Kaiser Family Foundation found that out of 3,513 health news stories in newspapers, on TV, 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 prefers 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 far from ideal when healthcare legislation is being debated, as reporters (and pundits) aren\’t exactly healthcare experts. Management–producers and execs, however, were thrilled that healthcare reform was introduced so early into the Obama administration\’s first term. Why? The answer lies in history.
During President Bill Clinton\’s efforts at health care reform in the 1990s, media reports disproportionately focused on politics rather than actual 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.
Spats, of course, receive huge ratings. Record-breaking ratings make people like Roger Ailes ecstatic.
So in 2010, why did this administration expect that history wouldn\’t repeat itself, and the media would somehow turn its nose to a partisan dustup and personality games (Hillarycare–Obamacare)?
Apparently they felt that their campaign promise would trump the media\’s power to derail legitimate reform on the heels of \’Hope and Change\’. Following 14 months of intense debate on the issue, society\’s been granted legislation that looks more like Mitt Romney than Lyndon Johnson. As much as we like to think our politicians don\’t respond (or work) for us, that disingenuous on almost all levels. If 70% of the people wanted a single payer healthcare system, would a liberal Congress have passed a healthcare reform package that is almost identical to the Republican-proposed alternative to Bill Clinton\’s healthcare bill?
Of course not, because even our near-dysfunctional democratic republic doesn\’t allow it, and that\’s why the media has such an important role to play when public policy, especially healthcare reform, is being constructed.
Now we have a choice to make. We can accept what the media tells us, retreat to our ideological bubbles and be content with a healthcare cycle that starts with no sustainability prospects, looming disaster and ends with weak reform. Or we can cast away our selfishness and ignore the media as it attempts to derail healthcare progress by obscuring real issues at a critical time. In this moment, selflessness, priority and responsibility no longer apply to just the individual, they also apply to the media.