This post is not intended to mock or even evaluate the positions espoused by Hillary Clinton now or in the past. I chose the title to be short and to grab attention. The purpose of this post is to summarize and evaluate how the news media covered the issue of health care reform during the presidency of Bill Clinton. I think that the fact that the proposal is now known as Hillarycare is as telling about the media coverage as anything else I will say here.
James Fallows calls the health care debate of the mid 1990’s “The Press’s Vietnam War.” The image being that there could be no winners in the debate, only combatants. I will follow the format of his coverage – as a seven act drama – to show how the media coverage of the day served to hinder the average citizen from ever getting a clear view of what what being discussed and what might be best for the country.
Health Care as a political issue began to be noticed during the Democratic primary. Rather than evaluate the proposals by Bill Clinton and Robert Kerrey (the candidates most closely tied to that issue) the media coverage focused on how the differences in their proposals (whether to try a single-payer approach or not) would play in the primary race. People could gain no understanding of the issue from the coverage, all they could learn (if anything) was the potential political fallout. Once Kerrey dropped out the coverage ended because there was no political confrontation involved anymore.
Crafting the Bill
The Clinton team had been studying the issue of health care reform long before the presidential election and when Bill became president they intended to hit the ground running – and they did. In doing so the press later complained that they were operating in the dark because they spent their time communicating with congressional leaders etc. rather than running their work past the press for public vetting of their ideas.
When the plan was first unveiled the uniform reaction was positive but positive does not make for exciting press coverage. Fate stepped in to make the lives of reportes more exciting. Just when President Clinton was starting a tour to promote the Health Care Bill a crisis erupted in Somalia which diverted his attention and gave the press more exciting things to cover. At the same time this provided an opportunity for opponents of the bill (notably the insurance industry) to stage a counter-attack. By the time the news coverage focused on health care again the president was plagued with more energized opposition and a number of scandals.
I was excited to read about the work of Robert Pear who carefully delved into issues and provided in depth reporting. What interested me however was the effect of his work. Neither Mr. Pear, nor anyone else in journalism took the time to consider the whole health care proposal. Mr. Pear focused on one item, one leak at a time and evaluated it. Each time he would show who stood to lose over that particular aspect of the plan. The result was something like the reverse of Hitler’s ethnic cleansing in Germany – instead of one ruling group peeling off layers of “undesirable” elements of society each aspect of the plan reported by Pear drew the attention of a small group who stood to lose on that particular facet of the bill. As the groups combined, each focused on their pet issue, they grew to the point that they stopped the final bill. It may be that none of them realized or considered the potential positive effects of the whole bill.
Focus on Conflict
Kathleen Hall Jamieson, the dean of the Annenberg School for Communication relates an interesting experience of attending a presentation by Hillary Clinton on the health care reform bill.
She went into the substance of the plan, and took on virtually every argument that had been raised against it. . . When she was talking about her plan, the reporters had clearly heard all of this before and found it completely uninteresting. They talked to each other passing notes around.
But as soon as she made a brief attack on the Republicans, there was a physiological reaction, this surge of adrenaline, all around me. The pens moved. The reporters arched forward. They wrote everything down rapidly. As soon as this part was over, they clearly weren’t paying attention anymore. They were writing on their laptops as they began constructing the story of how the First Lady had attacked her opponents.
The press would always prefer to talk about alternate bills and problems with the current idea than actually talk about the whole issue and have people work towards a solution. Solutions make for a day of coverage while problems can be exploited day after day.
Eventually there was someone who read the whole bill and attempted to put it into perspective. Her name was Elizabeth McCaughey (pronounced “McCoy”). When she did so, whether she intended to or not, she included some crucial pieces of misinformation that made the bill sound draconian. The difference between her evaluation of the bill and the actual text of the bill is similar to the difference between what the people behind fightfoca.com say about the Freedom of Choice Act (FOCA) and what the actual bill says. (I discussed this difference last week.) No journalist ever explored the accuracy of her statements.
Out of Sight, Out of Mind
When the health care bill died the news coverage of the health care issue died as well until about 2006 when it was again a central issue for a presidential campaign season. During all that time the issue of affordable heath care has been at least as important as it was when it first started garnering media attention during the Democratic primaries for 1992.