Many of these reporters began the 2008 campaign in complete ignorance of the most basic features of American health policy. I spent dismaying amounts of time on e-mail or on the phone with reporters explaining the difference between Medicare and Medicaid or what SCHIP was. A few months later, some of these same reporters knew more than I did about key provisions in the final bill.This lesson came home to me last Thursday, when my daughter and I watched a spirited debate on health reform. Those representing the Democratic side started strong, quoting Norm Daniels on health as a human right, Jacob Hacker on the eventual need for a public option, Paul Krugman on the determinants of rising health care costs. They included poignant anecdotes of people denied care, and they noted the inefficiency of job lock addressed in health care reform.
Republican speakers responded by noting the possibility of adverse selection within the exchanges. They argued that legislated penalties were too low to really enforce the individual mandate. They worried that expanding Medicaid enrollment will hurt state budgets.
In response, Democrats responded with a detailed defense of the mandate. They also noted that managers' amendments included additional monies for states to cushion the financial blow.
The people making these arguments were not health policy experts or professional politicians. They were members of the Homewood-Flossmoor High School debate team. Starting with essentially zero knowledge and age-appropriate skills, they had gone out and mastered the debate with admirable detail and clarity.
In part, the high quality of news coverage reflected the sheer commitment of journalistic resources in a time of economic challenge to the entire industry. The New York Times and The Washington Post fielded a dozen of the best reporters in America for a year to cover this story. The Wall Street Journal, Newsweek, the Atlantic, and Time made major commitments, too. The legislative slog was maddening and sometimes boring. Yet the slow pace gave reporters time to actually understand the intermingled health-system and public health challenges the president and Congress were trying to address. The public cared, too. Health care touches everyone in America. So do the accompanying costs. Millions of people wanted to know what is happening, and how it affects them.
Coverage also reflected the capacity of the Internet to go deeper and faster into news stories than one could do before. When the Tea Partiers shouted "Read the Bill!" one could get on the web and do precisely that. Someone will even read the bills to you, if you wish. I was amazed by the number of key players willing to give long and detailed on-the-record interviews to more knowledgeable reporters than those who populate the Sunday talk circuit.
No legislation of this scale is passed without some backroom dealing and hard bargaining. Much of this dealing and bargaining was reported on the web or in print within hours of being done. At times, the process was too transparent. I worry that Congress and the president need more private space to get things done.
There was so much information that the biggest problem was to sift through it all. Reporters, citizens, advocates, and policymakers all struggled to figure out what complicated provisions actually meant. Some provisions of the final bill—for example the CLASS Act—were themselves 14-figure initiatives which would, in any other context, be viewed as major changes in American social policy.
What say you? Is "the information was available, if you looked" the right metric for health care coverage?
No comments:
Post a Comment